Penetration of Clindamycin into Decubitus Ulcers

Berger, Stephen A.; Barza, Michael; Haher, Jane N.; McFarland, J; Louie, Samuel; Kane, Anne

doi:10.1128/aac.14.3.498

Cited by 13 publications

(2 citation statements)

References 2 publications

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“…Lower concentrations were measured in bone , skin , and adipose tissues [ 129 ], but they were higher than the MIC values of the most common pathogens. On the contrary, in 29 subjects with decubitus ulcers, the tissue/plasma ratios were 1X for both bone and skin 0.5–1.5 h after dosing [ 130 ]. In lower limb ischemia, the different rates of perfusion influenced the penetration of clindamycin 0.6 g q8h in muscle (0.4–0.5X), bone (0.2–0.3X), and skin (0.2–0.4X) [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review—Part II

et al. 2022

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In patients that are admitted to intensive care units (ICUs), the clinical outcome of severe infections depends on several factors, as well as the early administration of chemotherapies and comorbidities. Antimicrobials may be used in off-label regimens to maximize the probability of therapeutic concentrations within infected tissues and to prevent the selection of resistant clones. Interestingly, the literature clearly shows that the rate of tissue penetration is variable among antibacterial drugs, and the correlation between plasma and tissue concentrations may be inconstant. The present review harvests data about tissue penetration of antibacterial drugs in ICU patients, limiting the search to those drugs that mainly act as protein synthesis inhibitors and disrupting DNA structure and function. As expected, fluoroquinolones, macrolides, linezolid, and tigecycline have an excellent diffusion into epithelial lining fluid. That high penetration is fundamental for the therapy of ventilator and healthcare-associated pneumonia. Some drugs also display a high penetration rate within cerebrospinal fluid, while other agents diffuse into the skin and soft tissues. Further studies are needed to improve our knowledge about drug tissue penetration, especially in the presence of factors that may affect drug pharmacokinetics.

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Section: Resultsmentioning

confidence: 99%

Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review—Part II

et al. 2022

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“…In these patients, the additional presence of diabetes had no effect on the penetration of ceftazidime into the bone [67]. Yet another study found that bone levels of clindamycin often exceeded serum concentrations following a single 600-mg dose given before excision of a decubitus ulcer [68]. Fosfomycin, with activity against MRSA and Staphylococcus aureus, including both MSSA and MRSA, has, been shown to penetrate adequately into bone in DFI using the microdialysis technique [69].…”

Section: Osteomyelitis: Antibiotic Pharmacokinetic and Pharmacodynamimentioning

confidence: 99%

Pharmacotherapy of diabetic foot osteomyelitis

Byren

Peters

Hoey

et al. 2009

Expert Opinion on Pharmacotherapy

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Diabetic foot osteomyelitis (DFO) complicates about 20% of diabetic foot infections (DFIs) and increases the risk of lower extremity amputation. This contentious infection is important to discuss, given the frequency with which diabetes mellitus and its complications occur and the devastating consequences of amputation. The diagnosis and management of DFO is complicated by the diverse presentations, delayed recognition, poorly defined diagnostic criteria, and lack of validated treatment regimens. Major issues of concern include when to undertake bone resection surgery and which antimicrobial agents to use, by what route, and for how long. Patients in whom DFO is suspected are best cared for by a multidisciplinary team, including infectious disease physicians or clinical microbiologists, orthopaedic, plastic and vascular surgeons, diabetologists, primary care physicians, podiatrists and specialist (especially tissue viability) nurses. Such multidisciplinary teams have repeatedly been shown to improve disease outcomes. We herein analyse the limited, and recently published, literature on the pharmacotherapy of DFO and put it into the broader context of management of DFI and osteomyelitis.

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Antimicrobial Therapy

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1985

Pediatric Infectious Diseases for the Practitioner

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Penetration of Clindamycin into Decubitus Ulcers

Cited by 13 publications

References 2 publications

Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review—Part II

Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review—Part II

Pharmacotherapy of diabetic foot osteomyelitis

Antimicrobial Therapy

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