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Serum and Synovial Vancomycin Concentrations in Patients with Prosthetic Joint Infection after Intra-articular Infusion

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European Journal of Drug Metabolism and Pharmacokinetics Aims and scope Submit manuscript

Abstract

Background and Objectives

Vancomycin is one of the most commonly used antibiotics for intra-articular (IA) infusion in the treatment of prosthetic joint infection (PJI). This study aimed to preliminarily investigate the serum and synovial vancomycin concentrations in patients with PJI after IA infusion.

Methods

In total, 16 patients who developed PJI were enrolled in this study; 14 of the patients were treated with IA infusion of vancomycin postoperatively, while the other 2 patients received intravenous (IV) infusion of vancomycin alone. Chemiluminescent immunoassay assay (CLIA) and high-performance liquid chromatography (HPLC) were used to determine the serum and synovial vancomycin concentrations, respectively.

Results

Administration of vancomycin 0.5 g once daily (qd) IA maintained a high vancomycin trough concentration in synovial fluid before the next IA dose, regardless of whether it was given in combination with IV administration. The combination vancomycin 0.5 g qd IA + vancomycin 1 g every 12 h (q12h) IV yielded relatively good trough concentrations of vancomycin in both serum and synovial fluid. The mean trough serum vancomycin concentration of patients who used vancomycin 1 g q12h IV therapy was above 10 μg/mL; however, no vancomycin was detected in their synovial fluid.

Conclusions

The rational use of IA vancomycin infusion may help to achieve effective therapeutic concentrations of vancomycin in the serum and synovial fluid of patients with PJI.

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Author notes

  1. Jia-Wei He and Jing Wang contributed equally to the work.

Authors and Affiliations

  1. Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyu Mountain Road, Urumqi, 830054, Xinjiang, China

    Jia-Wei He & Jian-Hua Yang

  2. Department of Pharmacy, The Eighth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China

    Jing Wang

  3. Department of Orthopaedics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China

    Li Cao, Xiao-Gang Zhang, Guo-Qing Li, Bo-Yong Xu & Bao-Chao Ji

  4. College of Pharmacy, Xinjiang Medical University, Urumqi, 830054, Xinjiang, China

    Si-Ya Ge

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  1. Jia-Wei He
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Corresponding author

Correspondence to Jian-Hua Yang.

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Funding

No sources of funding were used for this study.

Conflicts of interest

The authors declare that they have no conflict of interest in relation to this study.

Ethical approval

All procedures performed in the studies were in accordance with the 1964 Helsinki Declaration and its later amendments and national institutional research committees. This study was reviewed and approved by the Institutional Review Board of the First Affiliated Hospital of Xinjiang Medical University, and has the approval number 20190531-07.

Consent to participate

Written informed consent was obtained from all participants included in this study.

Consent for publication

Not applicable.

Availability of data and materials

Data and materials supporting the findings of this study are available within the paper and its supplementary data files.

Code availability

Analysis code is available upon request from the authors.

Authors’ contributions

Jia-Wei He: data curation, formal analysis, investigation, methodology, software, writing. Jing Wang: data curation, formal analysis, investigation, methodology, software, writing. Li Cao: conceptualization, project administration, supervision. Xiao-Gang Zhang: data curation, formal analysis, investigation, resources. Guo-Qing Li: data curation, formal analysis, investigation, resources. Bo-Yong Xu: data curation, formal analysis, investigation, resources. Bao-Chao Ji: data curation, formal analysis, investigation, resources, methodology. Si-Ya Ge: data curation, formal analysis, investigation. Jian-Hua Yang: conceptualization, project administration, supervision.

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He, JW., Wang, J., Cao, L. et al. Serum and Synovial Vancomycin Concentrations in Patients with Prosthetic Joint Infection after Intra-articular Infusion. Eur J Drug Metab Pharmacokinet 46, 637–643 (2021). https://doi.org/10.1007/s13318-021-00705-0

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  • DOI: https://doi.org/10.1007/s13318-021-00705-0

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