Periodontal Tissue Disposition of Azithromycin

Malizia, Tecla; Tejada, M.; Ghelardi, Emilia; Senesi, Sonia; Gabriele, Mario; Giuca, Maria Rita; Blandizzi, Corrado; Danesi, Romano; Campa, Mario; Tacca, M. Del

doi:10.1902/jop.1997.68.12.1206

Cited by 56 publications

(41 citation statements)

References 10 publications

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“…9 Consistent concentrations were noted for up to 6.5 days, indicating the retention of this antimicrobial agent in target tissues. 10 Because postoperative infection usually develops during the first few weeks, we focused on the effect of high and sustained tissue concentrations in impacted mandibular third-molar surgery, which often results in the development of dry socket infection.…”

Section: Discussionmentioning

confidence: 99%

Azithromycin as prophylaxis for the prevention of postoperative infection in impacted mandibular third-molar surgery

Ishihama

Kimura

Yasui

et al. 2006

Journal of Infection and Chemotherapy

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Section: Discussionmentioning

confidence: 99%

Azithromycin as prophylaxis for the prevention of postoperative infection in impacted mandibular third-molar surgery

Ishihama

Kimura

Yasui

et al. 2006

Journal of Infection and Chemotherapy

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“…Azithromycin was extracted from plasma and tissue samples as previously described, and its concentration was measured by agar diffusion bioassay using Micrococcus luteus NCTC 8440 (8). Different dilutions of each extract were assayed.…”

mentioning

confidence: 99%

Distribution of Azithromycin in Plasma and Tonsil Tissue after Repeated Oral Administration of 10 or 20 Milligrams per Kilogram in Pediatric Patients

Blandizzi¹,

Malizia²,

Batoni³

et al. 2002

Antimicrob Agents Chemother

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Azithromycin concentrations in the tonsils of 56 pediatric patients, treated with 10 or 20 mg of the drug per kg of body weight for 3 days, were compared. Azithromycin levels in plasma and tonsil samples were determined up to 8.5 days after the last dose. The 20-mg/kg regimen resulted in an improved tonsillar distribution of azithromycin, suggesting the achievement of enhanced therapeutic concentrations at infective sites of the upper respiratory tract.Azithromycin, the prototype of azalides, possesses peculiar pharmacokinetics, consisting of high distribution into target tissues (4), and displays a broad antimicrobial spectrum (12). Guidelines for azithromycin MICs have established that breakpoints of Յ2, 4, and Ն8 mg/liter indicate susceptible, intermediately resistant, and resistant bacteria, respectively (7).Studies with adults have suggested that once-daily dosing with 500 mg for 3 days should maintain tonsillar azithromycin levels higher than 2 mg/kg of body weight for 10 days (3, 4). In pediatric patients, a 3-day treatment with 10 mg/kg allows a tonsillar azithromycin distribution similar to that of adults (15). Cure and improvement rates of 93 to 100% were obtained in children with bacterial pharyngitis and/or tonsillitis treated with 10 mg of azithromycin/kg for 3 days (7). However, lower success rates have also been reported (2, 11).After oral administration, azithromycin undergoes a rapid uptake from systemic circulation into phagocytes, which then release the drug at infection sites, exposing local extracellular compartments to azithromycin concentrations higher than plasma levels (5, 6). On this basis, azithromycin administration at doses higher than standard regimens might improve eradication rates in pharyngitis and tonsillitis. Accordingly, this study compared azithromycin concentrations in tonsils collected from pediatric patients treated with 10 or 20 mg/kg daily for 3 days.The study was performed with children scheduled to undergo surgical tonsil removal. The exclusion criteria were history of drug allergy; drug treatments, including antimicrobials, nonprescription drugs, or enzymatic inducers and/or inhibitors within the previous 2 weeks; conditions affecting drug absorption (vomiting, diarrhea, malabsorption); and major medical problems. Informed consent was obtained from parents or legal guardians. The investigation was approved by the local University Hospital Ethics Committee. Fifty-six patients (30 males, 26 females; age range, 4 to 12 years; mean age, 6.46 Ϯ 0.32 years [mean Ϯ standard deviation]) entered the study. They were assigned to two groups, balanced for sex and age, and were treated once daily with azithromycin in an oral suspension (Zitromax; Pfizer Italiana, Rome, Italy) at 10 or 20 mg/kg for 3 days. Patients underwent surgery from 0.5 to 8.5 days after the last dose. Standard anesthesiological procedures and perioperative medications were applied. All surgical procedures were performed by the same surgeon (P.B.). Plasma samples (2 ml) were collected before surgery. Specimen...

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“…7 In a study on the tissue penetration of azithromycin in patients undergoing surgery for third-molar removal, drug concentrations in plasma, saliva, gingiva and alveolar bone were evaluated. 26 Azithromycin concentrations detected in periodontal tissues and saliva were significantly higher than those found in plasma. The concentrations found in both saliva and the periodontal tissues were also greater than the MIC of most susceptible pathogens commonly involved in odontogenic infections.…”

Section: Therapeutic Usesmentioning

confidence: 87%

“…[23][24][25][26][27][28][29] Azithromycin shows good bacteriostatic in-vitro activity against a wide variety of micro-organisms found in the mouth, 30 with a broad spectrum of activity towards anaerobic bacteria as well as Gram-negative bacilli. 31 One of the problems associated with using systemic antimicrobials for the adjunctive management of odontogenic infections is patient compliance.…”

Section: Therapeutic Usesmentioning

confidence: 99%