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Penetration of clarithromycin in experimental pleural empyema model fluid.
Respiration 2005 May-Jun; 72(3):296-300R

Abstract

BACKGROUND

The degree of penetration of clarithromycin into the pleural fluid has not been studied.

OBJECTIVE

To determine the degree to which clarithromycin penetrates into empyemic pleural fluid using a new rabbit model of empyema.

METHODS

An empyema was created via the intrapleural injection of 1 ml turpentine followed 24 h later by instillation of 5 ml (10(10)) Escherichia coli bacteria (ATCC 35218) into the pleural space of New Zealand white rabbits. After an empyema was verified by thoracentesis and pleural fluid analysis, clarithromycin 30 mg/kg was administered intravenously. Antibiotic levels were determined on samples of pleural fluid and blood samples collected serially over 12 h. Antibiotic levels were estimated using HPLC.

RESULTS

The antibiotic penetrated well into the empyemic pleural fluid (AUC(PF)/AUC(serum) ratio of 1.57). The time to equilibration between the pleural fluid and blood antibiotic levels was 8 h. The peak pleural fluid level (Cmax(PF) of 2.88 microg/ml) occurred 1 h (Tmax(PF) of 1 h) after infusion and decreased thereafter. The Cmax(serum) was 3.53 microg/ml at 1 h after administration.

CONCLUSION

The levels of clarithromycin in the pleural fluid after intravenous administration are inhibitory for most of the usual pathogens causing empyema. The degree of penetration of clarithromycin should be considered when macrolides are selected for the treatment of patients with empyema.

Authors+Show Affiliations

2nd Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.No affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

15942299

Citation

Liapakis, I E., et al. "Penetration of Clarithromycin in Experimental Pleural Empyema Model Fluid." Respiration; International Review of Thoracic Diseases, vol. 72, no. 3, 2005, pp. 296-300.
Liapakis IE, Light RW, Pitiakoudis MS, et al. Penetration of clarithromycin in experimental pleural empyema model fluid. Respiration. 2005;72(3):296-300.
Liapakis, I. E., Light, R. W., Pitiakoudis, M. S., Karayiannakis, A. J., Giamarellos-Bourboulis, E. J., Ismailos, G., ... Bouros, D. E. (2005). Penetration of clarithromycin in experimental pleural empyema model fluid. Respiration; International Review of Thoracic Diseases, 72(3), pp. 296-300.
Liapakis IE, et al. Penetration of Clarithromycin in Experimental Pleural Empyema Model Fluid. Respiration. 2005;72(3):296-300. PubMed PMID: 15942299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Penetration of clarithromycin in experimental pleural empyema model fluid. AU - Liapakis,I E, AU - Light,R W, AU - Pitiakoudis,M S, AU - Karayiannakis,A J, AU - Giamarellos-Bourboulis,E J, AU - Ismailos,G, AU - Anagnostoulis,S, AU - Simopoulos,C E, AU - Bouros,D E, PY - 2004/06/29/received PY - 2004/09/30/accepted PY - 2005/6/9/pubmed PY - 2005/10/27/medline PY - 2005/6/9/entrez SP - 296 EP - 300 JF - Respiration; international review of thoracic diseases JO - Respiration VL - 72 IS - 3 N2 - BACKGROUND: The degree of penetration of clarithromycin into the pleural fluid has not been studied. OBJECTIVE: To determine the degree to which clarithromycin penetrates into empyemic pleural fluid using a new rabbit model of empyema. METHODS: An empyema was created via the intrapleural injection of 1 ml turpentine followed 24 h later by instillation of 5 ml (10(10)) Escherichia coli bacteria (ATCC 35218) into the pleural space of New Zealand white rabbits. After an empyema was verified by thoracentesis and pleural fluid analysis, clarithromycin 30 mg/kg was administered intravenously. Antibiotic levels were determined on samples of pleural fluid and blood samples collected serially over 12 h. Antibiotic levels were estimated using HPLC. RESULTS: The antibiotic penetrated well into the empyemic pleural fluid (AUC(PF)/AUC(serum) ratio of 1.57). The time to equilibration between the pleural fluid and blood antibiotic levels was 8 h. The peak pleural fluid level (Cmax(PF) of 2.88 microg/ml) occurred 1 h (Tmax(PF) of 1 h) after infusion and decreased thereafter. The Cmax(serum) was 3.53 microg/ml at 1 h after administration. CONCLUSION: The levels of clarithromycin in the pleural fluid after intravenous administration are inhibitory for most of the usual pathogens causing empyema. The degree of penetration of clarithromycin should be considered when macrolides are selected for the treatment of patients with empyema. SN - 0025-7931 UR - https://www.unboundmedicine.com/medline/citation/15942299/Penetration_of_clarithromycin_in_experimental_pleural_empyema_model_fluid_ L2 - https://www.karger.com?DOI=10.1159/000085371 DB - PRIME DP - Unbound Medicine ER -