Summary
The concentrations of ciprofloxacin produced in bone, cartilage and menisci after a single administration of 200 mg were determined at different intervals in a group of patients with an average age of 80 years. Concentrations of 0.11 to 0.94 mg/kg bone tissue were measured after 0.5 to 5 hours. In the cartilage a concentration of active substance was measurable only once (4.18 mg/kg). In the presence of marked circulatory disorders the active substance concentrations reached in the bone were above those found in the seriously damaged muscle. Although the concentrations reached in the bone are effective, no risk should be taken in osteomyelitis. Ciprofloxacin should therefore be used at high dosage and possibly be combined with another substance. Given for therapeutic purposes, a single dose of ciprofloxacin is naturally not effective enough, and given for prophylactic purposes, not safe enough to prevent a post-traumatic osteitis.
Zusammenfassung
Bei einem Patientenkollektiv mit einem Durchschnittsalter von 80 Jahren wurden Knochen, Knorpel und Menisci auf ihren Gehalt von Ciprofloxacin nach Einmalgabe von 200 mg der Substanz nach unterschiedlichen Zeitspannen untersucht. Im Knochen wurden nach einer Zeitdauer von 0,5 bis 5 Stunden 0,11 bis 0,94 mg/kg Gewebe gemessen. In Knorpel fand nur einmal eine Anreicherung statt (4,18 mg/kg). Bei erheblichen Durchblutungsstörungen lagen die Substanzspiegel der Knochen über denen der schwer geschädigten Muskulatur. Die Werte zeigen zwar effektive Knochenspiegel, dennoch sollte bei der Osteomyelitis kein Risiko eingegangen werden und Ciprofloxacin höher dosiert und eventuell mit einer anderen Substanz kombiniert werden. Eine Einmalgabe ist natürlich als Therapiedauer zu kurz, als Prophylaxe zur Verhinderung einer posttraumatischen Osteitis zu unsicher.
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Wacha, H., Wagner, D., Schäfer, H. et al. Concentration of ciprofloxacin in bone tissue after single parenteral administration to patients older than 70 years. Infection 18, 173–176 (1990). https://doi.org/10.1007/BF01642108
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DOI: https://doi.org/10.1007/BF01642108