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Antibiotic levels in empyemic pleural fluid
L R Teixeira1, S A Sasse, M A Villarino
1Pulmonary Disease Program, Saint Thomas Hospital and Vanderbilt University, Nashville, TN 37202, USA.
Chest
|June 20, 2000
Summary
Antibiotic penetration into empyemic pleural fluid varied significantly in a rabbit model. Penicillin and metronidazole showed the best penetration, informing clinical treatment decisions for empyema.
Area of Science:
- Pharmacology
- Infectious Diseases
- Animal Models
Background:
- Empyema, a serious infection of the pleural space, requires effective antibiotic therapy.
- Understanding antibiotic penetration into infected pleural fluid is crucial for successful treatment outcomes.
Purpose of the Study:
- To evaluate the penetration of several key antibiotics into empyemic pleural fluid.
- To compare the efficacy of penicillin, metronidazole, ceftriaxone, clindamycin, vancomycin, and gentamicin in a rabbit empyema model.
Main Methods:
- Empyema was induced in New Zealand white rabbits by intrapleural injection of Pasteurella multocida.
- Antibiotics were administered intravenously after empyema confirmation.
- Pleural fluid and serum antibiotic levels were measured over time using a bioassay.
Main Results:
- Significant variability was observed in antibiotic penetration into empyemic pleural fluid.
- Penicillin demonstrated the highest and most rapid penetration, followed by metronidazole.
- Penicillin and metronidazole achieved the quickest equilibration, with penicillin levels remaining elevated in pleural fluid longer than serum levels.
Conclusions:
- The study highlights marked variations in antibiotic penetration into empyemic fluid in a rabbit model.
- These findings suggest that antibiotic selection for human empyema should consider the differential penetration into the pleural space, despite species differences.