Concentrations of piperacillin-tazobactam in human jaw and hip bone.
OBJECTIVE
It is unclear to what extent pharmacokinetic data from bone outside the facial area can be transferred to the maxillofacial area. The aim of this study was to evaluate the penetration characteristics of piperacillin-tazobactam into human jaw and hip bone as a model for different bone characteristics.


METHODS
The drug was administered at the start of surgery in a single 15-min intravenous infusion dose (4g piperacillin & 0.5g tazobactam i.v.). Plasma and bone samples of ten patients were analyzed.


RESULTS
Mean concentration of piperacillin in plasma was 309microg/ml at 0.5h declining at 4h to 14microg/ml. The respective values for tazobactam were 34microg/ml declining to 2.8microg/ml. The piperacillin-tazobactam ratio dropped during the study interval from 0.5h: 9.2%+/-0.8 to 2h: 7.2%+/-1.1 and 4h: 4.9%+/-0.7. Mean bone concentrations of piperacillin and tazobactam were 9.0+/-11.6microg/g and 1.2+/-1.3microg/g, respectively. Mean penetration ratios for all bone samples were 15% (+/-17) for piperacillin and 13% (+/-14) for tazobactam without a difference between bone of different origin.


CONCLUSIONS
Piperacillin-tazobactam levels in jaw bone tissue after a single dose are sufficient to assure antibacterial activity of the combination and are above the minimal inhibitory concentrations of the most relevant pathogens in head and neck surgery. Our data suggests the use of piperacillin-tazobactam as an alternative for the therapy of severe infections of the head and neck.
Al-Nawas
Bilal
B
Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. W. Wagner), University Mainz, Germany.
Kinzig-Schippers
Marion
M
Soergel
Fritz
F
Shah
Pramod M
PM
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000097:blood / Q000493:pharmacokinetics*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007568:Jaw / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000187:drug effects*; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics; D010878:Piperacillin / Q000097:blood / Q000493:pharmacokinetics; D000077725:Piperacillin, Tazobactam Drug Combination; D014018:Tissue Distribution; D055815:Young Adult; D065093:beta-Lactamase Inhibitors; D001618:beta-Lactamases / Q000097:blood / Q000493:pharmacokinetics*
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D065093:beta-Lactamase Inhibitors; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D001618:beta-Lactamases; D010878:Piperacillin