Penetration of ciprofloxacin into bronchial secretions from mechanically ventilated patients with nosocomial bronchopneumonia

The aim of the study was to evaluate the penetration of ciprofloxacin into bronchial secretions from mechanically ventilated patients with nosocomial bronchopneumonia. For this purpose, in each patient studied, simultaneous serial blood and bronchial secretion samples were obtained over a 12-h period on days 2 and 4. Eight patients were included in the study. Ciprofloxacin was given at a dose of 200 mg over 30 min by using an automatic pump. Ciprofloxacin was measured by high-performance liquid chromatography. Peak levels of drug in serum were 2.95 +/- 1 mg/liter on day 2 and 2.43 +/- 0.7 mg/liter on day 4. Peak and trough levels in bronchial secretions were 0.95 +/- 0.51 and 0.21 +/- 0.12 mg/liter, respectively, on day 2 and 0.76 +/- 0.17 and 0.18 +/- 0.14 mg/liter, respectively, on day 4. The ratios of peak concentrations in bronchial secretions/serum were 0.32 +/- 0.11 and 0.33 +/- 0.06 on days 2 and 4, respectively. The ratios of the area under the concentration-time curve from 0 to 12 h (AUC0-12) for bronchial secretions/those for serum were 0.66 +/- 0.40 and 0.55 +/- 0.30 on days 2 and 4, respectively. A significant positive correlation was found on day 4 between the AUC0-12 for serum and the AUC0-12 for bronchial secretions. No significant correlations were found between peak values in serum and bronchial secretions.

[1]  C. Marchbanks,et al.  Dose ranging and fractionation of intravenous ciprofloxacin against Pseudomonas aeruginosa and Staphylococcus aureus in an in vitro model of infection , 1993, Antimicrobial Agents and Chemotherapy.

[2]  A Iliadis,et al.  APIS: a software for model identification, simulation and dosage regimen calculations in clinical and experimental pharmacokinetics. , 1992, Computer methods and programs in biomedicine.

[3]  Jerome J. Schentag,et al.  Evaluation of intravenous ciprofloxacin in patients with nosocomial lower respiratory tract infections. Impact of plasma concentrations, organism, minimum inhibitory concentration, and clinical condition on bacterial eradication. , 1989, Archives of internal medicine.

[4]  H. Polk,et al.  The importance of tissue antibiotic activity in the prevention of operative wound infection. , 1989, The Journal of antimicrobial chemotherapy.

[5]  E. Hvidberg,et al.  Comparative pharmacokinetics of ciprofloxacin and ofloxacin in cystic fibrosis patients. , 1987, The Journal of antimicrobial chemotherapy.

[6]  R. Stern,et al.  Ciprofloxacin monotherapy for acute pulmonary exacerbations of cystic fibrosis. , 1987, The American journal of medicine.

[7]  M. Hodson,et al.  Pharmacokinetics and sputum penetration of ciprofloxacin in patients with cystic fibrosis , 1986, Antimicrobial Agents and Chemotherapy.

[8]  M. Bergeron,et al.  Pharmacokinetics and pharmacodynamics of ciprofloxacin in cystic fibrosis patients , 1986, Antimicrobial Agents and Chemotherapy.

[9]  L. Ayers,et al.  Antibacterial activities of ciprofloxacin, norfloxacin, oxolinic acid, cinoxacin, and nalidixic acid , 1984, Antimicrobial Agents and Chemotherapy.

[10]  D. Reeves,et al.  In-vitro studies with ciprofloxacin, a new 4-quinolone compound. , 1984, The Journal of antimicrobial chemotherapy.

[11]  E. Bergogne-Bérézin Penetration of antibiotics into the respiratory tree. , 1981, The Journal of antimicrobial chemotherapy.

[12]  John G. Wagner,et al.  Fundamentals of Clinical Pharmacokinetics , 1975 .

[13]  G. D. Thomas,et al.  Nosocomial respiratory infections with gram-negative bacilli. The significance of colonization of the respiratory tract. , 1972, Annals of internal medicine.

[14]  M. Niederman,et al.  Patterns and routes of tracheobronchial colonization in mechanically ventilated patients. The role of nutritional status in colonization of the lower airway by Pseudomonas species. , 1989, Chest.

[15]  F. Fraschini,et al.  Ciprofloxacin: multiple-dose pharmacokinetic and clinical results in patients with hypercrinic bronchopulmonary diseases. , 1987, International journal of clinical pharmacology research.