We evaluated the concentration of cefotaxime in the exudate from ischemic leg ulcers in 9 subjects with severe obstructive arterial disease. The administration of the drug was either systemic (1 g in 250 ml of saline given in 30 min) or regional at a vein of the foot while a tourniquet was applied at the level of the thigh during 30 min. Hygroscopic discs were used to collect samples of ulcer exudate at hourly intervals for 4 hr. Cefotaxime concentration was determined by HPL chromatography. A significantly greater concentration of antibiotic was obtained with regional as compared to systemic administration (46 +/- 16 vs 25 +/- 14, p less than 0.01) and a greater percentage of patients attained MIC 90. A stable concentration of the drug was observed during the 4 hr period indicating a decreased rate of elimination of the antibiotic from the ulcer tissue. Thus, regional administration of antibiotics affords greater concentration than systemic administration, for treatment of ischemic leg ulcers.
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