Measurement Of The Concentration Of Cephalosporins Antibiotic In Intervertebral Disk And The Relationship Between The Administration Occasion And Concentration

ObjectiveThe use of Antibiotics to prevent and remedy Spondylodiscitis before or after a operation of Spine Surgery is still a popular argue nowadays.If the concentration of Antibiotics in intervertebral disc can reach the effective minimum inhibitory concentration(MIC),can effectively inhibit the growth of bacterium and control the inflammation are concerned questions of clinicians. This experiment measures the concentration of Cefotaxime Sodium, cefoperazone(CPZ), Cefamandole Nafate using the High Pressure Liquid Chromatography,analyse and contrast their advantages and disadvantages in preventing and remedying Spondylodiscitis,provide references for rationally selecting Antibiotics in medical treatment.Materials and methods60 lumbar disc herniation(LDH) patients,36males,24females,age 21-68y,weight 50-75kg,MRI shows the nucleus pulposus are still circumvolutioed in annulus fibrosus.The patients have not any other diseases and a week before the treatment they had not taken medicine.We divide the patients into 6 groups randomly,each group contains 10 patients:Group A:A1 Cefotaxime Sodium 2.0g ivgtt before the operationA2 Cefotaxime Sodium 2.0g ivgtt BID the day before the operation+Cefotaxime Sodium 2.0g ivgtt before the operationGroup B:B1 cefoperazone 2.0g ivgtt before the operationB2 cefoperazone 2.0g ivgtt BID the day before the operation+ cefoperazone 2.0g ivgtt before the operationGroup C:C1 Cefamandole Nafate 2.0g ivgtt before the operationC2 Cefamandole Nafate 2.0g ivgtt BID the day before the operation+ Cefamandole Nafate 2.0g ivgtt before the operationGroup D:D1+D2:no Antibiotics before the operationAfter the intravenous infusion we take the operation immediately and pick out the nucleus pulposus in about 60 min, exsanguinate 2ml at the same time.Measuring the concentration of Cefotaxime Sodium, cefoperazone(CPZ), Cefamandole Nafate in nucleus pulposus and blood serum using the High Pressure Liquid Chromatography, statistic analysis and contrast with Staphylococcus aureus MIC.Inject Staphylococcus aureus into the nucleus pulposus samples.Culture 5 days and inspect weather or not the Staphylococcus aureus will infect the nucleus pulposus.ResultsIn each big groups,the concentration in No.2 minor team is obvious higher than the concentration in No.1 minor team. The concentration of Cefamandole Nafate is 6.3～12.7 times than MIC of Cefamandole Nafate to Staphylococcus aureus. The concentration of cefoperazone(CPZ) is 1/8～1/4,so it can not reach its MIC. The concentration of Cefotaxime Sodium is 1/2～2 times of MIC.Conclusions1. Cefotaxime Sodium, cefoperazone(CPZ), Cefamandole Nafate can stay in intervertebral space after intravenous infusion.2.The way giving intravenous infusion twice the day before the operation+once before the operation is better than only once before the operation to increase the concentration in the disk.2. Cefotaxime Sodium,Cefoperazone(CPZ) and Cefamandole Nafate can smosis into the intervertebral space.The concentration of nucleus pulpos can reach the effective concentration when we use Cefamandole Nafate. Cefamandole Nafate can meet our expect of preventing and remedying Spondylodiscitis.