Intervertebral disc penetration by antibiotics used prophylactically in spinal surgery: implications for the current standards and treatment of disc infections.

Manu N Capoor, Jan Lochman, Andrew Mc Dowell, Jonathan E Schmitz, Martin Solansky, Martina Zapletalova, Todd F Alamin, Michael F Coscia, Steven R Garfin, Radim Jancalek, Filip Ruzicka, A Nick Shamie, Martin Smrcka, Jeffrey C Wang, Christof Birkenmaier, Ondrej Slaby

Research output: Contribution to journalArticle

Abstract

PURPOSE: The presence of Propionibacterium acnes in a substantial component of resected disc specimens obtained from patients undergoing discectomy or microdiscectomy has led to the suggestion that this prominent human skin and oral commensal may exacerbate the pathology of degenerative disc disease. This hypothesis, therefore, raises the exciting possibility that antibiotics could play an important role in treating this debilitating condition. To date, however, little information about antibiotic penetration into the intervertebral disc is available. METHODS: Intervertebral disc tissue obtained from 54 microdiscectomy patients given prophylactic cefazolin (n = 25), clindamycin (n = 17) or vancomycin (n = 12) was assayed by high-performance liquid chromatography, with cefaclor as an internal standard, to determine the concentration of antibiotic penetrating into the disc tissue. RESULTS: Intervertebral disc tissues from patients receiving the positively charged antibiotic clindamycin contained a significantly greater percentage of the antibacterial dose than the tissue from patients receiving negatively charged cefazolin (P < 0.0001) and vancomycin, which has a slight positive charge (P < 0.0001). CONCLUSION: Positively charged antibiotics appear more appropriate for future studies investigating potential options for the treatment of low-virulence disc infections. These slides can be retrieved under Electronic Supplementary Material.
LanguageEnglish
Pages783-791
Number of pages8
JournalEuropean Spine Journal
Volume4
Publication statusE-pub ahead of print - 1 Dec 2018

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Intervertebral Disc
Anti-Bacterial Agents
Cefazolin
Infection
Clindamycin
Vancomycin
Cefaclor
Therapeutics
Propionibacterium acnes
Diskectomy
Virulence
High Pressure Liquid Chromatography
Pathology
Skin

Keywords

  • Biofilm; Cefazolin; Clindamycin; Cutibacterium acnes; Degenerative disc disease; Propionibacterium acnes; Surgical prophylaxis; Vancomycin

Cite this

Capoor, Manu N ; Lochman, Jan ; Mc Dowell, Andrew ; Schmitz, Jonathan E ; Solansky, Martin ; Zapletalova, Martina ; Alamin, Todd F ; Coscia, Michael F ; Garfin, Steven R ; Jancalek, Radim ; Ruzicka, Filip ; Shamie, A Nick ; Smrcka, Martin ; Wang, Jeffrey C ; Birkenmaier, Christof ; Slaby, Ondrej. / Intervertebral disc penetration by antibiotics used prophylactically in spinal surgery: implications for the current standards and treatment of disc infections. In: European Spine Journal. 2018 ; Vol. 4. pp. 783-791.
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abstract = "PURPOSE: The presence of Propionibacterium acnes in a substantial component of resected disc specimens obtained from patients undergoing discectomy or microdiscectomy has led to the suggestion that this prominent human skin and oral commensal may exacerbate the pathology of degenerative disc disease. This hypothesis, therefore, raises the exciting possibility that antibiotics could play an important role in treating this debilitating condition. To date, however, little information about antibiotic penetration into the intervertebral disc is available. METHODS: Intervertebral disc tissue obtained from 54 microdiscectomy patients given prophylactic cefazolin (n = 25), clindamycin (n = 17) or vancomycin (n = 12) was assayed by high-performance liquid chromatography, with cefaclor as an internal standard, to determine the concentration of antibiotic penetrating into the disc tissue. RESULTS: Intervertebral disc tissues from patients receiving the positively charged antibiotic clindamycin contained a significantly greater percentage of the antibacterial dose than the tissue from patients receiving negatively charged cefazolin (P < 0.0001) and vancomycin, which has a slight positive charge (P < 0.0001). CONCLUSION: Positively charged antibiotics appear more appropriate for future studies investigating potential options for the treatment of low-virulence disc infections. These slides can be retrieved under Electronic Supplementary Material.",
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author = "Capoor, {Manu N} and Jan Lochman and {Mc Dowell}, Andrew and Schmitz, {Jonathan E} and Martin Solansky and Martina Zapletalova and Alamin, {Todd F} and Coscia, {Michael F} and Garfin, {Steven R} and Radim Jancalek and Filip Ruzicka and Shamie, {A Nick} and Martin Smrcka and Wang, {Jeffrey C} and Christof Birkenmaier and Ondrej Slaby",
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Capoor, MN, Lochman, J, Mc Dowell, A, Schmitz, JE, Solansky, M, Zapletalova, M, Alamin, TF, Coscia, MF, Garfin, SR, Jancalek, R, Ruzicka, F, Shamie, AN, Smrcka, M, Wang, JC, Birkenmaier, C & Slaby, O 2018, 'Intervertebral disc penetration by antibiotics used prophylactically in spinal surgery: implications for the current standards and treatment of disc infections.', European Spine Journal, vol. 4, pp. 783-791.

