Penetration of ofloxacin into heart valves, myocardium, mediastinal fat, and sternal bone marrow in humans

Abstract

Ofloxacin penetration into heart tissue (valve and myocardium), mediastinal fat, and sternal bone marrow was the object of a prospective nonrandomized study. Thirty-six patients undergoing mitral and/or aortic valve replacement were included. Patients were divided into two groups of 18 patients each. Group 1 patients were administered a single 400-mg intravenous dose of ofloxacin over a 30-min period upon anesthesia (n = 6) or at 1 h (n = 6) or 6 h (na-6) prior to surgery. Group 2 patients received a 200-mg oral dose of ofloxacin every 12 h during the 48 h preceding surgery. In this group, the final dose of ofloxacin was administered 3 h (n = 9) or 8 h (n = 9) before anesthesia. Plasma and tissue ofloxacin concentrations were assayed by high-pressure liquid chromatography. In group 1 patients, the peak level in plasma was 15.9 2.5 pg/ml. Peak ofloxacin levels in tissue were reached by hour 1 and were 8.89 2.16 pg/g in myocardium and 5 0.75 pg/g in heart valves. A significant decrease in ofloxacin levels in heart valve tissue and sternal bone marrow was observed after hour 3. Nevertheless, ofloxacin myocardial, heart valve, and sternal bone marrow levels remained higher than the MICs for the usually susceptible pathogens for at least 3 h. In group 2 patients, myocardial levels were long lasting (

Population Pharmacokinetics of Levofloxacin in Plasma and Bone of Patients Undergoing Hip or Knee Surgery

“…In the past, using population kinetics, others reported a volume of distribution of 0.836 L/kg and a clearance of 9.27 L/h in a North American population with a mean age of 46.9 years and a mean weight of 77.5 kg. 7,[22][23][24] In a previous report, 400 mg of levofloxacin was infused prior to cardiac surgery over a period of 30 minutes. 20 Although our clearance estimate of 0.16 L/h/kg is in reasonable agreement with the reported estimates, our estimated volume of distribution of 0.84 L/kg is close to the one described by Preston et al 19 and slightly higher than the value of 0.58 L/kg determined in highly obese patients.…”

“…19 In a Japanese population with normal renal function (mean age, 47 years; mean weight, 56.7 kg), a volume of distribution of 1.46 L/kg and a clearance of 0.178 L/h/kg were described. 22 In treatment trials of chronic osteomyelitis, levofloxacin was clinically effective in 60% to 84% of the patients. 21 Several previous investigators have studied concentrations of DNA gyrase inhibitors in bone, and there is consensus that gyrase inhibitors enter bone well.…”

“…21 Several previous investigators have studied concentrations of DNA gyrase inhibitors in bone, and there is consensus that gyrase inhibitors enter bone well. 7,[22][23][24] In a previous report, 400 mg of levofloxacin was infused prior to cardiac surgery over a period of 30 minutes. This led to peak plasma concentrations of about 16 μg/mL and concentration in the bone (sternal bone marrow) of about 5 μg/g (within 1 hour) that gradually declined.…”

Fluoroquinolone Antibiotics Having the Potential to Interfere with Fluorescence‐Based Diagnosis†

“…Steady-state serum concentration following administration of 4 · 400 mg doses reached 12.7 nmol mL )1 (26). In one study (27) a single 400 mg dose resulted in a plasma concentration of 44 nmol mL )1 with corresponding concentrations in the myocardium and heart valves of 14.6 and 13.8 nmol g )1 , respectively. Table 1 were derived from the work of Villette et al (28) who examined primary cultures of normal and tumoral esophageal epithelium cells.…”

“…Steady‐state serum concentration following administration of 4 × 400 mg doses reached 12.7 nmol mL −1 (26). In one study (27) a single 400 mg dose resulted in a plasma concentration of 44 nmol mL −1 with corresponding concentrations in the myocardium and heart valves of 14.6 and 13.8 nmol g −1 , respectively.…”