Bone and subcutaneous adipose tissue pharmacokinetics of vancomycin in total knee replacement patients
| Autor: | Hanne Birke-Sørensen, Mikkel Tøttrup, Mats Bue, Kjeld Søballe, Torben L. Andersson, Theis Muncholm Thillemann, Pelle Hanberg, Otto Langhoff |
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| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Microdialysis medicine.medical_treatment Surgical Wound Infection/prevention & control 030106 microbiology Subcutaneous Fat 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Vancomycin medicine Surgical Wound Infection Humans Knee Orthopedics and Sports Medicine 030212 general & internal medicine Arthroplasty Replacement Knee Orthopedic surgery Microdialysis/methods business.industry Arthroplasty Replacement Knee/adverse effects Soft tissue Anti-Bacterial Agents/analysis General Medicine Perioperative biochemical phenomena metabolism and nutrition Vancomycin/analysis Arthroplasty Anti-Bacterial Agents Surgery medicine.anatomical_structure Anesthesia Cancellous Bone Subcutaneous Fat/chemistry Cortical bone business human activities RD701-811 Cancellous Bone/chemistry medicine.drug |
| Zdroj: | Bue, M, Tøttrup, M, Hanberg, P, Langhoff, O, Birke-Sørensen, H, Thillemann, T M, Andersson, T L & Søballe, K 2018, ' Bone and subcutaneous adipose tissue pharmacokinetics of vancomycin in total knee replacement patients ', Acta Orthopaedica, vol. 89, no. 1, pp. 95-100 . https://doi.org/10.1080/17453674.2017.1373497 Acta Orthopaedica Acta Orthopaedica, Vol 89, Iss 1, Pp 95-100 (2018) |
| ISSN: | 1745-3682 1745-3674 |
| DOI: | 10.1080/17453674.2017.1373497 |
| Popis: | Background and purpose - The incidence of orthopedic methicillin-resistant Staphylococcus aureus (MRSA) infections is increasing. Vancomycin may therefore play an increasingly important role in orthopedic perioperative antimicrobial prophylaxis. Studies investigating perioperative bone and soft tissue concentrations of vancomycin are sparse and challenged by a lack of appropriate methods. We assessed single-dose plasma, subcutaneous adipose tissue (SCT) and bone concentrations of vancomycin using microdialysis in male patients undergoing total knee replacement. Methods - 1,000 mg of vancomycin was administered postoperatively intravenously over 100 minutes to 10 male patients undergoing primary total knee replacement. Vancomycin concentrations in plasma, SCT, cancellous, and cortical bone were measured over the following 8 hours. Microdialysis was applied for sampling in solid tissues. Results - For all solid tissues, tissue penetration of vancomycin was significantly impaired. The time to a mean clinically relevant minimal inhibitory concentration (MIC) of 2 mg/L was 3, 36, 27, and 110 min for plasma, SCT, cancellous, and cortical bone, respectively. As opposed to the other compartments, a mean MIC of 4 mg/L could not be reached in cortical bone. The area under the concentration-time curve from 0 to the last measured value and peak drug concentrations (Cmax) for SCT, cancellous, and cortical bone was lower than that of free plasma. The time to Cmax was higher for all tissues compared with free plasma. Interpretation - Postoperative penetration of vancomycin to bone and SCT was impaired and delayed in male patients undergoing total knee replacement surgery. Adequate perioperative vancomycin concentrations may not be reached using standard prophylactic dosage. |
| Databáze: | OpenAIRE |
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