Do augmentin or cefuroxime reach effective levels in lumbar vertebral discs when used prophylactically for discectomy? A preliminary report.
The incidence of discitis following discectomy is reported at between 0.75% and 3.0%. We believe this rate could be reduced if an antibiotic that penetrated the disc tissue with an appropriate spectrum were to be given prophylactically to cover surgery. A prospective study of 20 patients undergoing routine lumbar discectomy was performed. Ten patients received Augmentin 1.2 g and ten received cefuroxime 1.5 g pre-operatively. In eight patients sequestrated disc fragments were analysed, and the majority were found to have drug levels higher than in the attached disc material; the reasons for this are discussed. We conclude that Augmentin penetrates damaged disc material to a limited extent, but cefuroxime achieves levels effective against the most commonly implicated pathogens in discitis tissue and is a rational choice of antibiotic for prophylaxis during lumbar discectomy.
Housden
P L
PL
Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
Sullivan
M F
MF
D000328:Adult; D000368:Aged; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002444:Cefuroxime / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015299:Discitis / Q000453:epidemiology / Q000517:prevention & control*; D017586:Diskectomy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007403:Intervertebral Disc; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination; D002444:Cefuroxime