Abstract：
The aim of this study was to investigate the jawbone concentration of clindamycin (CLI) in patients with an osteonecrosis of the jaw (ONJ). Patients with medication-related ONJ (MRONJ) and osteoradionecrosis (ORN) with an antibiotic treatment with CLI were included. Plasma, vital and necrotic bone samples were collected. Plasma and jawbone samples were analyzed by liquid chromatography-tandem mass spectrometry. Patients with MRONJ exhibited a mean plasma CLI concentration of 9.6 μg/mL (SD ± 3.6 μg/mL) and mean concentrations of 2.3 μg/g CLI (SD ± 1.4 μg/g) and 2.1 μg/g CLI (SD ± 2.4 μg/g) in vital and necrotic bone samples, without statistical significance (p = 0.79). In patients with ORN, mean concentration in plasma was 12.0 μg/mL (SD ± 2.6 μg/mL), in vital bone 2.1 μg/g (SD ± 1.5 μg/g), and in necrotic bone 1.7 μg/g (SD ± 1.2 μg/g). Vital and necrotic bone concentrations did not differ significantly (p = 0.88). The results demonstrate that CLI concentrations are considerably lower than in plasma, but sufficient for most bacteria present in ONJ. Within the limitations of the study, it seems that CLI is a relevant alternative to other antibiotics in the treatment of ONJ because it reaches adequate concentrations in jawbone.
摘要：
这项研究的目的是调查颌骨坏死（ONJ）患者的克林霉素（CLI）的颌骨浓度。包括与药物相关的ONJ（MRONJ）和放射性骨坏死（ORN）并使用CLI进行抗生素治疗的患者。血浆,收集重要和坏死骨样本。通过液相色谱-串联质谱法分析血浆和颌骨样品。MRONJ患者的平均血浆CLI浓度为9.6μg/mL（SD±3.6μg/mL），平均浓度为2.3μg/gCLI（SD±1.4μg/g）和2.1μg/gCLI（SD±2.4μg/g）。无统计学意义(p=0.79)。ORN患者,血浆平均浓度为12.0μg/mL（SD±2.6μg/mL），在重要骨骼中2.1μg/g（SD±1.5μg/g），坏死骨中1.7μg/g（SD±1.2μg/g）。重要和坏死骨浓度没有显着差异（p=0.88）。结果表明，CLI浓度明显低于血浆，但对于ONJ中存在的大多数细菌来说足够了。在研究的局限性内，CLI似乎是治疗ONJ的其他抗生素的相关替代品，因为它在颌骨中达到足够的浓度。
