Antibiotic penetration into bone and joints: An updated review
| Autor: | Ola A. Barnawi, Shahad F. Alhejaili, Lana O. Basudan, Maryam S. Bamakhrama, Dania F. Fatani, Abrar K. Thabit |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty medicine.drug_class 030106 microbiology Antibiotics Bone and Bones lcsh:Infectious and parasitic diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine polycyclic compounds medicine Humans lcsh:RC109-216 030212 general & internal medicine Arthritis Infectious business.industry Oritavancin Clindamycin Osteomyelitis General Medicine biochemical phenomena metabolism and nutrition Amoxicillin Anti-Bacterial Agents Penicillin Infectious Diseases chemistry Linezolid Vancomycin Joints business medicine.drug Piperacillin |
| Zdroj: | International Journal of Infectious Diseases, Vol 81, Iss, Pp 128-136 (2019) |
| ISSN: | 1201-9712 |
| Popis: | Treatment of bone and joint infections can be challenging as antibiotics should penetrate through the rigid bone structure and into the synovial space. Several pharmacokinetic studies measured the extent of penetration of different antibiotics into bone and joint tissues. This review discusses the results of these studies and compares them with minimum inhibitory concentrations (MIC) of common pathogens implicated in bone and joint infections in order to determine which antibiotics may have a greater potential in the treatment of such infections. Clinical outcomes were also evaluated as data were available. More than 30 antibiotics were evaluated. Overall, most antibiotics, including amoxicillin, piperacillin/tazobactam, cloxacillin, cephalosporins, carbapenems, aztreonam, aminoglycosides, fluoroquinolones, doxycycline, vancomycin, linezolid, daptomycin, clindamycin, trimethoprim/sulfamethoxazole, fosfomycin, rifampin, dalbavancin, and oritavancin, showed good penetration into bone and joint tissues reaching concentrations exceeding the MIC90 and/or MIC breakpoints of common bone and joint infections pathogens. Few exceptions include penicillin and metronidazole which showed a lower than optimum penetration into bones, and the latter as well as flucloxacillin had poor profiles in terms of joint space penetration. Of note, studies on joint space penetration were fewer than studies on bone tissue penetration. Although clinical studies in osteomyelitis and septic arthritis are not available for all of the evaluated antibiotics, these pharmacokinetic results indicate that agents with good penetration profiles would have a potential utilization in such infections. Keywords: Antibiotics, Bone, Cortical, Cancellous, Penetration, Synovial fluid, Pharmacokinetics |
| Databáze: | OpenAIRE |
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