Determination of cephazolin, ceftazidime, and ceftriaxone distribution in nucleus pulposus

Yan, Denglu; Li, Jian; Zhang, Zaiheng; Zhu, Haodong

doi:10.1007/s00402-012-1514-7

Cited by 6 publications

(4 citation statements)

References 27 publications

(39 reference statements)

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“…Finally, ceftazidime 2 g reached tissue/plasma ratios of 0.03–0.08X in lower limb bone tissues of 10 patients who underwent amputation [ 76 ]. The penetration of cefazolin, ceftazidime or ceftriaxone (2 g each) into the nucleus pulposus of 22 patients undergoing elective vertebral surgery was always lower than 0.06X 60 min after drug administration [ 77 ].…”

Section: Resultsmentioning

confidence: 99%

Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review—Part I

et al. 2022

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The challenging severity of some infections, especially in critically ill patients, makes the diffusion of antimicrobial drugs within tissues one of the cornerstones of chemotherapy. The knowledge of how antibacterial agents penetrate tissues may come from different sources: preclinical studies in animal models, phase I–III clinical trials and post-registration studies. However, the particular physiopathology of critically ill patients may significantly alter drug pharmacokinetics. Indeed, changes in interstitial volumes (the third space) and/or in glomerular filtration ratio may influence the achievement of bactericidal concentrations in peripheral compartments, while inflammation can alter the systemic distribution of some drugs. On the contrary, other antibacterial agents may reach high and effective concentrations thanks to the increased tissue accumulation of macrophages and neutrophils. Therefore, the present review explores the tissue distribution of beta-lactams and other antimicrobials acting on the cell wall and cytoplasmic membrane of bacteria in critically ill patients. A systematic search of articles was performed according to PRISMA guidelines, and tissue/plasma penetration ratios were collected. Results showed a highly variable passage of drugs within tissues, while large interindividual variability may represent a hurdle which must be overcome to achieve therapeutic concentrations in some compartments. To solve that issue, off-label dosing regimens could represent an effective solution in particular conditions.

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Section: Resultsmentioning

confidence: 99%

Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review—Part I

et al. 2022

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“…Gibson et al 41 found no detectable levels of flucloxacillin or cephadrine in the discs of adolescents undergoing scoliosis surgery and in an animal model Fraser et al 42 found very low levels of cephazolin in the disc 30 min after administration, becoming undetectable at 60 min. More recently, several studies [43][44][45][46] have found measureable levels of cephalosporins in the majority of discs although not necessarily in concentrations above the minimum inhibitory concentration to prevent S. aureus growth. It has been argued that the internal structure of the disc plays an important role in its permeability.…”

Section: Resultsmentioning

confidence: 99%

Do bacteria play an important role in the pathogenesis of low back pain?

Fisher

Osti

2015

ANZ Journal of Surgery

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Considerable interest has been generated recently regarding an alternative hypothesis for the pathogenesis of low back pain and radiculopathy in the presence of intervertebral disc prolapse. Traditionally, back pain and radicular (sciatic) symptoms have been attributed to mechanical compression of neural tissue by herniated disc material and to inflammation caused by exposure of the nerve roots to disc tissue. Recent research however has suggested that low-grade infection within the intervertebral disc by anaerobic bacteria may be responsible. The development of Modic changes in the corresponding adjacent vertebral endplates has also been suggested as an indicator of infection. This article is a thorough review of the current literature regarding the hypothesis that low-grade anaerobic bacterial infection may be the cause of disabling low back pain and radiculopathy.

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“…They receive their nutrition and get rid of waste products via the process of diffusion 1 . This diffusion depends on several factors which include, among others, drug molecular charge, protein binding, serum concentration, time after administration and disc degeneration [5][6][7]10,22 . For the antibiotic to be effective in preventing infection, it must penetrate into the disc in a concentration above the minimal inhibitory concentration (MIC) of the causative bacteria 23 .…”

Section: Discussionmentioning

confidence: 99%

“…If antibiotics do not reach the inner part of the disc (nucleus pulposus, NP) in a sufficient concentration that exceeds the minimal inhibitory concentration (MIC) of the causative micro-organism, it may not protect against infections during discectomy and may result in discitis and failure of operation 2 . Several antibiotics were found to have good penetration into the intervertebral disc such as ceftriaxone, ceftazidime and cefazolin [3][4][5][6] , cefuroxime & gentamicin [7][8] , clindamycin and tobramycin [9][10] , vancomycin 11 and several others. On the other hand, antibiotics like linezolid 12 , ciprofloxacin, co-amoxiclav and amoxicillin 13,14 , cefalothin 9 , and cefradine and flucloxacillin 14 had intermediate or low penetration.…”

Section: Introductionmentioning

confidence: 99%

Penetration of Cefotaxime Into Intervertebral Discs Removed From Patients Undergoing Discectomy

Hamdan,

hashim,

Haddad

et al. 2031

BJSRG

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The intervertebral disc is an avascular tissue, and penetration of antibiotics occurs by passive diffusion. Cefotaxime penetration has not been well studied. The aim is to investigate the penetration of cefotaxime into the intervertebral disc removed from patients undergoing discectomy. Twenty-six patients undergoing discectomy were recruited for this study. They were given one gram of cefotaxime intravenously as a prophylactic antibiotic. Cefotaxime was extracted from nucleus pulposus and serum and analyzed using an HPLC method with cefuroxime axetil as internal standard. Cefotaxime penetrated into all the 26 samples of nucleus pulposus resulting in a mean concentration of 0.66±0.13 µg/gm. The mean serum concentration at time of disc removal was 13.61±3.54 µg/ml. The concentration in 16 samples were below the minimum inhibitory concentration against Staph. aureus with an average of 0.27±0.03 µg/g. There is a statistically significant correlation between time after intravenous cefotaxime administration and its concentration in the nucleus pulposus. The greater increase is in the third hour after administration. Factors like age, body weight, gender, number of associated diseases and surgical history did not seem to affect nucleus pulposus cefotaxime concentration. In conclusion, cefotaxime can penetrate into the nucleus pulposus but its concentration is relatively low. This concentration has a strong positive correlation with time after cefotaxime intravenous administration. Cefotaxime, therefore, needs to be given at least two hours before disc removal, with re-dosing immediately before operation to maintain high serum concentration.

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Determination of cephazolin, ceftazidime, and ceftriaxone distribution in nucleus pulposus

Abstract: The antibiotics of cephazolin, ceftazidime, and ceftriaxone had concentration in the NP tissue, which was higher than the stated MIC. Ceftazidime had highest penetration in to NP tissue, and ceftriaxone had the lowest penetration in to NP tissue.

Cited by 6 publications

References 27 publications

Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review—Part I

Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review—Part I

Do bacteria play an important role in the pathogenesis of low back pain?

Penetration of Cefotaxime Into Intervertebral Discs Removed From Patients Undergoing Discectomy

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