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

Abstract

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.

Tissue and Plasma Concentrations of Antibiotic During Cardiac Surgery With Cardiopulmonary Bypass - Microdialysis Study

“…Haemodilution, hypothermia, redistribution of blood fl ow in the peripheral tissue, isolation of the lungs from the circulation, sequestration in the CPB equipment, decreased renal function, diminished protein binding, reduced clearance, changes in volume of distribution, the activation of the systemic infl ammatory reaction are factors that may alter the pharmacokinetic behaviour of antibiotics [16][17][18] . In the past various methods were developed to quantify the penetration of antibiotics into soft tissue, but major disadvantages of the these methods (skin blister fl uid method, biopsy and the tissue homogenisation, imaging procedures such as a positron emission tomography or magnetic resonance imaging) are limitations for tissue pharmacokinetic studies as well as inability to discriminate between free and bound fractions 19,20 . In the present study, we used in vivo microdialysis measurement of antibiotic tissue concentrations during the cardiac operation.…”

Importance of Relating Efficacy Measures to Unbound Drug Concentrations for Anti-Infective Agents

“…Improvements in the methodology used to sample ELF drug concentrations have addressed known limitations of the technique (144), namely, the inaccuracies associated with quantifying the ELF volume and the inability to sample the same site multiple times (145). Microdialysis has also been applied as a means to quantify lung concentrations of antimicrobials in human subjects (83,85,94,142,146,147). However, a limitation of the technique in this setting is that pulmonary infections may be located in different compartments (e.g., alveoli, bronchioles, and intracellularly) (148).…”

Lung microdialysis—A powerful tool for the determination of exogenous and endogenous compounds in the lower respiratory tract (mini-review)

“…8 To avoid the risk of pneumothorax, the performance of thoracotomy is inevitable ( Figure 2 ); thereby limiting MD experiments in the human lung to elective thoracic surgery. [9][10][11] However, if the MD probe is properly implanted under direct vision during conventionally performed lung surgery, no adverse events or clinical complications related to MD have been reported. [9][10][11] Lung MD in clinical studies was performed in spontaneously breathing patients after the end of the surgical procedures.…”

“…[9][10][11] However, if the MD probe is properly implanted under direct vision during conventionally performed lung surgery, no adverse events or clinical complications related to MD have been reported. [9][10][11] Lung MD in clinical studies was performed in spontaneously breathing patients after the end of the surgical procedures. In these studies fl exible custom-made MD probes (Metalant AB, Stockholm, Sweden) with a total length of ~50 cm to allow for pulmonal movement due to respiration were employed.…”