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[Bronchopulmonary penetration of ciprofloxacin]
1Medizinische Universitätsklinik Bonn.
Abstract:
We determined ciprofloxacin levels in plasma, saliva, bronchial secretions, lavage fluid, and alveolar macrophages in 9 patients five hours following the last administration of the drug (2 x 750 mg ciprofloxacin daily over a period of at least 3 days). The ciprofloxacin concentration in the alveolar film was determined using urea as internal marker for the lavage. On average it was 2.51 micrograms/ml (= 186% of the plasma level), and clearly exceeded the minimal inhibition concentrations for the facultative pathogenic organism. This means that, in the alveolar film--which represents the barrier to descending pneumonia--an effective accumulation of the quinolone takes place.
Insights
Ciprofloxacin effectively accumulates in the alveolar film, exceeding plasma levels by 186%. This concentration surpasses minimal inhibitory levels, suggesting efficacy against respiratory pathogens.
Area of Science:
- Pharmacokinetics and Drug Distribution
- Respiratory Medicine
- Infectious Diseases
Context:
- Pneumonia is a significant cause of morbidity and mortality.
- Effective antibiotic penetration into lung tissues is crucial for treating respiratory infections.
- Quinolones are a class of antibiotics used to treat bacterial infections.
Purpose:
- To quantify ciprofloxacin concentrations in various lung compartments and bodily fluids.
- To assess the penetration and accumulation of ciprofloxacin in the alveolar film.
- To determine if ciprofloxacin levels in the alveolar film are sufficient to inhibit common respiratory pathogens.
Summary:
- Ciprofloxacin levels were measured in plasma, saliva, bronchial secretions, lavage fluid, and alveolar macrophages in 9 patients.
- Five hours post-administration (2 x 750 mg daily for at least 3 days), alveolar film concentrations averaged 2.51 µg/ml.
- This concentration was 186% of plasma levels and exceeded minimal inhibitory concentrations for facultative pathogenic organisms.
Impact:
- Demonstrates effective accumulation of ciprofloxacin in the alveolar film, a key barrier against pneumonia.
- Suggests therapeutic potential of ciprofloxacin for treating lung infections where pathogen resides in alveolar space.
- Provides crucial pharmacokinetic data for optimizing ciprofloxacin dosing in respiratory infections.