Pharmacokinetics of topical gentamicin in total hip arthroplasty

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Abstract
Two different ways of administering topical gentamicin were examined in patients undergoing total hip arthroplasty. Gentamicin (160 mg), dissolved in isotonic saline, was instilled into the wounds of 5 of 10 patients. In the other 5 patients, the components of the prostheses were inserted by means of gentamicin-containing cement, 0.5 g/40 g powder. The serum and wound concentrations of gentamicin were determined constantly during the postoperative period. The average half-lives of gentamicin in the surgical wounds of the 2 groups of patients were 3 1/2 and 25 h, respectively. The average wound concentration was higher than the minimum inhibitory concentration for staphylococci and aerobic gram-negative rods for 18 and 11 h, respectively, in the group of patients treated with gentamicin solution compared with 160 and 67 h, respectively, in the group treated with the gentamicin-containing cement.