ArticleAntimicrobial agents and chemotherapy2009
Bone penetration of amoxicillin and clavulanic acid evaluated by population pharmacokinetics and Monte Carlo simulation.
Article in Antimicrobial agents and chemotherapy, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- The role of oral amoxicillin/clavulanic acid in the treatment of osteomyelitis: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Pooled it
- Population Pharmacokinetic Study of Amoxicillin-Treated Burn Patients Hospitalized at a Swiss Tertiary-Care Center.Antimicrobial agents and chemotherapy · 2018Trial
- Population Pharmacokinetics and Target Attainment of Meropenem in Plasma and Tissue of Morbidly Obese Patients after Laparoscopic Intraperitoneal Surgery.Antimicrobial agents and chemotherapy · 2015Trial
- Concentrations of amoxicillin and clindamycin in teeth following a single dose of oral medication.Clinical oral investigations · 2014Trial
- In vitro emergence of amoxicillin-resistance and impact of amoxicillin on biofilm production across Cutibacterium acnes phylotypes?European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- A Physiologically Based Pharmacokinetic Model for the Prediction of Plasma and Bone Tissue Exposure after Prophylactic Administration of Ampicillin/Sulbactam in Patients with Osteonecrosis of the Jaw.Clinical pharmacokinetics · 2025Article
- Calcium Sulfate Disks for Sustained-Release of Amoxicillin and Moxifloxacin for the Treatment of Osteomyelitis.Materials (Basel, Switzerland) · 2024Article
- Population pharmacokinetics and humanized dosage regimens matching the peak, area, trough, and range of amikacin plasma concentrations in immune-competent murine bloodstream and lung infection models.Antimicrobial agents and chemotherapy · 2024Article
- Improved characterization of aminoglycoside penetration into human lung epithelial lining fluid via population pharmacokinetics.Antimicrobial agents and chemotherapy · 2024Article
- Facts and trends in dental antibiotic and analgesic prescriptions in Germany, 2012-2021.Clinical oral investigations · 2024Article
- Infective Costochondritis after Augmentation Mammoplasty: A Rare Case Report and Review of the Literature.Archives of plastic surgery · 2023Article
- Individual Components of Polymyxin B Modeled via Population Pharmacokinetics to Design Humanized Dosage Regimens for a Bloodstream and Lung Infection Model in Immune-Competent Mice.Antimicrobial agents and chemotherapy · 2023Article
- Intradiscal pharmacokinetics of oral antibiotics to treat Chronic Lower Back Pain.npj antimicrobials and resistance · 2023Review
- Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review-Part I.Antibiotics (Basel, Switzerland) · 2022Review
- Concentration of Penicillin G in Jawbone Affected by Antiresorptive Agent-Related Osteonecrosis Following a Single Preoperative Dose.Antibiotics (Basel, Switzerland) · 2020Article
- Physiologically Based Population Pharmacokinetic Modeling Approach for Ciprofloxacin in Bone of Patients Undergoing Orthopedic Surgery.ACS pharmacology & translational science · 2020Article
- Bone and Joint Tissue Penetration of theAntimicrobial agents and chemotherapy · 2019Article
- Population Pharmacokinetics and Target Attainment of Ertapenem in Plasma and Tissue Assessed via Microdialysis in Morbidly Obese Patients after Laparoscopic Visceral Surgery.Antimicrobial agents and chemotherapy · 2017Article
- Bone and joint infections due to anaerobic bacteria: an analysis of 61 cases and review of the literature.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2014Review
- Attenuation of colistin bactericidal activity by high inoculum of Pseudomonas aeruginosa characterized by a new mechanism-based population pharmacodynamic model.Antimicrobial agents and chemotherapy · 2010Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Amoxicillin (amoxicilline)-clavulanic acid has promising activity against pathogens that cause bone infections. We present the first evaluation of the bone penetration of a beta-lactam by population pharmacokinetics and pharmacodynamic profiling via Monte Carlo simulations. Twenty uninfected patients undergoing total hip replacement received a single intravenous infusion of 2,000 mg/200 mg amoxicillin-clavulanic acid before surgery. Blood and bone specimens were collected. Bone samples were pulverized under liquid nitrogen with a cryogenic mill, including an internal standard. The drug concentrations in serum and total bone were analyzed by liquid chromatography-tandem mass spectrometry. We used NONMEM and S-ADAPT for population pharmacokinetic analysis and a target time of the non-protein-bound drug concentration above the MIC for > or = 50% of the dosing interval for near-maximal bactericidal activity in serum. The median of the ratio of the area under the curve (AUC) for bone/AUC for serum was 20% (10th to 90th percentile for between-subject variability [variability], 16 to 25%) in cortical bone and 18% (variability, 11 to 29%) in cancellous bone for amoxicillin and 15% (variability, 11 to 21%) in cortical bone and 10% (variability, 5.1 to 21%) in cancellous bone for clavulanic acid. Analysis in S-ADAPT yielded similar results. The equilibration half-lives between serum and bone were 12 min for amoxicillin and 14 min for clavulanic acid. For a 30-min infusion of 2,000 mg/200 mg amoxicillin-clavulanic acid every 4 h, amoxicillin achieved robust (> or = 90%) probabilities of target attainment (PTAs) for MICs of < or = 12 mg/liter in serum and 2 to 3 mg/liter in bone and population PTAs above 95% against methicillin-susceptible Staphylococcus aureus in bone and serum. The AUC of amoxicillin-clavulanic acid was 5 to 10 times lower in bone than in serum, and amoxicillin-clavulanic acid achieved a rapid equilibrium and favorable population PTAs against pathogens commonly encountered in bone infections.
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