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Fluconazole penetration into the pancreas
S Shrikhande1, H Friess, C Issenegger
1Department of Visceral and Transplantation Surgery, University of Bern, Switzerland.
Antimicrobial Agents and Chemotherapy
|August 22, 2000
Summary
Antibiotic prophylaxis for necrotizing pancreatitis increases fungal superinfections. Fluconazole (antifungal medication) shows sufficient penetration into pancreatic tissues, indicating its potential for treating fungal contamination in patients with pancreatic necrosis.
Area of Science:
- Pharmacology
- Gastroenterology
- Infectious Diseases
Background:
- Antibiotic prophylaxis for necrotizing pancreatitis is associated with an increased incidence of fungal superinfections.
- Pancreatic necrosis presents a significant clinical challenge, often complicated by secondary infections.
Purpose of the Study:
- To evaluate the penetration of fluconazole into human pancreatic tissue.
- To assess fluconazole concentrations in experimental models of acute pancreatitis.
Main Methods:
- Analysis of fluconazole concentrations in human pancreatic tissues obtained during surgery.
- Measurement of fluconazole levels in pancreatic tissue from experimental edematous and necrotizing pancreatitis models.
- Comparison of pancreatic fluconazole concentrations with simultaneous serum levels.
Main Results:
- Mean fluconazole concentration in human pancreatic tissue was 8.19 ± 3.38 microg/g, representing 96% of serum concentration.
- In experimental edematous pancreatitis, pancreatic fluconazole concentration reached 88% of serum levels.
- In experimental necrotizing pancreatitis, pancreatic fluconazole concentration was 91% of serum levels.
Conclusions:
- Fluconazole demonstrates adequate penetration into the pancreas in both human subjects and experimental models.
- These findings support the use of fluconazole for the prevention and treatment of fungal superinfections in patients with pancreatic necrosis.