The penetration of ceftriaxone and cefamandole into bone, fat and haematoma and relevance of serum protein binding to their penetration into bone.
Thirteen patients undergoing total hip replacement were given ceftriaxone 1 g and cefamandole 1 g simultaneously, either immediately or 8 h before surgery. For both agents the concentrations seen in the bone and fat during the operation, and for haematoma fluid <or=24 h after the operation, exceeded the MIC for susceptible staphylococci and would be expected to provide adequate prophylaxis. Although ceftriaxone concentrations in bone and fat were significantly higher than those of cefamandole, after correction for the simultaneous blood concentrations, we were unable to detect any differences in the bone or fat penetration of the two agents. We conclude that there is no evidence that cephalosporins with a lower serum protein binding penetrate bone better than ones with higher serum protein binding.
Bristol Centre for Antimicrobial Research and Evaluation (BCARE), Department of Medical Microbiology, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK. Lovering_a@southmead.swest.nhs.uk
A M
AM
Lovering
T R
TR
Walsh
G C
GC
Bannister
A P
AP
MacGowan
D000273:Adipose Tissue / Q000378:metabolism*; D001798:Blood Proteins / Q000378:metabolism*; D001826:Body Fluids / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism*; D002435:Cefamandole / Q000097:blood / Q000493:pharmacokinetics*; D002443:Ceftriaxone / Q000097:blood / Q000493:pharmacokinetics*; D006406:Hematoma / Q000378:metabolism*; D006615:Hip / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D013997:Time Factors
D001798:Blood Proteins; D002435:Cefamandole; D002443:Ceftriaxone