Penetration of antibiotics into respiratory tree

Bergogne-Bérézin, E

doi:10.1093/jac/8.3.171

Cited by 54 publications

(41 citation statements)

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“…In cases of lower respiratory tract infections, chemical analysis of sputum (6,9,28) and analyses of tissue biopsy specimens and bronchoalveolar lavage fluid (15,32), epithelial lining fluid (4,35), and alveolar macrophages (12,13) have been performed to obtain information about the penetration of antibiotics into the lungs (3,16). However, the determination of concentrations of antibiotics in sputum is unreliable.…”

Section: Discussionmentioning

confidence: 99%

“…However, the determination of concentrations of antibiotics in sputum is unreliable. Various studies demonstrated considerable variability in the absolute concentrations of antimicrobial agents in sputum, even when identical classes of antimicrobial agents were considered (6,9,28). Furthermore, although the determination of antibiotic concentrations in bronchial biopsy specimens is comparatively easy and shows better reproducibility than sputum analysis, it has limited clinical relevance, since it provides no information on the relative drug concentration in the interstitial fluid.…”

Section: Discussionmentioning

confidence: 99%

“…Concentrations of antibiotics have been measured in sputum samples (6,9,19,28), bronchoscopically harvested biopsy specimens, and bronchoalveolar lavage fluids (15,32). More sophisticated approaches include the determination of antibiotic concentrations in epithelial lining fluid (4,35) or in alveolar macrophages (12,13).…”

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confidence: 99%

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Penetration of Meropenem into Pneumonic Human Lung Tissue as Measured by In Vivo Microdialysis

Tomaselli

Maier

Matzi

et al. 2004

Antimicrob Agents Chemother

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Until recently, information on antibiotic pharmacokinetic properties in infected human lung tissue was limited. We therefore studied a microdialysis-based approach for measurement of the penetration of meropenem into the extracellular space fluid of human pneumonic lung parenchyma. The lung penetration of meropenem was determined for seven patients with pneumonia and metapneumonic pleural empyema treated by decortication. Intraoperatively, two microdialysis probes were inserted into pneumonic lung tissue and one was inserted into healthy skeletal muscle for reference values.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Penetration of Meropenem into Pneumonic Human Lung Tissue as Measured by In Vivo Microdialysis

Tomaselli

Maier

Matzi

et al. 2004

Antimicrob Agents Chemother

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“…These pathogens are capable of causing pulmonary infections (3,4,8). Successful treatment of bacterial pneumonia depends on adequate delivery of antibiotic into the area of infection (1,9,12), yet little is known about the penetration of vancomycin into lung tissue (10). Lymph is considered identical in composition to the interstitial fluid that is its source (16).…”

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confidence: 99%

“…Several alternative approaches, all with limitations, have been used to estimate tissue penetration. Sputum and bronchial studies show wide variations in results, possibly because of sample 10%), cefoxitin (25%), cefuroxime (18%), and cefotaxime (25%) (1,2,17). The penetration of tetracycline antibiotics itito bronchial secretions varies widely, as shown with minocycline (37%), doxycycline (18%), and rolitetracycline (71%).…”

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confidence: 99%

Vancomycin entry into lung lymph in sheep

May

Stratton

Denney

et al. 1987

Antimicrob Agents Chemother

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The distribution of antibiotics into target tissues is a crucial factor in therapeutic efficacy. To estimate the availability of systemically administered vancomycin to the interstitial fluid in the lung, we have used a sheep model with a chronic pulmonary lymph fistula to collect simultaneously series of plasma and pulmonary lymph specimens during a 6-h period after an intravenous dose of vancomycin (7 mg/kg). After a minor delay in transit from blood to lymph, vancomycin was completely distributed to pulmonary lymph with a ratio of free drug in lymph to free drug in plasma of 0.9. This suggests that vancomycin is an excellent choice for treating pulmonary infections by susceptible organisms.Vancomycin is a glycopeptide antibiotic widely used to treat infections caused by staphylococci and enterococci. These pathogens are capable of causing pulmonary infections (3,4,8 RESULTS Peak levels in serum were comparable to those achieved in humans after a single dose of 7.0 mg/kg (7, 11). Immediately after infusion, total (bound plus free) vancomycin concentration in lymph was approximately 65% of total concentration in plasma. After a 30-min lag, total vancomycin concentration in lymph was at least 80% of the corresponding total concentration in plasma. Elimination of vancomycin from both sheep plasma and lymph appeared to be a multiexponential process (Fig. 1). Terminal half-lives and their associated rate constants in plasma and lymph were similar. Protein concentrations were slightly lower than those of 1689

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Respiratory Tract Penetration of Quinolone Antimicrobials: A Case in Study

Ritrovato,

Deeter

1991

Pharmacotherapy

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Antimicrobial lung penetration is thought to be predictive of efficacy in the treatment of lower respiratory tract infections. Lung penetration studies are commonly conducted with new antimicrobial agents to elucidate their potential utility in treating such infections. Although some very useful information may emerge, these studies are complicated by technical difficulties, theoretical assumptions, and numerous intricacies. Many studies describing quinolone penetration into saliva, sputum, bronchial secretions, and lung tissue have been published. In general, quinolone concentrations in lung tissue are 1.5–4 times the serum levels, whereas those in sputum and bronchial secretion are equal to or less than serum, and penetration into saliva is even less. The failure rate predicted from saliva, sputum, and bronchial secretion penetration and marginal in vitro activity of quinolones against streptococci does not consistently correlate with clinical efficacy data. In light of such conflicting data and the high lung tissue penetration of quinolones, the relevance of saliva, sputum, and bronchial secretion studies should be reevaluated. The utility of investigational quinolones in the treatment of lower respiratory tract infections can be determined only by well‐designed clinical trials.

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Penetration of antibiotics into respiratory tree

Cited by 54 publications

References 0 publications

Penetration of Meropenem into Pneumonic Human Lung Tissue as Measured by In Vivo Microdialysis

Penetration of Meropenem into Pneumonic Human Lung Tissue as Measured by In Vivo Microdialysis

Vancomycin entry into lung lymph in sheep

Respiratory Tract Penetration of Quinolone Antimicrobials: A Case in Study

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