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The penetration of flucloxacillin into cortical and cancellous bone during arthroplasty of the knee

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Antibiotic prophylaxis with 2 g flucloxacillin was given 2 h before operation in 23 adult patients undergoing knee replacement operations for rheumatoid arthritis or osteoarthrosis. The mean extracted concentration of flucloxacillin obtained at operation was 12.9 μg/ml (SD 5.25) in synovial fluid; 2.9 μg/g (SD 3.59) in synovium; 2.0 μg/g (SD 1.48) in cancellous bone and 1.3 μg/g (SD 1.25) in cortical bone. The minimum inhibiting concentration (MIC) value for flucloxacillin was usually 0.25 μg/g against Staphylococcus aureus. Therapeutically active concentrations were thus obtained. There were no adverse reactions from the antibiotic administration.


Une antibiothérapie prophylactique a été réalisée, au moyen de 2 g de flucloxacilline injectés 2 h avant l'intervention, chez 23 malades adultes opérés d'arthroplastie totale du genou pour polyarthrite rhumatoïde ou pour gonarthrose. La concentration moyenne de flucloxacilline mise en évidence au cours de l'opération a été de 12,9 μg/ml (S.D 5,25) dans le liquide synovial, 2,9 μg/g (S.D 3,59) dans la synoviale, 2,0 μg/g (S.D 1,48) dans l'os spongieux et 1,3 μg/g (S. D 1,25) dans l'os cortical. La concentration minimale inhibitrice (CMI) de flucloxacilline efficace vis-à-vis du Staphylocoque doré est habituellement de 0,25 μg/g. Une concentration valable sur le plan thérapeutique a donc été obtenue. Il n'y a pas eu d'effets indésirables imputables à l'administration de l'antibiotique.

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Correspondence to Sven-Erik Larsson.

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Holm, S., Larsson, S. The penetration of flucloxacillin into cortical and cancellous bone during arthroplasty of the knee. International Orthopaedics 6, 243–247 (1983). https://doi.org/10.1007/BF00267145

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Key words

  • Penetration of Flucloxacillin
  • Cortical bone
  • Cancellous bone
  • Arthroplasty of the Knee