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

Published on Dec 1, 2019in Apmis2.225
· DOI :10.1111/apm.12996
Mikkel Tøttrup1
Estimated H-index: 1
(AAU: Aalborg University),
Kjeld Søballe53
Estimated H-index: 53
(Aarhus University Hospital)
+ 5 AuthorsMats Bue5
Estimated H-index: 5
(Aarhus University Hospital)
Abstract
  • References (23)
  • Citations (1)
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References23
Newest
#1Mats Bue (Aarhus University Hospital)H-Index: 5
#2Pelle Hanberg (Aarhus University Hospital)H-Index: 4
Last. Mikkel Tøttrup (Aarhus University Hospital)H-Index: 6
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The increasing incidence of orthopaedic methicillin-resistant Staphylococcus aureus (MRSA) infections represents a significant therapeutic challenge. Being effective against MRSA, the role of vancomycin may become more important in the orthopaedic setting in the years to come. Nonetheless, vancomycin bone and soft tissue penetration during infection remains unclear. In eight pigs, implant-associated osteomyelitis was induced on day 0, using a Staphylococcus aureus strain. Following administratio...
4 CitationsSource
#1Mikkel Tøttrup (Aarhus University Hospital)H-Index: 6
#2Mats Bue (Aarhus University Hospital)H-Index: 5
Last. Kjeld Søballe (Aarhus University Hospital)H-Index: 53
view all 9 authors...
Background: The prolonged antibiotic therapy that is often needed for successful management of osteomyelitis may be related to incomplete penetration of antibiotics into the target site. The objective of this study was to assess the effects of implant-associated osteomyelitis on cefuroxime penetration into bone. Methods: Implant-associated osteomyelitis using a Staphylococcus aureus strain was induced in the right tibia in ten pigs. After five days and following administration of 1500 mg of cefu...
13 CitationsSource
#1Mikkel Tøttrup (Aarhus University Hospital)H-Index: 6
#2Bo Martin Bibby (AU: Aarhus University)H-Index: 27
Last. Hanne Birke-Sørensen (Aarhus University Hospital)H-Index: 7
view all 8 authors...
The relatively short half-lives of most β-lactams suggest that continuous infusion of these time-dependent antimicrobials may be favorable compared to short-term infusion. Nevertheless, only limited solid-tissue pharmacokinetic data are available to support this theory. In this study, we randomly assigned 12 pigs to receive cefuroxime as either a short-term or continuous infusion. Measurements of cefuroxime were obtained every 30 min in plasma, subcutaneous tissue, and bone. For the measurements...
15 CitationsSource
#1Mikkel Tøttrup (Aarhus University Hospital)H-Index: 6
#2Tore Forsingdal Hardlei (Aarhus University Hospital)H-Index: 9
Last. Hanne Birke-Sørensen (Aarhus University Hospital)H-Index: 7
view all 8 authors...
ABSTRACT Traditionally, the pharmacokinetics of antimicrobials in bone have been investigated using bone biopsy specimens, but this approach suffers from considerable methodological limitations. Consequently, new methods are needed. The objectives of this study were to assess the feasibility of microdialysis (MD) for measuring cefuroxime in bone and to obtain pharmacokinetic profiles for the same drug in porcine cortical and cancellous bone. The measurements were conducted in bone wax sealed and...
15 CitationsSource
#1Kenneth D. Illingworth (Southern Illinois University School of Medicine)H-Index: 14
#2William M. Mihalko (UT: University of Tennessee)H-Index: 12
Last. Khaled J. Saleh (Southern Illinois University School of Medicine)H-Index: 26
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Abstract: Total joint arthroplasty is one of the most common and most successful orthopaedic procedures. Infection after total joint arthroplasty is a devastating problem that expends patient, surgeon, and hospital resources, and it substantially decreases the chances of a successful patient outcome. Postoperative infection affects approximately 1% to 7% of all total joint arthroplasties, at a cost of approximately $50,000 per infection. Decreasing postoperative periprosthetic joint infection is...
58 CitationsSource
#1Johan W. Mouton (Radboud University Nijmegen Medical Centre)H-Index: 45
#2D. F. J. BrownH-Index: 10
Last. Gunnar KahlmeterH-Index: 43
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Abstract Clinical breakpoints are used in clinical microbiology laboratories to categorize microorganisms as clinically susceptible (S), intermediate (I) or resistant (R) dependent on the quantitative antimicrobial susceptibility as indicated by the MIC value determined in a well-defined standard test system. The laboratory report, with the designations of S, I or R for each antimicrobial agent, provides guidance to clinicians with respect to the potential use of agents in the treatment of patie...
