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Measurements of Cefuroxime levels performed in dogs show a decrease against time in well perfused tissue similar to that in serum, while in bradytrophic tissue--such as bone and articular capsule--there is a distinct rise of these values in the time scale assessed. In similar investigations in man the higher levels in bradytrophic tissue are attributable to delayed elimination from the compact and spongy bone as compared to the serum. The effect on osteomyelitis, to be derived from this, is discussed.

A randomised, comparative study is reported of single intravenous doses of cephradine 2 g or cefuroxime 1.5 g given as prophylactic cover for total hip replacements in 40 patients. The serum and bone levels of cephalosporin achieved were higher in the cephradine treated group in proportion to the higher dose employed. Both agents provided adequate bone levels on average, cephradine 25.34 mcg/g, cefuroxime 17.39 mcg/g, although bone penetration was more variable with cefuroxime.

This paper presents the results of adding the antibiotic cefuroxime to CMW bone cement in a group of patients undergoing total hip or knee replacement, in which the levels of cefuroxime were assayed in the blood, wound drainage fluid, urine and surplus bone cement. It was found that very small amounts of cefuroxime, less than 5%, were recovered in the urine, serum and drainage fluid in the first week following operation, and since it is known that cefuroxime is not metabolised or excreted elsewhere in the body, it must follow that approximately 95% remains in the bone cement as a potential source of prophylaxis against infection.