Related Experiment Videos
Penetration of clindamycin and metronidazole into the appendix and peritoneal fluid in children
H Nagar1, S A Berger, B Hammar
1Department of Pediatric Surgery, Tel-Aviv Medical Center, Israel.
Insights
Clindamycin showed higher appendix tissue concentrations than metronidazole in children undergoing appendectomy. However, metronidazole achieved greater peritoneal fluid levels, suggesting different distribution patterns for these antibiotics.
Area of Science:
- Pharmacology
- Surgical Infectious Diseases
Background:
- Appendectomy is a common surgical procedure in children.
- Antibiotic prophylaxis is crucial in preventing surgical site infections.
- Clindamycin and metronidazole are commonly used antibiotics for intra-abdominal infections.
Purpose of the Study:
- To compare the tissue and fluid concentrations of clindamycin and metronidazole in children undergoing appendectomy.
- To evaluate the pharmacokinetic profiles of these antibiotics in the surgical site environment.
Main Methods:
- A prospective study involving 31 children undergoing appendectomy.
- Administration of a single intravenous dose of either clindamycin (10 mg/kg) or metronidazole (7.5 mg/kg).
- Measurement of serum, appendix tissue, and peritoneal fluid antibiotic concentrations.
Main Results:
- Serum antibiotic levels were comparable between the two groups.
- Clindamycin demonstrated significantly higher concentrations in appendix tissue compared to metronidazole (7.23 vs. 2.27 µg/g).
- Metronidazole showed higher concentrations in peritoneal fluid than clindamycin (14.26 vs. 7.72 µg/ml).
Conclusions:
- Clindamycin achieves superior concentrations within the appendix tissue.
- Metronidazole exhibits higher penetration into the peritoneal cavity.
- These findings have implications for antibiotic selection in appendicitis and related intra-abdominal infections.
Abstract:
Thirty-one children underwent appendectomy following administration of a single i.v. dose of clindamycin 10 mg/kg or metronidazole 7.5 mg/kg. The serum levels of the antibiotics at that time were comparable, but the tissue concentration of clindamycin in the appendix (mean 7.23 micrograms/g) exceeded that of metronidazole (mean 2.27 micrograms/g). The concurrent mean concentration of metronidazole in peritoneal fluid (14.26 micrograms/ml) was higher than that of clindamycin (7.72 micrograms/ml).