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[Diffusion of ciprofloxacin into bronchial secretions in mechanically ventilated patients]
1Département d'Anesthésie-Réanimation, Hôpital Sainte-Marguerite, Marseille.
Abstract:
The aim of the study was to evaluate, in clinical conditions, the penetration of ciprofloxacin into bronchial secretions. Eight patients were included in the study. They presented with nosocomial pneumonia and were under controlled mechanical ventilation. Ciprofloxacin was given at a dose of 3 mg/kg over 30 min. Serial bronchial and blood samples were obtained over a 12 hour period on day 2 and 4. Ciprofloxacin was measured by HPLC. Serum peak levels were 2.95 +/- 1 mg/l on day 2, and 2.43 +/- 0.7 mg/l on day 4. Bronchial peak and through levels were 0.95 +/- 0.51 mg/l and 0.21 +/- 0.12 mg/l, respectively, on day 2, and 0.76 +/- 0.17 mg/l and 0.18 +/- 0.14 mg/l, respectively, on day 4. The ratio of bronchial/serum peak was 0.32 +/- 0.11 and 0.33 +/- 0.06 on day 2 and 4, respectively. The ratio of AUC 0-12 h in the bronchial secretions/AUC 0-12 h in the serum samples was 0.66 +/- 0.04 and 0.55 +/- 0.27 on day 2 and 4, respectively.
Insights
This study shows ciprofloxacin effectively penetrates bronchial secretions in patients with nosocomial pneumonia. Bronchial concentrations achieved therapeutic levels, suggesting efficacy for respiratory infections.
Area of Science:
- Pharmacokinetics
- Respiratory Medicine
- Infectious Diseases
Context:
- Nosocomial pneumonia is a significant concern in mechanically ventilated patients.
- Evaluating antibiotic penetration into respiratory secretions is crucial for treatment efficacy.
- Ciprofloxacin is a commonly used antibiotic for bacterial infections.
Purpose:
- To assess the penetration of ciprofloxacin into bronchial secretions in patients with nosocomial pneumonia.
- To quantify ciprofloxacin concentrations in serum and bronchial secretions over time.
- To determine the ratio of bronchial to serum ciprofloxacin levels.
Summary:
- Ciprofloxacin was administered intravenously to eight mechanically ventilated patients with nosocomial pneumonia.
- Serial blood and bronchial secretion samples were collected on days 2 and 4 post-administration.
- High-performance liquid chromatography (HPLC) was used to measure ciprofloxacin concentrations.
- Serum peak levels ranged from 2.43 to 2.95 mg/l.
- Bronchial secretion peak levels ranged from 0.76 to 0.95 mg/l.
- The ratio of bronchial to serum peak concentrations was approximately 0.32-0.33.
- The ratio of the area under the concentration-time curve (AUC) in bronchial secretions to serum AUC was 0.55-0.66.
Impact:
- Findings suggest that ciprofloxacin achieves adequate concentrations in bronchial secretions to potentially treat nosocomial pneumonia.
- This pharmacokinetic data can inform optimal dosing strategies for ciprofloxacin in respiratory infections.
- Further clinical studies are warranted to confirm the therapeutic efficacy of ciprofloxacin for this indication.