Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec;132(12):992-1025.
doi: 10.1111/apm.13490. Epub 2024 Nov 12.

Dynamic distribution of systemically administered antibiotics in orthopeadically relevant target tissues and settings

Affiliations

Dynamic distribution of systemically administered antibiotics in orthopeadically relevant target tissues and settings

Maria Bech Damsgaard Nielsen et al. APMIS. 2024 Dec.

Abstract

This review aimed to summarize the current literature on antibiotic distribution in orthopedically relevant tissues and settings where dynamic sampling methods have been used. PubMed and Embase databases were systematically searched. English-published studies between 2004 and 2024 involving systemic antibiotic administration in orthopedically relevant tissues and settings based on dynamic measurements were included. In total, 5385 titles were identified. After title and abstract screening, 97 eligible studies (43 different antibiotic drugs) were included. The studies covered both preclinical (42%) and clinical studies including healthy and infected tissues (21%) and prophylactic and steady-state situations (35%). Microdialysis emerged as the predominant sampling method in 98% of the studies. Most of the presented antibiotics (80%) were only assessed once or twice. Among the most extensively studied antibiotics were cefuroxime (18 studies), linezolid (9 studies) and vancomycin (9 studies). This review presents valuable insights into the microenvironmental distribution of antibiotics in orthopedically relevant target tissues and settings and seeks to provide a basis for improving dosing recommendations and treatment outcomes. However, it is important to acknowledge that our findings are limited to the specific drug, dosing regimens, administration method and target tissue, and are crucially linked to the selected PK/PD target.

Keywords: Antibiotics; bone; orthopaedic; penetration; pharmacokinetics.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
PRISMA Flowchart of study selection [31].
Fig. 2
Fig. 2
(A) Ultrafiltration relies on vacuum as a driving force to extract interstitial fluid (n = 2/97 studies). (B) Microdialysis relies on continuous concentration‐driven diffusion (n = 95/97 studies).
Fig. 3
Fig. 3
Graphical presentation of the number of studies according to antibiotic drug.

References

    1. Hackett DJ, Rothenberg AC, Chen AF, Gutowski C, Jaekel D, Tomek IM, et al. The economic significance of orthopaedic infections. J Am Acad Orthop Surg. 2015;23 Suppl:S1–S7. - PubMed
    1. Malizos KN. Global forum: the burden of bone and joint infections: a growing demand for more resources. J Bone Joint Surg Am. 2017;99(5):e20. - PubMed
    1. Metsemakers WJ, Smeets B, Nijs S, Hoekstra H. Infection after fracture fixation of the tibia: analysis of healthcare utilization and related costs. Injury. 2017;48(6):1204–1210. - PubMed
    1. Moore AJ, Blom AW, Whitehouse MR, Gooberman‐Hill R. Deep prosthetic joint infection: a qualitative study of the impact on patients and their experiences of revision surgery. BMJ Open. 2015;5(12):e009495. - PMC - PubMed
    1. Orfanos AV, Michael RJ, Keeney BJ, Moschetti WE. Patient‐reported outcomes after above‐knee amputation for prosthetic joint infection. Knee. 2020;27(3):1101–1105. - PubMed

Publication types

MeSH terms