Summary
The pharmacokinetics of gentamicin were studied after total hip joint arthroplasties performed with ‘Palacos R plus gentamicin’ in 10 patients. Urine was collected at 12-hour intervals for 15 days after operation, and drainage fluids for 48, 72 or 108 hours. Blood samples were taken 3 and/or 5 hours after prosthesis implantation.
High concentrations of gentamicin were found in drainage fluids. Excretion curves in drainage fluids or urine were fitted by a computer-aided design program (SIAM) and the mean curves established. Elimination of gentamicin was biphasic in both cases. The rapid phases had a half-life of 2.97 hours in drainage fluids and 7.16 hours in urine. Half-lives of the slow phases were 13.5 and 47.12 hours, respectively. The mean percentage of total gentamicin released by the two routes was 5.78% of the quantity implanted. The calculated peak blood concentration was 0.12 mg/L.
It is concluded that gentamicin concentrations locally reach levels higher than minimum inhibitory concentrations of most of the likely pathogens in patients undergoing total hip joint arthroplasties with ‘Palacos R plus gentamicin’ bone cement. However, as blood concentrations appear to be low, patients may not be protected against systemic infections.
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Alftnan O, Renkonen OV, Sivonen A. Concentrations of gentamicin in serum, urine and urogenital tissue in man. Acta Pathologica Microbiologica et Immunologica Scandinavica (B) 241 (Suppl.): 92–94, 1973
Andrews HJ, Arden GP, Hart GM, Owen JW. Deep infections after total hip replacement. Journal of Bone and Joint Surgery — British Volume 63-B: 53–57, 1981
Buchholz H, Engelbrecht H. Über die Depotwirkung einiger Antibiotica bei Vermischung mit dem Kunstharz Palacos. Chirurgie 41: 511–515, 1970
Charnley J. Post-operative infection after total hip replacement with special reference to air contamination in the operation room. Clinical Orthopaedics 87: 167–170, 1972
Duval J, Soussy CJ. Antibiotherapie. Editions Masson, Paris, 1985
Elson RA, Jephcott AE, McGechie DB, Verattas D. Antibioticloaded acrylic cement. Journal of Bone and Joint Surgery — British Volume 59-B: 200–205, 1977
Hill C, Flamant R, Mazas F, Evrard J. Prophylactic cefazolin versus placebo in total hip replacement: report of a multicentre double-blind randomised trial. Lancet 1: 795–797, 1981
Innes A, Hughes S, Robertson S, Dash C. Cefuroxime in CMW bone cement. International Orthopaedics 9: 265–269, 1985
Jackson GG, Arciert G. Ototoxicity of gentamicin in man: a survey and controlled analysis of clinical experience in the United States. Journal of Infectious Diseases 124 (Suppl.): 130–171, 1971
Josefsson G, Lindberg L, Wiklander B. Systemic antibiotics and gentamicin containing bone cement in the prophylaxis of postoperative infections in total hip arthroplasty. Clinical Orthopaedics 159: 194–200, 1981
O’Leary TD, Ratcliff RM, Geary TD. Evaluation of an enzyme immunoassay for serum gentamicin. Antimicrobial Agents and Chemotherapy 17: 776–778, 1980
Percheron E, Segui A, Lebaron JP. La pharmacocinétique sans equation: un outil pour les biologistes. Presentation du Systeme SIAM. Innovation et Technologie en Biologie et Médecine 7: 677–696, 1986
Salvati EA, Robinson RP, Zeno SM, Koslin HL. Infection rates after 3175 total hip and total knee replacements performed with and without a horizontal unidirectional filtered air flow system. Journal of Bone and Joint Surgery — American Volume 64-A: 525–535, 1982
Segui A, Lebaron JP, Leverge R. Biomedical engineering approach of pharmacokinetic problems: computer aided design in pharmacokinetics and bioprocessing. IEE Proceedings 133, Pt. D: 217–223, 1986
Torholm C, Lidgren L, Lindberg L, Kahlmeter G. Total hip joint arthroplasty with gentamicin impregnated cement. Clinical Orthopaedics 181: 99–106, 1983
Vielpeau C, Aubriot JH, Morel C. Devenir de la gentamicine mélangée au méthacrylate de methyle. Revue de Chirurgie Orthopédique 66 (Suppl. II): 74–78, 1980
Wahlig H, Dingeldein E, Buchholz H, Buchholz M, Bachman F. Pharmacokinetic study of gentamicin-loaded cement in total hip replacements. Journal of Bone and Joint Surgery — British Volume 66-B: 175–179, 1984
Whelton A. The aminoglycosides. Clinical Orthopaedics 190: 66–73, 1984
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Bunetel, L., Segui, A., Cormier, M. et al. Release of Gentamicin from Acrylic Bone Cement. Clin-Pharmacokinet 17, 291–297 (1989). https://doi.org/10.2165/00003088-198917040-00006
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DOI: https://doi.org/10.2165/00003088-198917040-00006