Vancomycin concentrations in the cervical spine after intravenous administration: results from an experimental pig study

Figures & data

Table: Pharmacokinetic parameters for plasma, subcutaneous adipose tissue, vertebral cancellous bone, and intervertebral disc

Tissue	AUC0–last (min µg/mL)	Cmax (µg/mL)	Tmax (min)	T1/2 (min)	AUCtissue/AUCplasma
Plasma (unbound)	7,880 (7164–8597) ^b	40.0 (35.7–44.3) ^b	75 (61–89)	325 (99–552)
Subcutaneous adipose tissue	4,719 (4002–5436)	18.0 (14.1–21.9)	113 (96–129)	224 (197–250)	0.60 (0.48–0.72)
Vertebral cancellous bone	3,677 (2960–4393) ^c	12.3 (9.6–15.0) ^c	159 (134–184)	271 (227–315)	0.46 (0.40–0.53)
Intervertebral disc	1,983 (1237–2729) ^d	6.6 (3.6–9.6)4	270 (187–353)	933 (527–1,339) ^e	0.24 (0.17–0.31)
p-value ^a	< 0.001	< 0.001	–	< 0.008

Values are given as means (95% confidence interval).

AUC_0–last, area under the concentration-time curve from 0 to the last measured value; C_max, peak drug concentration; T_max, time to C_max; T1/2, half-life at β-phase; AUC_tissue/AUC_plasma, tissue penetration expressed as the ratio of AUC_tissue/AUC_plasma.

^aOverall comparison using F test for plasma (unbound), subcutaneous adipose tissue, vertebral cancellous bone, and intervertebral disc.

^bp < 0.001 for all comparisons between plasma and the other compartments.

^cp < 0.01 for comparison with subcutaneous adipose tissue.

^dp < 0.01 for comparison between intervertebral disc and the other compartments.

^ep < 0.001 for all comparisons between intervertebral disc and the other compartments.

Figure 1. Representative fluoroscopic image showing the location of the microdialysis (MD) probes in a sagittal view: the Kirschner wire with the fixating device in the C2 vertebral body, C3 and C4 vertebral body, C3–C4 intervertebral disc (IVD), the gold thread within the microdialysis probe membrane tip in the vertebral cancellous bone (VCB) and intervertebral disc.

Figure 2. Mean concentration-time profiles for plasma, subcutaneous adipose tissue, vertebral cancellous bone, and the intervertebral disc. Bars represent 95% confidence intervals. MICs of 2, 4, and 8 µg/mL are also inserted.