TY  - JOUR
A1  - Straub, Anton
A1  - Stapf, Maximilian
A1  - Fischer, Markus
A1  - Vollmer, Andreas
A1  - Linz, Christian
A1  - Lâm, Thiên-Trí
A1  - Kübler, Alexander
A1  - Brands, Roman C.
A1  - Scherf-Clavel, Oliver
A1  - Hartmann, Stefan
T1  - Bone concentration of ampicillin/sulbactam: a pilot study in patients with osteonecrosis of the jaw
T2  - International Journal of Environmental Research and Public Health
N2  - Osteonecrosis of the jaw (ONJ) occurs typically after irradiation of the head and neck area or after the intake of antiresorptive agents. Both interventions can lead to compromised bone perfusion and can ultimately result in infection and necrosis. Treatment usually consists of surgical necrosectomy and prolonged antibiotic therapy, usually through beta-lactams such as ampicillin/sulbactam. The poor blood supply in particular raises the question as to whether this form of antibiosis can achieve sufficient concentrations in the bone. Therefore, we investigated the antibiotic concentration in plasma and bone samples in a prospective study. Bone samples were collected from the necrosis core and in the vital surrounding bone. The measured concentrations in plasma for ampicillin and sulbactam were 126.3 ± 77.6 and 60.2 ± 35.0 µg/mL, respectively. In vital bone and necrotic bone samples, the ampicillin/sulbactam concentrations were 6.3 ± 7.8/1.8 ± 2.0 µg/g and 4.9 ± 7.0/1.7 ± 1.7 µg/g, respectively. These concentrations are substantially lower than described in the literature. However, the concentration seems sufficient to kill most bacteria, such as Streptococci and Staphylococci, which are mostly present in the biofilm of ONJ. We, therefore, conclude that intravenous administration of ampicillin/sulbactam remains a valuable treatment in the therapy of ONJ. Nevertheless, increasing resistance of Escherichia coli towards beta-lactam antibiotics have been reported and should be considered.
KW  - osteonecrosis of the jaw
KW  - ARONJ
KW  - MRONJ
KW  - ONJ
KW  - osteoradionecrosis
KW  - antibiotic bone concentration
KW  - jaw bone
KW  - beta-lactam
KW  - ampicillin
Y1  - 2022
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/29741
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-297413
SN  - 1660-4601
VL  - 19
IS  - 22
ER  -