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Concentration of pefloxacin in feces during infection prophylaxis in neutropenic patients
J J van de Leur1, E J Vollaard, A J Janssen
1Department of Internal Medicine, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
Abstract:
Pefloxacin (400 mg twice daily) was administered orally for infection prophylaxis in neutropenic patients. Diffusible fecal pefloxacin concentration was determined by bioassay during 24 neutropenic periods. The median diffusible fecal pefloxacin concentration was 187 micrograms/g. This concentration was comparable with those found in volunteers following oral and intravenous administration of pefloxacin (400 mg twice daily) (median of 171 and 155 micrograms/g, respectively). From this study, it is concluded that pefloxacin administered orally results in a predictable high diffusible fecal concentration which leads to effective elimination of susceptible aerobic gram-negative bacilli from the colonic flora.
Insights
Oral pefloxacin (400 mg twice daily) effectively eliminates gram-negative bacilli in neutropenic patients. High fecal pefloxacin concentrations achieved orally ensure predictable and potent antimicrobial activity in the colon.
Area of Science:
- Pharmacology and Microbiology
- Infectious Disease Management
Background:
- Neutropenic patients are highly susceptible to infections, often caused by aerobic gram-negative bacilli.
- Antibiotic prophylaxis is crucial in managing infections in immunocompromised individuals.
Purpose of the Study:
- To evaluate the diffusible fecal concentration of pefloxacin in neutropenic patients receiving oral prophylaxis.
- To assess the efficacy of oral pefloxacin in eliminating susceptible aerobic gram-negative bacilli from the colonic flora.
Main Methods:
- Pefloxacin (400 mg twice daily) was administered orally to neutropenic patients for infection prophylaxis.
- Diffusible fecal pefloxacin concentrations were measured using a bioassay during 24 neutropenic periods.
- Fecal concentrations were compared to those observed in volunteers after oral and intravenous pefloxacin administration.
Main Results:
- The median diffusible fecal pefloxacin concentration in neutropenic patients was 187 micrograms/g.
- This concentration was comparable to median values of 171 micrograms/g (oral) and 155 micrograms/g (intravenous) in volunteers.
- Oral pefloxacin administration resulted in predictable and high fecal concentrations.
Conclusions:
- Oral administration of pefloxacin achieves high and predictable diffusible fecal concentrations.
- These concentrations are effective in eliminating susceptible aerobic gram-negative bacilli from the colonic flora in neutropenic patients.
- Pefloxacin is a viable option for infection prophylaxis in neutropenic patients, targeting colonic gram-negative bacilli.