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Epithelial lining fluid concentrations of ceftriaxone in children with community-acquired pneumonia
Yi-Ning Dong1,2, Ya-Kun Wang3, Qian Li4
1Department of Clinical Pharmacy, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China.
Insights
This study measured ceftriaxone levels in pediatric patients with pneumonia, finding significantly higher concentrations in epithelial lining fluid (ELF) compared to plasma. These findings offer crucial insights into antibiotic penetration in pediatric respiratory infections.
Area of Science:
- Pediatric Pharmacology
- Infectious Diseases
- Respiratory Medicine
Background:
- Ceftriaxone is a common antibiotic for community-acquired pneumonia in children.
- Data on ceftriaxone concentrations in pediatric epithelial lining fluid (ELF) is lacking.
- Understanding drug distribution in the lungs is vital for effective treatment.
Purpose of the Study:
- To determine ceftriaxone concentrations in plasma and ELF in pediatric patients.
- To compare ELF and plasma ceftriaxone levels in children treated for pneumonia.
Main Methods:
- Opportunistic sampling of blood and bronchoalveolar lavage fluid (BALF) from 22 children (0.5-11.7 years).
- Analysis of 36 plasma and 22 ELF samples to quantify ceftriaxone concentrations.
- Calculation of the ratio of ELF to plasma ceftriaxone concentrations.
Main Results:
- Ceftriaxone plasma concentrations ranged from 1.07 to 138.71 mg/L.
- Ceftriaxone ELF concentrations ranged from 0.61 to 26.69 mg/L.
- Mean ELF ceftriaxone concentration was 12.18 ± 5.15 times higher than plasma, with ratios from 1.29 to 20.44.
Conclusions:
- Ceftriaxone achieves significantly higher concentrations in the epithelial lining fluid of children's lungs compared to plasma.
- These elevated ELF concentrations suggest good penetration of ceftriaxone into the site of infection for pediatric pneumonia.
- Further research can explore optimal dosing strategies based on these drug concentration findings.
Abstract:
Ceftriaxone is widely used in children with community-acquired pneumonia. Currently, there are no available data regarding epithelial lining fluid (ELF) concentrations of ceftriaxone in children. Thus, blood and bronchoalveolar lavage fluids samples were collected by using an opportunistic sampling design, then we determined plasma and ELF concentrations in 22 children (0.5-11.7 years), with a total of 36 plasma and 22 ELF samples available for analysis. Ceftriaxone plasma and ELF concentrations ranged from 1.07 to 138.71 mg/L and from 0.61 to 26.69 mg/L, respectively. Ceftriaxone concentration in ELF was 12.18 ± 5.15 (mean ± standard deviation) times higher than that in plasma, ranging from 1.29 to 20.44.
