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Antibacterial and mezlocillin-enhancing activity of pure human pancreatic fluid
C Bassi1, R Fontana, S Vesentini
1Surgical Department, University of Verona, Borgo Roma Hospital, Italy.
Abstract:
The majority of deaths in severe pancreatitis are the result of superinfection of necrotic tissue. The pathogen most commonly responsible for such infections is Escherichia coli. Antibiotic prophylaxis would appear a logical precaution. The antibacterial drugs of choice should possess two basic characteristics: they must be active against the flora responsible for the infections and must be capable of penetrating into the pancreas at adequate minimum inhibitory concentrations (MICs). Mezlocillin--which is active against E. coli--has been shown to possess the latter requisite, but achieving therapeutic concentrations requires administration at high doses. In the present study, pure human pancreatic fluid showed properties similar to those observed in the dog against E. coli (bacterial colony growth 100 times lower than in a control culture) and produced a 75% reduction in mezlocillin MICs against this organism. These enhancing characteristics might make the commonly used doses sufficient for prophylactic purposes.
Insights
Antibiotic prophylaxis can prevent deaths from severe pancreatitis superinfections. Human pancreatic fluid enhances mezlocillin activity against Escherichia coli, potentially allowing lower, effective doses for prophylaxis.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Severe pancreatitis frequently leads to death due to superinfection of necrotic tissue.
- Escherichia coli is the most common pathogen responsible for these superinfections.
- Antibiotic prophylaxis is a logical preventive strategy.
Purpose of the Study:
- To evaluate the effect of human pancreatic fluid on the activity of mezlocillin against Escherichia coli.
- To determine if pancreatic fluid can enhance mezlocillin's efficacy for prophylactic use in severe pancreatitis.
Main Methods:
- Assessing the growth of Escherichia coli in pure human pancreatic fluid.
- Determining the minimum inhibitory concentrations (MICs) of mezlocillin against Escherichia coli in the presence of pancreatic fluid.
Main Results:
- Human pancreatic fluid significantly inhibited Escherichia coli growth (100-fold reduction compared to control).
- Pancreatic fluid reduced mezlocillin MICs against Escherichia coli by 75%.
- Mezlocillin demonstrated activity against E. coli, but high doses were previously needed for adequate pancreatic penetration.
Conclusions:
- Human pancreatic fluid possesses properties that enhance mezlocillin's antibacterial activity.
- These enhancing characteristics may enable commonly used mezlocillin doses to be sufficient for prophylactic purposes in severe pancreatitis.
- Further research may support mezlocillin as an effective prophylactic agent against E. coli superinfections in pancreatitis.