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[Studies on penetration of cefepime into respiratory tract using broncho-alveolar lavage and sputum]
Abstract:
We investigated broncho-alveolar distribution of cefepime (CFPM), a fourth generation cephem, using 38 BALF specimens from 19 serious pneumonia patients who underwent artificial respiratory system control. The mean broncho-alveolar CFPM level was 3.44 microgram/ml (5.34% of the mean peak blood level). We thus observed that the BALF level after a single dose of 1 g of CFPM exceeds the MIC90 of the drug against RTI causing bacteria such as Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophillus influenzae, Branhamella catarrhalis, coagulase-negative Staphylococcus, Pseudomonas aeruginosa and Staphylococcus aureus.
Insights
Cefepime (CFPM) concentrations in broncho-alveolar fluid of pneumonia patients exceeded the minimum inhibitory concentration for common respiratory pathogens. This suggests effective lung tissue penetration for treating serious respiratory tract infections.
Area of Science:
- Pharmacology
- Infectious Diseases
- Critical Care Medicine
Background:
- Broncho-alveolar distribution of antibiotics is crucial for effective pneumonia treatment.
- Fourth-generation cephem antibiotics like cefepime (CFPM) are used for serious respiratory tract infections (RTIs).
Purpose of the Study:
- To determine the broncho-alveolar distribution of cefepime (CFPM) in patients with serious pneumonia.
- To assess if CFPM levels in broncho-alveolar fluid (BALF) are sufficient to inhibit common RTI pathogens.
Main Methods:
- Analysis of 38 broncho-alveolar lavage fluid (BALF) specimens from 19 patients with serious pneumonia.
- Measurement of cefepime (CFPM) concentrations in BALF and correlation with peak blood levels.
Main Results:
- The mean broncho-alveolar cefepime (CFPM) concentration was 3.44 microgram/ml, representing 5.34% of the mean peak blood level.
- Achieved BALF cefepime (CFPM) levels surpassed the MIC90 for key respiratory pathogens including Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa.
Conclusions:
- A single 1g dose of cefepime (CFPM) achieves therapeutic concentrations in the broncho-alveolar space.
- Cefepime (CFPM) demonstrates potential efficacy against a broad spectrum of bacteria causing serious respiratory tract infections.