Tibial bone and soft-tissue concentrations following combination therapy with vancomycin and meropenem – evaluated by microdialysis in a porcine model: should patients with open fractures have higher doses of antibiotics?

[摘要] AimsMIC) in tibial compartments for the bacteria most frequently encountered in open fractures. Low and high MIC targets were applied: 1 and 4 µg/ml for vancomycin, and 0.125 and 2 µg/ml for meropenem.MethodsEight pigs received a single dose of 1,000 mg vancomycin and 1,000 mg meropenem simultaneously over 100 minutes and 10 minutes, respectively. Microdialysis catheters were placed for sampling over eight hours in tibial cancellous bone, cortical bone, and adjacent subcutaneous adipose tissue. Venous blood samples were collected as references.ResultsMIC ranged between 30 and 446 minutes (7% to 99%) for vancomycin and between 45 and 181 minutes (10% to 40%) for meropenem.ConclusionMIC in all the exposed tissues, and thereby lower the risk of acquiring an infection after open tibial fractures.

[学科分类] 骨科学

[关键词] Microdialysis;Vancomycin;Meropenem;Open fracture;Antibiotic prophylaxis;vancomycin;soft-tissues;tibial bone;porcine model;Open tibial fractures;Cortical bone;antibiotics;infections;catheters;subcutaneous adipose tissue