Document Detail


Angioplasty increases target site concentrations of ciprofloxacin in patients with peripheral arterial occlusive disease.
MedLine Citation:
PMID:  11753269     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Patients with peripheral arterial occlusive disease are prone to soft tissue infections and frequently require antibiotics. To date, however, it is not known whether improvement of arterial blood flow by angioplasty of stenosis increases antibiotic concentrations in ischemic lesions. PATIENTS AND METHODS: All patients were scheduled to undergo elective percutaneous transluminal angioplasty (n = 10). Following a single, 400-mg dose of ciprofloxacin, drug concentrations in plasma, ischemic and healthy soft tissue; arterial peak systolic velocity; and ankle-brachial pressure index were assessed before and after angioplasty. Unbound ciprofloxacin concentrations were measured at the site of infection with use of in vivo microdialysis. RESULTS: Angioplasty increased peak systolic velocity and ankle-brachial pressure index compared with baseline (P <.002). Before angioplasty area under concentration-time curve (AUC(0-300)) values for ciprofloxacin were lower in ischemic tissue than in healthy tissue, with median values of 7.1 mg.h/L (range, 3.5-13.0) and 11.3 mg.h/L (range, 3.4-19.0), respectively (P =.03). After angioplasty AUC(0-300) values were identical in ischemic and healthy adipose tissue; median AUC(0-300) values were 8.0 mg.h/L (range, 4.0-20.7) and 8.5 mg.h/L (range, 4.4-22.9), respectively (P =.7). A combined in vivo pharmacokinetic/in vitro pharmacodynamic simulation based on tissue concentration data indicates that this difference in pharmacokinetics is also reflected in antimicrobial effect. CONCLUSION: Antibiotic concentrations are reduced significantly in ischemic lesions compared to those of healthy adipose tissue in patients with peripheral arterial occlusive disease. From the present data it might be speculated that improvement of arterial blood flow at the affected extremity is associated with increased cure rates of soft tissue infections in these patients.
Authors:
C Joukhadar; N Klein; M Frossard; E Minar; H Stass; E Lackner; M Herrmann; E Riedmüller; M Müller
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical pharmacology and therapeutics     Volume:  70     ISSN:  0009-9236     ISO Abbreviation:  Clin. Pharmacol. Ther.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-25     Completed Date:  2002-01-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372741     Medline TA:  Clin Pharmacol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  532-9     Citation Subset:  AIM; IM    
Affiliation:
Division of Clinical Pharmacokinetics, Department of Clinical Pharmacology, University of Vienna Medical School, Vienna, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adipose Tissue / metabolism
Aged
Aged, 80 and over
Angioplasty*
Anti-Infective Agents / adverse effects,  pharmacokinetics*,  pharmacology
Area Under Curve
Arterial Occlusive Diseases / metabolism*,  surgery
Chromatography, High Pressure Liquid
Ciprofloxacin / adverse effects,  pharmacokinetics*,  pharmacology
Female
Half-Life
Hemodynamics / physiology
Humans
Ischemia / metabolism
Male
Microbial Sensitivity Tests
Microdialysis
Middle Aged
Vascular Surgical Procedures
Chemical
Reg. No./Substance:
0/Anti-Infective Agents; 85721-33-1/Ciprofloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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