The sustained release of cefotaxim from a fibrin-cefotaxim compound in treatment of osteitis. Pharmacokinetic study and clinical results.

Following a survey of the literature regarding clinical examinations and experimental studies of local absorbable carrier for an antibiotic in treatment of osteitis, a study is presented concerning clinical experience with 46 patients treated with a cefotaxim-loaded fibrin sealant. In connection with simultaneous focal sanitation the clinical results were satisfying. When autogenous cancellous bone was added at the same time, only one surgical operation was necessary in some cases to show results equivalent to other methods. Postoperatively, the cefotaxim levels in the blood and in the wound drainage fluid were measured. The serum cefotaxim concentrations were low and only identifiable for a period of 36h, whereas the wound drainage fluid contained very highly effective antibacterial concentrations over a measured period of 3.5 days. The best results were seen in cases of hematogenic osteomyelitis. The disadvantage of this system is the quick release of the antibiotic by diffusion. Therefore, high concentrations can be obtained only for a short period of several days.