Tissue and serum concentrations of levofloxacin in orthopaedic patients

• Published in: International journal of antimicrobial agents 2001-10, Vol.18 (4), p.335-340
• Main Authors: Baum, H.v, Böttcher, S, Abel, R, Gerner, H.J, Sonntag, H.-G
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Infective Agents - blood; Anti-Infective Agents - pharmacokinetics; Anti-Infective Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Bone and Bones - metabolism; Female; Humans; Intraoperative Care; Levofloxacin; Male; Medical sciences; Middle Aged; Muscles - metabolism; Ofloxacin - administration & dosage; Ofloxacin - blood; Ofloxacin - pharmacokinetics; Ofloxacin - therapeutic use; Orthopaedic patients; Orthopedics; Pharmacology. Drug treatments; Tissue and serum concentrations; Tissue Distribution
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/S0924-8579(01)00423-X

The level of levofloxacin was determined in serum, bone and several tissues after a single dose of 500 mg i.v. Twenty-one patients (mean age: 56.8 years) undergoing bone surgery (nine patients) or surgical debridement of a decubitus ulcer (12 patients) who received levofloxacin as perioperative prophylaxis were included in the study. During surgery, blood and tissue samples were obtained approximately 1.5 h (range 40–210 min) postdosing. Levofloxacin concentrations in 87 specimens including 21 serum samples were determined using high-performance liquid chromatography (HPLC). The mean serum concentration at 1.5 h was 8.6±2.3 μg/ml. Concentrations above the MIC of common pathogens were reached in all tissues during the collection period with a maximum in skin samples (19.9±9.9 μg/g) followed by wound tissue and granulation tissue with 17.3±6.5 and 13.7±6.4 μg/g respectively. In muscle and fatty tissue mean levofloxacin concentrations of 8.0±0.9 and 4.0±2.2 μg/g were attained. Mean levels in cancellous bone were 6.6±3.6 μg/g, lowest levels were measured in cortical bone (2.8±1.1 μg/g). Twenty-two different pathogens were cultivated from the lesions of 11 of 12 patients with pressure ulcers. MIC values for levofloxacin were determined and compared with the corresponding tissue concentrations. Levofloxacin may be useful for perioperative prophylaxis and treatment in orthopaedic patients due to its good tissue penetration.