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Antibiotic levels in empyemic pleural fluid.
Chest 2000; 117(6):1734-9Chest

Abstract

OBJECTIVE

To determine the degree to which bioactive penicillin, metronidazole, ceftriaxone, clindamycin, vancomycin, and gentamicin penetrate into empyemic pleural fluid using our new rabbit model of empyema.

METHODS

An empyema was created via the intrapleural injection of 10(8)()Pasteurella multocida bacteria into the pleural space of New Zealand white rabbits. After an empyema was verified by thoracentesis and pleural fluid analysis, penicillin, 24,000 U/kg; metronidazole, 37 mg/kg; ceftriaxone, 30 mg/kg; clindamycin, 9 mg/kg; vancomycin, 15 mg/kg; or gentamicin, 1 mg/kg, were administered IV. Antibiotic levels in samples of pleural fluid and serum, collected serially for up to 480 min, were then determined using a bioassay.

RESULTS

The degree to which the different antibiotics penetrated into the infected pleural space was highly variable. Penicillin penetrated most easily, followed by metronidazole, ceftriaxone, clindamycin, vancomycin, and gentamicin. Of the antibiotics tested, penicillin and metronidazole equilibrated the most rapidly with the infected pleural fluid. Penicillin levels remained elevated in pleural fluid even after serum levels had decreased.

CONCLUSIONS

Using this rabbit model of empyema, there was marked variation in the penetration of antibiotics into the empyemic fluid. Although there are species differences between rabbit and human pleura, the variance in degree of penetration of antibiotics into the pleural space should be considered when antibiotics are selected for the treatment of patients with empyema.

Authors+Show Affiliations

Pulmonary Disease Program, Saint Thomas Hospital and Vanderbilt University, Nashville, TN 37202, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10858410

Citation

Teixeira, L R., et al. "Antibiotic Levels in Empyemic Pleural Fluid." Chest, vol. 117, no. 6, 2000, pp. 1734-9.
Teixeira LR, Sasse SA, Villarino MA, et al. Antibiotic levels in empyemic pleural fluid. Chest. 2000;117(6):1734-9.
Teixeira, L. R., Sasse, S. A., Villarino, M. A., Nguyen, T., Mulligan, M. E., & Light, R. W. (2000). Antibiotic levels in empyemic pleural fluid. Chest, 117(6), pp. 1734-9.
Teixeira LR, et al. Antibiotic Levels in Empyemic Pleural Fluid. Chest. 2000;117(6):1734-9. PubMed PMID: 10858410.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibiotic levels in empyemic pleural fluid. AU - Teixeira,L R, AU - Sasse,S A, AU - Villarino,M A, AU - Nguyen,T, AU - Mulligan,M E, AU - Light,R W, PY - 2000/6/20/pubmed PY - 2000/7/25/medline PY - 2000/6/20/entrez SP - 1734 EP - 9 JF - Chest JO - Chest VL - 117 IS - 6 N2 - OBJECTIVE: To determine the degree to which bioactive penicillin, metronidazole, ceftriaxone, clindamycin, vancomycin, and gentamicin penetrate into empyemic pleural fluid using our new rabbit model of empyema. METHODS: An empyema was created via the intrapleural injection of 10(8)()Pasteurella multocida bacteria into the pleural space of New Zealand white rabbits. After an empyema was verified by thoracentesis and pleural fluid analysis, penicillin, 24,000 U/kg; metronidazole, 37 mg/kg; ceftriaxone, 30 mg/kg; clindamycin, 9 mg/kg; vancomycin, 15 mg/kg; or gentamicin, 1 mg/kg, were administered IV. Antibiotic levels in samples of pleural fluid and serum, collected serially for up to 480 min, were then determined using a bioassay. RESULTS: The degree to which the different antibiotics penetrated into the infected pleural space was highly variable. Penicillin penetrated most easily, followed by metronidazole, ceftriaxone, clindamycin, vancomycin, and gentamicin. Of the antibiotics tested, penicillin and metronidazole equilibrated the most rapidly with the infected pleural fluid. Penicillin levels remained elevated in pleural fluid even after serum levels had decreased. CONCLUSIONS: Using this rabbit model of empyema, there was marked variation in the penetration of antibiotics into the empyemic fluid. Although there are species differences between rabbit and human pleura, the variance in degree of penetration of antibiotics into the pleural space should be considered when antibiotics are selected for the treatment of patients with empyema. SN - 0012-3692 UR - https://www.unboundmedicine.com/medline/citation/10858410/Antibiotic_levels_in_empyemic_pleural_fluid_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(15)35171-0 DB - PRIME DP - Unbound Medicine ER -