Antibiotic concentration in the exudate of venous ulcers: the prediction of ulcer healing rate.

We have designed a test to measure the local circulatory insufficiency in the base of chronic venous ulcers by measuring the concentration of Cefuroxime in the ulcer exudate following a single intravenous injection of the antibiotic at a dose of 500 mg/m2. We have studied 28 patients with 42 ulcers and shown that the concentration achieved increased with in-patient conservative treatment (P less than 0.01), decreased again on discharge from hospital if the ulcers had not healed (P less than 0.01) and correlated with observed healing rates (r = 0.72). This test may assist in the clinical management of these cases by predicting healing rates and the likely outcome of conservative treatment.