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[Diffusion of piperacillin into the sinuses of patients with nosocomial sinusitis]
L Holzapfel1, F Jehl, P Miranda
1Service de Réanimation, Centre Hospitalier, Bourg-en-Bresse.
Abstract:
Six mechanically ventilated patients with nosocomial sinusitis received an intravenous infusion of 4 g of piperacillin. Piperacillin concentrations were measured in the serum and in drained sinusal fluid 1, 2, 3, 4, 6 and 8 hours after the beginning of the infusion. A peak piperacillin level of 33 mg/l was obtained 30 minutes after the end of administration, and concentrations of 14 mg/l or more persisted for up to 8 hours. It is concluded that piperacillin can be used to treat patients with nosocomial sinusitis.
Insights
Piperacillin effectively treats nosocomial sinusitis in mechanically ventilated patients. Intravenous piperacillin achieved therapeutic sinusal fluid concentrations lasting up to 8 hours, supporting its clinical use.
Area of Science:
- Pharmacology and Infectious Diseases
- Critical Care Medicine
Background:
- Nosocomial sinusitis is a complication in mechanically ventilated patients.
- Effective antibiotic treatment is crucial for managing sinonasal infections in this population.
Purpose of the Study:
- To evaluate piperacillin concentrations in serum and sinusal fluid.
- To determine the efficacy of piperacillin for treating nosocomial sinusitis.
Main Methods:
- Intravenous infusion of 4g piperacillin in six mechanically ventilated patients.
- Measurement of piperacillin levels in serum and sinusal fluid at serial time points (1-8 hours).
Main Results:
- Peak serum piperacillin level of 33 mg/l achieved 30 minutes post-infusion.
- Therapeutic piperacillin concentrations (≥14 mg/l) persisted in sinusal fluid for up to 8 hours.
Conclusions:
- Piperacillin demonstrates favorable pharmacokinetic properties in sinonasal tissues.
- Intravenous piperacillin is a viable treatment option for nosocomial sinusitis.