Regional and systemic prophylaxis with teicoplanin in total knee arthroplasty: a tissue penetration study.
Five patients undergoing total knee arthroplasty (TKA) received 800 mg intravenous teicoplanin systemically 2.5 hours before surgery and 15 patients received 200 mg teicoplanin into a foot vein in the leg to be treated. Samples of bone, synovia, subcutaneous tissue, and skin were collected at 20, 40, and 60 minutes after tourniquet inflation and at the end of surgery. None of the study subjects experienced adverse effects, adverse events, or infections during the postoperative and follow-up period. Mean teicoplanin concentration in the collected tissue ranged from 1.52 to 5.81 mg/L after regional prophylaxis and from 0.9 to 2.94 mg/L after systemic prophylaxis. Bone and soft tissue penetration of teicoplanin after regional prophylaxis with 200 mg is at least comparable with that achieved after systemic prophylaxis with 800 mg. Regional prophylaxis in TKA appears to be safe and valuable. Higher dosages of teicoplanin seem to be needed to ensure coverage against coagulase negative staphylococci.
Infectious Diseases Unit, San Bortolo Hospital, Viale Rodolfi 47, 36100 Vicenza, Italy.
Luca
L
Lazzarini
Andrea
A
Novelli
Nicola
N
Marzano
Lia
L
Timillero
Stefania
S
Fallani
Renato
R
Viola
Fausto
F
de Lalla
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D019072:Antibiotic Prophylaxis; D019645:Arthroplasty, Replacement, Knee; D001842:Bone and Bones / Q000378:metabolism; D005260:Female; D005528:Foot / Q000098:blood supply; D005542:Forearm / Q000098:blood supply; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D012867:Skin / Q000378:metabolism; D040521:Subcutaneous Tissue / Q000378:metabolism; D013530:Surgical Wound Infection / Q000517:prevention & control; D013583:Synovial Membrane / Q000378:metabolism; D017334:Teicoplanin / Q000008:administration & dosage / Q000493:pharmacokinetics*
D000900:Anti-Bacterial Agents; D017334:Teicoplanin