Transport of Vancomycin and Cefepime into Human Intervertebral Discs: Quantitative Analyses

Qiaoqiao Zhu, Xin Gao, Mark D. Brown, Frank Eismont, Weiyong Gu

Research output: Contribution to journalArticle

Abstract

Study Design.Simulation of antibiotics transport into human intervertebral disc with intravenous infusion.Objective.The objective of this study was to quantitatively investigate antibiotic concentrations in the disc.Summary of Background Data.Intravenous infusion of antibiotics is typically used to treat intervertebral disc infection in clinics. However, it is difficult to evaluate the drug concentrations within discs in vivo.Methods.A computational model was used in this study. The variation of drug charge with pH was considered in the model. Thirty-minute infusions of two commonly used antibiotics in clinic - vancomycin and cefepime - were numerically investigated. Spatial and temporal concentration distributions of these drugs in both nondegenerated and moderately degenerated discs were calculated.Results.For intravenous infusion of 1g vancomycin and 2g cefepime in 30 minutes repeated every 12 hours, it was predicted that vancomycin concentration in the disc fluctuated between 17.0 and 31.0 times of its minimum inhibitory concentration (1ug/mL) and cefepime concentration fluctuated between 1.1 and 4.2 times of its minimum inhibitory concentration (i.e., 8ug/mL) in about 2 days. It was also found that vancomycin concentration in moderately degenerated disc was lower than that in the nondegenerated disc.Conclusion.This study provides quantitative guidance on selecting proper dosage for treating disc infection. The method used in this study could be used to provide quantitative information on transport of other antibiotics and drugs in discs as well.Level of Evidence: N/A.

Original languageEnglish (US)
Pages (from-to)E992-E999
JournalSPINE
Volume44
Issue number17
DOIs
StatePublished - Sep 1 2019

Keywords

  • antibiotic penetration
  • cefepime
  • disc infection
  • finite element method
  • intervertebral disc
  • mixture theory
  • modeling
  • transport phenomena
  • vancomycin

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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