Tissue and serum concentrations of levofloxacin in orthopaedic patients

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 yea rs) undergoing bone surgery (nine patients) or surgical debridement of a de cubitus ulcer (12 patients) who received levofloxacin as perioperative prop hylaxis were included in the study. During surgery, blood and tissue sample s were obtained approximately 1.5 h (range 40-210 min) postdosing. Levoflox acin concentrations in 87 specimens including 21 serum samples were determi ned using high-performance liquid chromatography (HPI-C). The mean serum co ncentration at 1.5 It was 8.6 +/- 2.3 mug/ml. Concentrations above the MIC of common pathogens were reached in all tissues during the collection perio d with a maximum in skin samples (19.9 +/- 9.9 mug/g) followed by wound tis sue and granulation tissue with 17.3 +/- 6.5 and 13.7 +/- 6.4 mug/g respect ively. In muscle and fatty tissue mean levofloxacin concentrations of 8.0 /- 0.9 and 4.0 +/- 2.2 mug/g were attained. Mean levels in cancellous bone were 6.6 +/- 3.6 mug/g, lowest levels were measured in cortical bone (2.8 /- 1.1 mug/g). Twenty-two different pathogens were cultivated from the lesi ons 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 o rthopaedic patients due to its good tissue penetration. (C) 2001 Elsevier S cience B.V. and International Society of Chemotherapy. All rights reserved.