• Qiaoqiao Zhu, Xin Gao, Mark D Brown, Frank Eismont, and Weiyong Gu.
• Department of Mechanical and Aerospace Engineering, University of Miami, Coral Gables, FL.
• Spine. 2019 Sep 1; 44 (17): E992-E999.

Study DesignSimulation of antibiotics transport into human intervertebral disc with intravenous infusion.ObjectiveThe objective of this study was to quantitatively investigate antibiotic concentrations in the disc.Summary Of Background DataIntravenous 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.MethodsA 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.ResultsFor intravenous infusion of 1 g vancomycin and 2 g 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 (1 ug/mL) and cefepime concentration fluctuated between 1.1 and 4.2 times of its minimum inhibitory concentration (i.e., 8 ug/mL) in about 2 days. It was also found that vancomycin concentration in moderately degenerated disc was lower than that in the nondegenerated disc.ConclusionThis 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 EvidenceN/A.

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