130 CitationsSource
#1Elisabet I. Nielsen (Uppsala University)H-Index: 14
#2Otto Cars (Uppsala University)H-Index: 44
Last. Lena E. Friberg (Uppsala University)H-Index: 21
view all 3 authors...
A pharmacokinetic-pharmacodynamic (PKPD) model that characterizes the full time course of in vitro time-kill curve experiments of antibacterial drugs was here evaluated in its capacity to predict the previously determined PK/PD indices. Six drugs (benzylpenicillin, cefuroxime, erythromycin, gentamicin, moxifloxacin, and vancomycin), representing a broad selection of mechanisms of action and PK and PD characteristics, were investigated. For each drug, a dose fractionation study was simulated, usi...
105 CitationsSource
#1Dora E. Wiskirchen (Hartford Hospital)H-Index: 10
#2Ashley Shepard (Hartford Hospital)H-Index: 4
Last. David P. Nicolau PharmD Fccp Fidsa (Hartford Hospital)H-Index: 51
view all 4 authors...
ABSTRACT Staphylococcus aureus and other Gram-positive organisms, including methicillin-resistant S. aureus, continue to be the predominant pathogens associated with diabetic foot infections. Consequently, linezolid is often used to treat these infections. The purpose of the current study was to describe the pharmacokinetic profile and determine the level of penetration of linezolid into healthy thigh tissue and infected wound tissue of the same extremity in 9 diabetic patients with chronic lowe...
30 CitationsSource
#1Catharine C. Bulik (Hartford Hospital)H-Index: 14
#2Dora E. Wiskirchen (Hartford Hospital)H-Index: 10
Last. David P. Nicolau PharmD Fccp Fidsa (Hartford Hospital)H-Index: 51
view all 6 authors...
Tissue penetration of systemic antibiotics is an important consideration for positive outcomes in diabetic patients. Herein we describe the exposure profile and penetration of tigecycline in the interstitial fluid of wound margins versus that of uninfected thigh tissue in 8 adult diabetic patients intravenously (IV) administered 100 mg and then 50 mg of tigecycline twice daily for 3 to 5 doses. Prior to administration of the first dose, 2 microdialysis catheters were inserted into the subcutaneo...
36 CitationsSource
#1Michael V. Schintler (Medical University of Graz)H-Index: 15
#2Friederike Traunmüller (Medical University of Graz)H-Index: 3
Last. Christian JoukhadarH-Index: 40
view all 9 authors...
Objectives: Appropriate antimicrobial therapy and surgical intervention may be required in diabetic patients presenting with severe bacterial foot infection. Methicillin-resistant Staphylococcus aureus (MRSA) agents such as fosfomycin are increasingly in demand because of recent concern regarding vancomycin and daptomycin efficacy and constant use. Intravenous fosfomycin is approved for the therapy of severe soft tissue infections and is highly active against methicillin-susceptible S. aureus an...
66 CitationsSource
Cited By1
Newest
#1Pelle Hanberg (AU: Aarhus University)H-Index: 4
#1Pelle Hanberg (AU: Aarhus University)
Last. Maiken Stilling (AU: Aarhus University)H-Index: 12
view all 7 authors...
Abstract Background context Postoperative pyogenic spondylodiscitis is associated with prolonged antimicrobial therapy and high relapse rates. Cefuroxime is a time-dependent antimicrobial widely used for intravenous perioperative prophylaxis in spine surgery. A previous study has indicated that a single dose of cefuroxime (1.5 g) provides insufficient spine tissue concentrations for spine procedures lasting more than 2–3 hours. Purpose To evaluate the time with concentrations above relevant mini...
Source
#1Mats Bue (Aarhus University Hospital)H-Index: 5
#2Tomás Sou (Uppsala University)H-Index: 1
Last. Steffen Christensen (Aarhus University Hospital)H-Index: 23
view all 9 authors...
Abstract Objectives Piperacillin is a β-lactam antimicrobial frequently used in critically ill patients with acute kidney injury treated with continuous renal replacement therapy (CRRT). However, data regarding piperacillin tissue concentrations in this patient population is limited. We conducted a prospective observational study of free piperacillin concentrations during a single 8 h dosing interval in plasma (eight samples) and subcutaneous tissue (SCT) (thirteen samples) in 10 patients treate...
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