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Anatomical barriers for antimicrobial agents

M Barza1

  • 1Division of Geographic Medicine and Infectious Diseases, New England Medical Center, Boston, Massachusetts 02111.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|January 1, 1993
PubMed
Summary
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Most body tissues readily allow antibiotic passage, but the central nervous system, eye, and prostate present barriers. Specialized transport mechanisms and pH differences further reduce antibiotic concentrations in these specific tissues.

Area of Science:

  • Pharmacology
  • Physiology
  • Infectious Diseases

Background:

  • Anatomic barriers are often cited as limiting antibiotic penetration into body tissues.
  • Understanding drug distribution is crucial for effective antimicrobial therapy.

Purpose of the Study:

  • To evaluate the anatomic and physiological barriers affecting antibiotic distribution in various body tissues.
  • To determine factors influencing antibiotic concentrations at equilibrium in different compartments.

Main Methods:

  • Review of existing literature on drug diffusion across capillary beds.
  • Analysis of factors such as capillary fenestration, lipid solubility, transport pumps, and pH partitioning.
  • Comparison of antibiotic concentrations in plasma versus tissue fluids.

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Main Results:

  • Most capillary beds are fenestrated, allowing relatively free passage of antibiotics.
  • Equilibrium concentrations of free antibiotics in plasma and most tissue fluids are generally equal.
  • Nonfenestrated capillaries in the central nervous system, eye, and prostate limit antibiotic diffusion.
  • Transport pumps and pH partitioning create lower equilibrium concentrations in the central nervous system, eye, and prostate.

Conclusions:

  • Anatomic barriers are significant only in specific sites like the central nervous system, eye, and prostate.
  • Factors beyond capillary structure, including active transport and pH, influence antibiotic distribution.
  • Optimizing antibiotic therapy requires consideration of these site-specific distribution challenges.