Bone, subcutaneous tissue and plasma pharmacokinetics of cefuroxime in total knee replacement patients - a randomized controlled trial comparing continuous and short-term infusion

Autor: Mats Bue, Kjeld Søballe, Peter Riis Hansen, Mikkel Tøttrup, Kurt Fuursted, Tore Forsingdal Hardlei, Hanne Birke-Sørensen, Bo Martin Bibby
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
Microdialysis
Subcutaneous Tissue/metabolism
Antibiotic Prophylaxis/methods
law.invention
Prosthesis-Related Infections/prevention & control
0302 clinical medicine
Subcutaneous Tissue
Randomized controlled trial
law
population pharmacokinetics
Immunology and Allergy
Antibiotic prophylaxis
Arthroplasty
Replacement
Knee
Infusions
Intravenous
education.field_of_study
General Medicine
Middle Aged
continuous infusion
bone concentrations
Anti-Bacterial Agents
medicine.anatomical_structure
030220 oncology & carcinogenesis
Anesthesia
medicine.drug
Subcutaneous tissue
Microbiology (medical)
Prosthesis-Related Infections
microdialysis
Population
Microbial Sensitivity Tests
Bone and Bones/metabolism
Bone and Bones
Drug Administration Schedule
Pathology and Forensic Medicine
03 medical and health sciences
Pharmacokinetics
Anti-Bacterial Agents/administration & dosage
medicine
Humans
education
Aged
Cefuroxime
business.industry
Antibiotic Prophylaxis
Cefuroxime/administration & dosage
cefuroxime
030104 developmental biology
Cortical bone
business
Zdroj: Tøttrup, M, Søballe, K, Bibby, B M, Hardlei, T F, Hansen, P, Fuursted, K, Birke-Sørensen, H & Bue, M 2019, ' Bone, subcutaneous tissue and plasma pharmacokinetics of cefuroxime in total knee replacement patients : a randomized controlled trial comparing continuous and short-term infusion ', A P M I S. Acta Pathologica, Microbiologica et Immunologica Scandinavica, vol. 127, no. 12, pp. 779-788 . https://doi.org/10.1111/apm.12996
Tøttrup, M, Søballe, K, Bibby, B M, Hardlei, T F, Hansen, P, Fuursted, K, Birke-Sørensen, H & Bue, M 2019, ' Bone, subcutaneous tissue and plasma pharmacokinetics of cefuroxime in total knee replacement patients-a randomized controlled trial comparing continuous and short-term infusion ', APMIS-Journal of Pathology, Microbiology and Immunology, vol. 127, no. 12, pp. 779-788 . https://doi.org/10.1111/apm.12996
ISSN: 1600-0463
Popis: Cefuroxime is widely used as antibiotic prophylaxis for orthopaedic procedures. We evaluated bone, subcutaneous tissue (SCT) and plasma pharmacokinetics of cefuroxime in male patients undergoing total knee replacement (TKR) after both traditional short-term infusion (STI) and continuous infusion (CI). Eighteen male patients undergoing TKR were randomly assigned to STI or CI of 1.5 g of cefuroxime. Measurements were obtained in plasma, SCT, cancellous and cortical bone every 30 min for 8 h following surgery. For sampling in solid tissues, microdialysis was applied. Population pharmacokinetic modelling was performed in order to estimate pharmacokinetic parameters, and to assess the probability of attaining cefuroxime concentrations above clinically relevant minimal inhibitory concentrations (MICs) for 65% and 90% of the 8 h dosing interval. Low SCT and cortical bone penetration were found in both the STI and the CI group, but the findings were only significant in the STI group. Irrespective of MIC, tissue and target, CI leads to improved probability of attaining relevant pharmacokinetic targets compared with STI. For the Staphylococcus aureus MIC breakpoint (4 mu g/mL), STI leads to inadequate probability of target attainment. CI of 1.5 g of cefuroxime leads to improved probability of attaining relevant pharmacokinetic targets in male TKR patients compared with traditional STI. These findings suggest that application of CI may improve antibiotic prophylaxis for male TKR patients.
Databáze: OpenAIRE
Externí odkaz: