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Penetration of antibiotics in diseased antral mucosa
V Westergren1, M Nilsson, U Forsum
1Department of Otorhinolaryngology-Head and Neck Surgery, Karolinska Hospital, Stockholm, Sweden.
Objectives:
To investigate extracellular concentrations of antibiotics in inflammatory diseased sinus mucosa in critically ill patients and to find out whether there were any correlations between the concentrations of antibiotics in extracellular tissue and the presence of bacterial infection.
Design:
Prospective case series. Sinoscopic findings were used as the criterion standard.
Setting:
The general and the neurosurgical intensive care units of a tertiary care hospital.
Patients:
Critically ill patients, nasotracheally intubated or tracheotomized, who received ventilator treatment (> 7 days) and antibiotic therapy.
Interventions:
Bilateral sinoscopies were performed; antral secretions were collected for bacterial cultures; and serum and tissue samples were obtained for bioassay of antibiotic concentrations.
Results:
The concentrations of all antibiotics found in extracellular fluid were lower than those found in serum samples.
Conclusion:
Measurable extracellular tissue concentrations of antibiotics were found in the antral mucosa, demonstrating that inflammatory maxillary sinus disease does not impede the antibiotic penetration of the mucosa or antibiotic activity in the extracellular tissue.