European Spine Journal

, Volume 2, Issue 3, pp 145–148

Do Augmentin or cefuroxime reach effective levels in lumbar vertebral discs when used prophylactically for discectomy?

A preliminary report
  • P. L. Housden
  • M. F. Sullivan
Original Articles

Summary

The incidence of discitis following discectomy is reported at between 0.75% and 3.0%. We believe this rate could be reduced if an antibiotic that penetrated the disc tissue with an appropriate spectrum were to be given prophylactically to cover surgery. A prospective study of 20 patients undergoing routine lumbar discectomy was performed. Ten patients received Augmentin 1 2 g and ten received cefuroxime 1.5 g pre-operatively. In eight patients sequestrated disc fragments were analysed, and the majority were found to have drug levels higher than in the attached disc material; the reasons for this are discussed. We conclude that Augmentin penetrates damaged disc material to a limited extent, but cefuroxime achieves levels effective against the most commonly implicated pathogens in discitis tissue and is a rational choice of antibiotic for prophylaxis during lumbar discectomy.

Key words

Discitis Prophylactic antibiotics Cefuroxime Augmentin 

Résumé

La fréquence des discites survenant après discectomie varie de 0,75% à 3,0% et nous pensons qu'elle pourrait être encore plus réduite si l'on protégeait le geste chirurgical par une antibiothérapie prophylactique pénètrant le tissu discal et de spectre approprié. Une étude prospective a été réalisée chez vingt patients subissant une discectomie lombaire de routine. Dix patients ont reçu en préopératoire 1,2 g d'Augmentin et dix autres 1,5 g de Céfuroxime. Chez huit patients, des fragments discaux exclus ont été analysés et dans la plupart d'entre eux on a trouvé un taux de médicament supérieur à celui retrouvé dans le matériel discal en place: les laisons en sont discutées. Nous pensons en conclusion que l'Augmentin pénètre le matériel discal endommagé de manjère limitée, mais le Céfuroxime y atteint des taux efficaces contre les germes pathogènes le plus communément impliqués dans le tissue de discité et représente un choix raisonnable dans l'antibiothérapie prophylactique de la chirurgie discale lombaire.

Mots-clés

Discite Antibiothérapie prophylactique Céfuroxime Augmentin 

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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • P. L. Housden
    • 1
  • M. F. Sullivan
    • 2
  1. 1.Royal National Orthopaedic HospitalStanmoreUK
  2. 2.Princess Grace HospitalLondonUK
  3. 3.StanmoreUK

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