The Kinetics of Antibiotic Release from a Fibrin-Clotting System: An Animal Experiment
In colon surgery fibrin glue is commonly used for the additional sealing of high-risk colonic anastomoses. As every anastomosis must be considered contaminated, and fibrin is a culture medium for pathogens, it is natural to suggest antibiotics should be added to the adhesive for its application to an anastomosis.
After preliminary studies concerning the influence of antibiotic combinations on the clotting and adhesive properties of fibrin glue, we investigated the release time of a clindamycin-cefotaxim combination from a fibrin clot under standardized conditions.
One millilitre of fibrin glue was mixed with 25 mg clindamycin and 25 mg cefotaxim, and the fibrin-antibiotic complex was implanted into the free peritoneal cavity of Wistar rats. The clot was removed after 1, 3, 5, 8 and 24h and the remaining quantity of antibiotic in the fibrin clot was measured. Escherichia coli was used for the assessment of cefotaxim release; clindamycin release was tested by Staphylococcus epidermidis. After 24 h we still found sufficiently high concentrations of antibiotic in the fibrin clot. This demonstrates that without impairment of clotting behavior and adhesive qualities of the fibrin glue it is possible to mix the adhesive with an antibiotic combination, which provides for extremely high local concentrations of antibiotic agents by slow release from the fibrin clot.
Key wordsFibrin glue antibiotics diffusion test
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