Perioperative antibiotic prophylaxis in maxillofacial surgery: penetrationof clindamycin into various tissues

Although clindamycin is recommended for prophylactic use in oral and maxill ofacial surgery, there is little data available regarding its ability to pr ovide sufficient tissue concentrations at the operative site. We investigat ed tissue samples from 31 patients, who had to undergo oral and maxillofaci al surgery and who received at least one dose of 600 mg clindamycin i.v. pr eoperatively, to determine clindamycin tissue concentrations in muscle, ora l mucosa, fatty tissue, skin and bone between 15 min and 8 h after administ ration. After homogenization, clindamycin concentration was determined by b ioassay. It mas demonstrated that clindamycin concentrations above the MIC9 0* of those pathogens most likely to cause contamination mere reached in al l kinds of tissues investigated. Already 15 min after administration, tissu e concentrations above the MIC90 were reached and were still detectable in the last samples taken between 4 and 8 h after the last clindamycin adminis tration. From the pharmacokinetic point of view, clindamycin is suitable fo r perioperative prophylaxis during oral and maxillofacial surgery providing sufficient tissue concentrations with no intraoperative additional dosage necessary unless procedures exceed 4 h duration.