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The intervertebral disc is an avascular tissue, and penetration of antibiotics occurs by passive <br />diffusion. Cefotaxime penetration has not been well studied. The aim is to investigate the <br />penetration of cefotaxime into the intervertebral disc removed from patients undergoing <br />discectomy. <br /> Twenty-six patients undergoing discectomy were recruited for this study. They were given one <br />gram of cefotaxime intravenously as a prophylactic antibiotic. Cefotaxime was extracted from <br />nucleus pulposus and serum and analyzed using an HPLC method with cefuroxime axetil as <br />internal standard. <br /> Cefotaxime penetrated into all the 26 samples of nucleus pulposus resulting in a mean <br />concentration of 0.66±0.13 µg/gm. The mean serum concentration at time of disc removal was <br />13.61±3.54 µg/ml. The concentration in 16 samples were below the minimum inhibitory <br />concentration against Staph. aureus with an average of 0.27±0.03 µg/g. There is a statistically <br />significant correlation between time after intravenous cefotaxime administration and its <br />concentration in the nucleus pulposus. The greater increase is in the third hour after <br />administration. Factors like age, body weight, gender, number of associated diseases and <br />surgical history did not seem to affect nucleus pulposus cefotaxime concentration. <br /> In conclusion, cefotaxime can penetrate into the nucleus pulposus but its concentration is <br />relatively low. This concentration has a strong positive correlation with time after cefotaxime <br />intravenous administration. Cefotaxime, therefore, needs to be given at least two hours before <br />disc removal, with re-dosing immediately before operation to maintain high serum concentration. <br /><br />