Comparative study of penetration of lomefloxacin and ceftriaxone into transudative and exudative pleural effusion

Abstract

We investigated the transpieural penetration of lomefloxacin (LFLX) and ceftriaxone (CTRX). LFLX (200 mg) was administered orally to three patients with transudative fluid and four with exudative fluid, and 2 g of CTRX was administered by drip infusion to four patients with transudative fluid and three with exudative fluid. For both groups that received LFLX and CTRX, blood samples were drawn at time zero and 1, 2, and 6 h after drug administration. Thoracocentesis of each group was performed at 6 h after drug administration. The mean ratios of concentrations in pleural fluid/maximum concentrations in serum (P/S max) of LFLX were 66% in patients with transudative fluid and 69%o in patients with exudative fluid. The mean ratios of P/S max of CTRX were 9.1% in patients with transudative fluid and 13.5% in patients with exudative fluid. The P/S max ratios for the penetration of LFLX were five to six times higher than those for CTRX. In addition, there was less differentiation in concentrations of LFLX in pleural fluid between the transudative and exudative effisions than there was in the concentrations of CTRX.Although there have been many studies on the penetration of ,B-lactam agents into pleural fluid (1, 2), little attention has been given to the penetration of new quinolones into pleural fluid (5,8). In the study described here, we investigated the transpleural penetration of lomefloxacin (LFLX) and ceftriaxone (CTRX) by comparing the concentrations of both drugs in pleural fluid (transudative and exudative fluid). LFLX is a new quinolone antibacterial agent developed by Hokuriku Seiyaku Co., Ltd. CIRX is a 1-lactam agent developed by Kyorin Yakuhin Co., Ltd. These drugs were chosen because they had almost the same half-lives in blood (4, 9). MATERIALS AND METHODSFourteen patients with pleural fluid (nine males and five females; age range, 47 to 84 years; mean age, 71.6 years) who were admitted to our hospital between January 1989 and September 1990 were used for the present study (Table 1). Patients 5 and 6 in the LFLX group and patient 6 in the CTRX group were diagnosed histologically by pleural biopsy. Patient 7 in the LFLX group and patient 7 in the CTRX group are the same patient; the patient was diagnosed clinically. The study was carried out after receiving informed consent from all patients.We administered 200 mg of LFLX orally to three patients with transudative effusions and to four patients with exudative effusions. Two grams of CTRX in 100 ml of saline was administered by drip infusion to four patients with transudative effusions and to three patients with exudative effusions. In the LFLX group, blood samples was drawn at 1, 2, and 6 h after administration. In the CTRX group, they were drawn just after administration of CTRX and at the times mentioned above. Thoracocentesis of each group was performed 6 h after drug administration. All samples were centrifuged, and serum and pleural fluid supernatants were stored at -20°C until they were assayed. The concentrations of LFLX were determined by the hi...

Η Φαρμακοκινητική Της Μοξιφλοξασίνης Σε Ασθενείς Με Υπεζωκοτική Συλλογή

“…όμοιος βαθμός διείσδυσης της αντιμικροβιακής ουσίας, αποτελεί κοινή διαπίστωση με τη μελέτη των Kimura M και συν. που μελέτησαν τη διεισδυτικότητα της λομεφλοξασίνης σε ασθενείς με εξιδρωματική και διιδρωματική συλλογή, διαπιστώνοντας παρόμοιο βαθμό διείσδυσης (66-69%) και στις 2 ομάδες ασθενών, ανεξάρτητα από το είδος της συλλογής 255. Αντίθετα, οι Joseph J και συν.…”