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Human intestinal tissue antibiotic concentrations. Clindamycin, gentamicin, and mezlocillin
H Thadepalli1, M A Lou, R H Prabhala
1Department of Medicine, Martin Luther King, Jr. General Hospital, Charles R. Drew University of Medicine and Science, Los Angeles, California.
Abstract:
An antibiotic, to be effective for prophylaxis in abdominal trauma, should quickly achieve high concentrations in the intestinal wall and at enough inhibitory levels to kill most aerobic and anaerobic bacteria that are potential contaminants at the site of surgical incision. Therefore, we studied the intestinal tissue levels of clindamycin, gentamicin, and mezlocillin to see whether the tissue levels achieved by these antibiotics in the intestinal tissue were adequate. A single dose of mezlocillin, 4 grams; clindamycin, 600 mg and gentamicin, 80 mg; quickly reached the desired concentrations, i.e., 52.3, 9.69 and 6.1 micrograms/gram of intestinal tissue respectively. These levels were high enough to inhibit the growth of most isolates of E. coli and B. fragilis, common pathogens involved in intra-abdominal abscess.
Insights
Antibiotics like mezlocillin, clindamycin, and gentamicin achieve high intestinal tissue concentrations after a single dose, effectively inhibiting common pathogens like E. coli and B. fragilis for abdominal trauma prophylaxis.
Area of Science:
- Pharmacology
- Surgical Infection Prophylaxis
- Microbiology
Background:
- Effective antibiotic prophylaxis in abdominal trauma requires rapid, high concentrations in intestinal tissue.
- Targeting aerobic and anaerobic bacteria is crucial for preventing surgical site infections.
Purpose of the Study:
- To evaluate intestinal tissue concentrations of clindamycin, gentamicin, and mezlocillin.
- To determine if achieved antibiotic levels are adequate for prophylaxis in abdominal trauma.
Main Methods:
- Administration of a single dose of mezlocillin (4g), clindamycin (600mg), and gentamicin (80mg).
- Measurement of antibiotic concentrations in intestinal tissue.
Main Results:
- Rapid achievement of high concentrations: mezlocillin (52.3 µg/g), clindamycin (9.69 µg/g), and gentamicin (6.1 µg/g).
- Achieved levels were sufficient to inhibit common pathogens, including E. coli and B. fragilis.
Conclusions:
- Mezlocillin, clindamycin, and gentamicin demonstrate rapid and adequate intestinal tissue penetration for prophylaxis.
- These antibiotics effectively inhibit key pathogens involved in intra-abdominal abscesses.