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The penetration of erythromycin into Waldeyer's ring--tonsil and adenoid tissue
Insights
Erythromycin ethylsuccinate effectively penetrates adenoid and tonsil tissues in children, reaching concentrations similar to plasma levels. This suggests potential efficacy in lymphatic tissues for treating infections.
Area of Science:
- Pharmacology
- Otolaryngology
- Microbiology
Background:
- Erythromycin is a macrolide antibiotic commonly prescribed for pediatric infections.
- Understanding antibiotic penetration into target tissues is crucial for effective treatment regimens.
- Adenoid and tonsil tissues are common sites for bacterial infections in children.
Purpose of the Study:
- To determine the concentration of erythromycin ethylsuccinate in adenoid and tonsil tissues of children.
- To compare tissue concentrations with simultaneous plasma levels.
- To infer the penetration of erythromycin into other lymphatic tissues.
Main Methods:
- Oral administration of erythromycin ethylsuccinate (30-60 mg/kg/day) to 72 children before adenoidectomy.
- Measurement of erythromycin concentrations in homogenized tissue, whole blood, and plasma.
- Administration of erythromycin ethylsuccinate (1000 mg) via gastric tube to six patients with chronic tonsillitis before tonsillectomy.
Main Results:
- Erythromycin tissue levels in adenoids were comparable to plasma levels (1.5-2.0 mg/l).
- Erythromycin concentrations in tonsil tissue were similar to concomitant plasma levels.
- The study demonstrated erythromycin penetration into both adenoid and tonsil tissues.
Conclusions:
- Erythromycin ethylsuccinate penetrates effectively into adenoid and tonsil tissues.
- Achieved tissue concentrations are similar to simultaneous plasma levels.
- It is inferred that erythromycin likely penetrates other lymphatic tissues to a similar extent.
Abstract:
Erythromycin ethylsuccinate was given orally (30-60 mg/kg/day) to 72 otherwise healthy children for different intervals before adenoidectomy. The concentration of erythromycin was assessed in homogenized tissue, in whole blood and in plasma, making it possible to calculate blood-free tissue levels. The tissue levels (1.5-2.0 mg/l) were the same as the plasma levels. Six patients with chronic tonsillitis were given 1000 mg erythromycin ethylsuccinate via a gastric tube, and tonsillectomy à froid was performed three to five hours later. This unusual mode of administration was chosen to avoid tonsil surface contamination, which might cause artificially high values. The concentration of erythromycin was assessed as described above. The levels of erythromycin in the tonsil tissue were the same as the concomitant plasma levels. Erythromycin has been shown to penetrate into adenoid and tonsil tissue and to attain levels similar to the simultaneous plasma levels. It may be inferred from this study that erythromycin penetrates into other lymphatic localities to the same degree.