Intervertebral disc penetration by antibiotics used prophylactically in spinal surgery: implications for the current standards and treatment of disc infections. / Capoor, Manu N; Lochman, Jan; Mc Dowell, Andrew; Schmitz, Jonathan E; Solansky, Martin; Zapletalova, Martina; Alamin, Todd F; Coscia, Michael F; Garfin, Steven R; Jancalek, Radim; Ruzicka, Filip; Shamie, A Nick; Smrcka, Martin; Wang, Jeffrey C; Birkenmaier, Christof; Slaby, Ondrej.

In: European Spine Journal, Vol. 4, 01.12.2018, p. 783-791.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intervertebral disc penetration by antibiotics used prophylactically in spinal surgery: implications for the current standards and treatment of disc infections.

AU - Capoor, Manu N

AU - Lochman, Jan

AU - Mc Dowell, Andrew

AU - Schmitz, Jonathan E

AU - Solansky, Martin

AU - Zapletalova, Martina

AU - Alamin, Todd F

AU - Coscia, Michael F

AU - Garfin, Steven R

AU - Jancalek, Radim

AU - Ruzicka, Filip

AU - Shamie, A Nick

AU - Smrcka, Martin

AU - Wang, Jeffrey C

AU - Birkenmaier, Christof

AU - Slaby, Ondrej

PY - 2018/12/1

Y1 - 2018/12/1

N2 - PURPOSE: The presence of Propionibacterium acnes in a substantial component of resected disc specimens obtained from patients undergoing discectomy or microdiscectomy has led to the suggestion that this prominent human skin and oral commensal may exacerbate the pathology of degenerative disc disease. This hypothesis, therefore, raises the exciting possibility that antibiotics could play an important role in treating this debilitating condition. To date, however, little information about antibiotic penetration into the intervertebral disc is available. METHODS: Intervertebral disc tissue obtained from 54 microdiscectomy patients given prophylactic cefazolin (n = 25), clindamycin (n = 17) or vancomycin (n = 12) was assayed by high-performance liquid chromatography, with cefaclor as an internal standard, to determine the concentration of antibiotic penetrating into the disc tissue. RESULTS: Intervertebral disc tissues from patients receiving the positively charged antibiotic clindamycin contained a significantly greater percentage of the antibacterial dose than the tissue from patients receiving negatively charged cefazolin (P < 0.0001) and vancomycin, which has a slight positive charge (P < 0.0001). CONCLUSION: Positively charged antibiotics appear more appropriate for future studies investigating potential options for the treatment of low-virulence disc infections. These slides can be retrieved under Electronic Supplementary Material.

AB - PURPOSE: The presence of Propionibacterium acnes in a substantial component of resected disc specimens obtained from patients undergoing discectomy or microdiscectomy has led to the suggestion that this prominent human skin and oral commensal may exacerbate the pathology of degenerative disc disease. This hypothesis, therefore, raises the exciting possibility that antibiotics could play an important role in treating this debilitating condition. To date, however, little information about antibiotic penetration into the intervertebral disc is available. METHODS: Intervertebral disc tissue obtained from 54 microdiscectomy patients given prophylactic cefazolin (n = 25), clindamycin (n = 17) or vancomycin (n = 12) was assayed by high-performance liquid chromatography, with cefaclor as an internal standard, to determine the concentration of antibiotic penetrating into the disc tissue. RESULTS: Intervertebral disc tissues from patients receiving the positively charged antibiotic clindamycin contained a significantly greater percentage of the antibacterial dose than the tissue from patients receiving negatively charged cefazolin (P < 0.0001) and vancomycin, which has a slight positive charge (P < 0.0001). CONCLUSION: Positively charged antibiotics appear more appropriate for future studies investigating potential options for the treatment of low-virulence disc infections. These slides can be retrieved under Electronic Supplementary Material.

KW - Biofilm; Cefazolin; Clindamycin; Cutibacterium acnes; Degenerative disc disease; Propionibacterium acnes; Surgical prophylaxis; Vancomycin

M3 - Article

VL - 4

SP - 783

EP - 791

JO - European Spine Journal

T2 - European Spine Journal

JF - European Spine Journal

SN - 0940-6719

ER -