Penetration of ceftazidime into human tissue in patients undergoing cardiac surgery

Adam, Dieter; Reichart, Bruno; Williams, K.J.

doi:10.1093/jac/12.suppl_a.269

Cited by 16 publications

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“…After a single intravenous dose of 2 g of ceftazidime it was found that in the myometrium, endometrium and salpinges, the tissue penetration is similar (0.34±0.43 quotient tissue/serum) to that we found in lung [6]. The concentration in cardiac muscle is 33% of that in serum and that in bone 60% [1]. In the mouse, the per centage penetration of ceftazidime from serum into the lung tissue is 17% and for the rabbit it is 11.3 % [9,10].…”

Section: Discussionsupporting

confidence: 69%

“…Many ways have been described for trying to eliminate it from the samples of lung tissue, such as drying them with a gauze, washing them repeat edly, expressing them, etc. [1,6], We washed and dried the samples but even so the homogenate showed a high content of hemoglobin (from 6.5 to 66.6% compared to that of blood), which has posed a statis tically significant correction factor in all the samples and in some cases also in the mean values. On the contrary other au thors hold that the blood content of the samples of tissue is of less importance [1].…”

Section: Discussionmentioning

confidence: 99%

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Penetration of Cefuroxime and Ceftazidime into Human Lungs

Ej¹,

Ayarra²,

Iglesias³

et al. 1988

Chemotherapy

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We have studied the penetration of cefuroxime and ceftazidime into lung tissue of 40 patients subjected to pulmonary surgery. Samples of blood and lung tissue were taken 1 and 2 h after antibiotic administration. Patients were randomly assigned to four dosage schedule groups: group A received a single intravenous injection of 750 mg cefuroxime; the lung tissue levels at 1 and 2 h were 9.6 ± 3.1 and 4.54 ± 2.64 μg/g of cefuroxime; the percentage penetration from serum into the lung tissue was 33.7 and 34.6%, respectively. Group B patients received three doses of 750 mg cefuroxime; lung tissue levels were 17.1 ± 7.7 and 14.7 ± 5.4 μg/g, the percentage of penetration being 89.1 and 102.8% at 1 and 2 h. Group C received a single intravenous injection of 1 g ceftazidime; the lung tissue levels were 16.3 ± 10.1 and 10 ± 5.04 μg/g; the percentage of penetration from serum was 38.3 and 35.3%. Group D received three doses of 1 g ceftazidime; the lung tissue concentrations were 11.98 ± 7.5 and 8.5 ± 7.3 μg/g and the percentage of penetration 35.1 and 32.2% at 1 and 2 h after last dose.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Penetration of Cefuroxime and Ceftazidime into Human Lungs

Ej¹,

Ayarra²,

Iglesias³

et al. 1988

Chemotherapy

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“…Aztreonam concentrations in cancellous bone (mean, 20% of that in concomitant serum) are similar to those of moxalactam (18%) (21), cefazolin (18%) (21), cefadroxil (23%) (23), cephalothin (5 to 33%) (7,9,26), cefamandole (5 to 20%) (18,24,26), cefuroxime (10 to 70%) (7), clindamycin (10 to 50%) (1,28), ceftazidime (54%) (1), and amoxicillin (16.4%) (2). However, the ranges for all these antibiotics were very wide (25,28), with some specimens showing no detectable concentrations.…”

mentioning

confidence: 69%

“…In general, single-dose (versus multiple-dose) studies (8,21) and studies that corrected for blood contamination (1,21,24) detected lower penetration values. In dogs, cefazolin, penicillin, and cefamandole in serum rapidly equilibrate with the interstitial fluid of bone (5,11,16).…”

