[Possibilities for the use of the basic cephalosporin cefuroxime in bone surgery. Tissue levels, effectiveness and tolerance].

In a prospective study with 725 patients we demonstrated the effectiveness and tolerability of cefuroxime as antibiotic prophylaxis in trauma surgery. The infection rates were 0.5 to 1.2% in the different treatment groups. Only in patients with third degree open fractures infection occurred in 8.3%. In addition, the serum drug levels (112 mg/l) and tissue concentrations in bone cortex (15 mg/kg), spongiosa (28 mg/kg), joint cartilage (44 mg/kg) and capsule (57 mg/kg) were measured 1 h following infusion of 1.5 g cefuroxime in 14 patients using HPLC. In a further clinical study with 68 patients suffering from chronic posttraumatic osteomyelitis of the tibia, we could show the value of the surgical treatment with unroofing of the tibia and performing muscleflaps in combination with antibiotic treatment using cefuroxime. Only 4.6% of the patients showed a persistent infection and the reinfection rate was 7.4%.