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[Tissue penetration of antibiotics. Does the treatment reach the target site?]

H Lagler1, M Zeitlinger

  • 1Klinische Abteilung für Infektionen & Tropenmedizin, Universitätsklinik für Innere Medizin I, Allgemeines Krankenhaus (AKH), Medizinische Universität Wien, Wien, Österreich.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|April 3, 2014
PubMed
Abstract

Insights

Optimizing antimicrobial treatment in critically ill patients requires understanding drug concentrations at infection sites. Comparing tissue pharmacokinetics of meropenem and levofloxacin highlights the need for careful data interpretation.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Critical Care Medicine

Context:

  • Infections in critically ill patients pose significant challenges.
  • Adequate antimicrobial drug exposure at the infection site is crucial for treatment success.
  • Bacteria can reside in interstitial spaces, organs, body cavities, or intracellularly.

Purpose:

  • To compare the tissue pharmacokinetics of meropenem (a hydrophilic beta-lactam) and levofloxacin (a lipophilic fluoroquinolone).
  • To discuss various methods for assessing antimicrobial pharmacokinetics in human tissues, including tissue biopsy, bronchoalveolar lavage, and microdialysis.
  • To analyze the implications of different assessment methods on data interpretation.

Summary:

  • Significant pharmacokinetic differences exist between plasma and tissue drug concentrations.
  • Variations are observed between healthy volunteers and critically ill patients.
  • Discrepancies in data arise even when using different methods within the same organ.

Impact:

  • Accurate pharmacokinetic data is essential for tailoring antimicrobial therapy in critically ill patients.
  • A critical appraisal of the pathogen, infection site, and data source is necessary for effective treatment optimization.
  • This study provides insights into optimizing drug dosing strategies for severe infections.

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