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Antibiotic penetration of experimental intra-abdominal abscesses
S Galandiuk1, J Lamos, W Montgomery
1Department of Surgery, University of Louisville School of Medicine, KY 40292, USA.
Abstract:
Intra-abdominal abscess is seldom adequately treated by systemic antibiotics alone and often requires surgical or computed tomography-guided drainage for resolution. Abscess penetration of six currently used antibiotics was examined in a murine intra-abdominal abscess model. Ampicillin/sulbactam, cefmetazole, clindamycin, and trospectomycin penetrated intra-abdominal abscesses to a greater degree than cefoxitin and ceftriaxone. Abscess pus antibiotic levels were not significantly higher after multiple doses than after a single dose. Pus antibiotic levels below the MIC90 for Bacteroides and E. coli within intra-abdominal abscess were observed for most antibiotics with the doses used in this study. Selection of antibiotics with a greater ability to penetrate abscess may be important in optimally treating patients with abdominal infection.
Insights
Antibiotic penetration into intra-abdominal abscesses varies significantly. Some antibiotics show better penetration, but levels may not reach effective concentrations for key bacteria, impacting treatment efficacy.
Area of Science:
- Infectious Diseases
- Pharmacology
- Surgical Infections
Background:
- Intra-abdominal abscesses often resist treatment with systemic antibiotics alone.
- Effective management typically necessitates surgical or image-guided drainage.
- Understanding antibiotic penetration is crucial for optimizing therapy.
Purpose of the Study:
- To evaluate the penetration of six common antibiotics into intra-abdominal abscesses.
- To compare the efficacy of different antibiotic classes in abscess models.
- To inform antibiotic selection for abdominal infections.
Main Methods:
- Utilized a murine model to simulate intra-abdominal abscesses.
- Administered single and multiple doses of six antibiotics.
- Measured antibiotic concentrations in abscess pus.
- Compared pus concentrations to MIC90 values for relevant bacteria.
Main Results:
- Ampicillin/sulbactam, cefmetazole, clindamycin, and trospectomycin demonstrated superior abscess penetration compared to cefoxitin and ceftriaxone.
- Multiple antibiotic doses did not significantly increase pus concentrations over single doses.
- Observed sub-optimal antibiotic levels below MIC90 for Bacteroides and E. coli with tested doses.
Conclusions:
- Antibiotic choice significantly impacts penetration into intra-abdominal abscesses.
- Current dosing strategies may not achieve adequate concentrations for certain pathogens.
- Selecting antibiotics with enhanced abscess penetration is vital for effective treatment.