mentioning

confidence: 97%

Aztreonam penetration into synovial fluid and bone

MacLeod¹,

Bartley²,

Jo³

et al. 1986

Antimicrob Agents Chemother

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Eighteen patients with uncomplicated degenerative joint disease requiring joint replacement (hip or knee) were given a single 2-g intravenous dose of aztreonam over a 5-min period preoperatively. The mean concentration in synovial fluid of 83.0 9.2 >g/ml averaged 0.99 times the concomitant levels in serum. The mean concentration in cancellous bone of 16.0 4.3 Lg/g averaged 0.20 times the concomitant levels in serum.The increasing incidence of gram-negative bone and joint infections (14,19), particularly in patients with underlying diseases (13), combined with a higher incidence of poor therapeutic outcome in patients with such infections treated with available antimicrobial agents (10,29) (17), except that the samples were pulverized with a Spex freezer-mill prior to assay. The limit of detection of the assay was 0.1 ,ug/g of bone. The coefficient of variation and mean recovery from standards were 8.0 and 79.0%, respectively.Bone samples were prepared for high-pressure liquid chromatography by a procedure identical to that used for the bioassay and then filtered (Millex; 0.45 pum [pore size]; Millipore Corp., Bedford, Mass.). They were then analyzed with a high-pressure liquid chromatography system consisting of an Altex model 11OA pump set for 2 ml/min, a 37-to 50-,um silica gel precolumn, a 30-to 38-,um C18 guard column, a Waters Associates, Inc., 10-,um ,Bondpak analytical column (150 by 3.9 mm), and a UV detector set for 290 nm. The mobile phase was 85 parts 5 mM tetrabutylammonium sulfate, adjusted to pH 2.85 with 1 M KH2PO4, and 15 parts acetonitrile. Samples were introduced via a 20-,u precision loop injector. The limit of detection was 1 ,ug/g, the coefficient of variation was 8.1%, and the mean recovery from standards was 87.0%.The method used for microbiological assay of synovial fluid was identical to that previously reported for urine (20), except that samples were diluted 1:20 in 0.1 M phosphate buffer (pH 6) prior to assay. The limit of detection was 0.4 ,g/ml. The coefficient of variation and mean recovery were 3.5 and 98%, respectively. The high-pressure liquid chromatographic assay of synovial fluid was done by a method identical to that previously reported for serum (20). The limit of detection was 0.5 ,ug/ml. The coefficient of variation and recovery from standards were 8.5 and 98%, respectively.Assays of hemoglobin in blood, bone, and synovial fluid and correction of aztreonam concentrations for blood contamination were performed by previously described methods (17). Samples whose blood contents were 51% or more were excluded from analysis. No specimens suitable for assay could be obtained from patient 6.Results of the aztreonam assays are listed in Table 1. The mean concentration in serum at the time of bone and synovial fluid removal was 78 ,ug/ml. The mean concentration in bone was 16 ,ug/g. Concentrations of aztreonam in individual bone specimens were variable but showed a 710

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“…This factor could therefore account for a more rapid trans port and distribution of antibiotic into heart muscle and heart muscle fluid. In this regard, a recent clinical study in pa tients undergoing cardiac surgery [1] sug gested that ceftazidime concentrations in cardiac muscle were slightly but not sig nificantly higher than in skeletal muscle.…”

Section: Discussionmentioning

confidence: 95%

Comparative Penetration of Ceftazidime into Cardiac and Skeletal Muscle in Rabbits

McColm¹,

Ryan²

1986

Chemotherapy

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The concentrations of ceftazidime attained in cardiac and leg muscles of rabbits were compared after a single intramuscular injection of 100 mg/kg. Simultaneous measurements of muscle and muscle fluid over an 8-hour period showed that ceftazidime penetrated heart muscle more rapidly and to a greater extent than leg muscle. Although the half-lives did not vary, the areas under the time/concentration curves for heart muscle and heart muscle fluid were significantly greater than those for leg muscle and leg muscle fluid. It is suggested that an increased fluid content and vascularity of cardiac muscle may explain these results. This study also confirms previous reports that whole muscle tissue levels of β-lactam antibiotics substantially underestimate the actual concentrations present in the extracellular fluid.

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Penetration of ceftazidime into human tissue in patients undergoing cardiac surgery

Cited by 16 publications

References 0 publications

Penetration of Cefuroxime and Ceftazidime into Human Lungs

Penetration of Cefuroxime and Ceftazidime into Human Lungs

Aztreonam penetration into synovial fluid and bone

Comparative Penetration of Ceftazidime into Cardiac and Skeletal Muscle in Rabbits

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