Jia-Wei He1, Jing Wang2, Li Cao3, Xiao-Gang Zhang3, Guo-Qing Li3, Bo-Yong Xu3, Bao-Chao Ji3, Si-Ya Ge4, Jian-Hua Yang5. 1. Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyu Mountain Road, Urumqi, 830054, Xinjiang, China. 2. Department of Pharmacy, The Eighth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. 3. Department of Orthopaedics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. 4. College of Pharmacy, Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. 5. Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyu Mountain Road, Urumqi, 830054, Xinjiang, China. hjwwlmq@sina.com.
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.
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.