[Excretion of beta-lactam antibiotics in human parotid saliva]

We investigated the penetration of beta-lactam antibiotics into parotid saliva after intravenous administration. Neither mezlocillin nor oxacillin could be detected in parotid saliva, but cefotaxime (CTX) and cefotiam (CTM) penetrated parotid saliva very well. While salivary CTM concentrations reached peak values (9.52 +/- 3.4 mg/l) within 30 min of the end of infusion, the highest CTX concentrations in parotid saliva (5.84 +/- 2.6 mg/l) were observed after 90 min. After 300 min the salivary CTM levels were below the limit of detection, while the mean CTX concentration even 360 min after the end of infusion was 2.27 +/- 1.23 mg/l. Both CTX and CTM achieve salivary concentrations that are inhibitory against the prevailing pathogens causing suppurative parotitis, and thus promise to be effective for the treatment of this disease. Furthermore, the excretion of comparatively high concentrations of both drugs into the mouth achieves a selective decontamination of the mucosal surfaces of the upper aerodigestive tract so that they are suitable for perioperative prophylaxis in head and neck surgery.