PENETRATION OF FLOMOXEF INTO HUMAN MAXILLARY AND MANDIBULAR BONES

Penetration of flomoxef into the maxillary and mandibular bones was as sayed clinically to provide data about its usefulness for the preventi on of postoperative infection after maxillofacial surgery. Twenty-one patients undergoing maxillofacial surgery at our department were given flomoxef 2 g dissolved in 20 ml of physiological saline intravenously over 3 minutes during operation, and the serum, maxillary and mandibu lar concentrations were measured 1, 3, and 6 hours after injection by the band culture method using Escherichia coli 7437 as the indicator s train. The mean concentrations were 53.4, 16.1, and 2.6 mu g/ml, respe ctively, in the serum, 17.6, 7.8, and 1.0 mu g/g in maxillary bone, an d 16.4, 4.2, and 0.9 mu g/g in mandibular bone. The mean bone:serum ra tios at 1, 3, and 6 hours were 33.0%, 48.2%,and 36.8%, respectively, f or maxillary bone, and 30.7%, 26.2%, and 35.7% for mandibular bone. Wh en compared with previously reported data on the bone:serum ratios in jaw of various other intravenous antibiotics, our results show that pe netration of flomoxef into maxillary and mandibular bone is extremely high. As all the intramaxillary and intramandibular concentrations exc eed its MIC(80) values against clinical isolates of bacteria frequentl y isolated in cases of infection in the oral and maxillofacial region, it is apparent that one intravenous shot of flomoxef 2 g allows penet ration of the drug into the maxillary and mandibular bones at effectiv e concentrations. Flomoxef is therefore potentially useful for the pre vention and treatment of infections in the oral and maxillofacial regi on, as it has excellent penetration into the maxillary and mandibular bones.