RAPID transport of antibiotics into the synovial space is critical in the treatment of septic arthritis. Most antibiotics have been studied,1 with the exception of the aminoglycoside, gentamicin sulfate. We have had the opportunity to study the transport of this agent into the synovial cavity in a patient with Serratia marcescens arthritis. Our findings demonstrate that gentamicin rapidly gains entrance into synovial fluid and reaches concentrations approaching those in serum.
Report of a Case
A 57-year-old white male farmer with a 30-year history of ankylosing spondylitis was hospitalized at the Bexar County Hospital for care of quadriplegia caused by trauma to his fused cervical spine. The patient was immobilized and treated initially with dexamethasone, 4 mg administered intravenously every six hours, to reduce cervical cord edema. On the 36th hospital day he developed a temperature of 38.9 C (102 F), and urine and blood cultures were obtained. Serratia marcescens
Marsh DC, Matthew EB, Persellin RH. Transport of Gentamicin Into Synovial Fluid. JAMA. 1974;228(5):607. doi:10.1001/jama.1974.03230300047030