Document Detail

Effect of cardiogenic shock on pharmacokinetics and tissue distribution of ampicillin-sulbactam.
MedLine Citation:
PMID:  7600637     Owner:  NLM     Status:  MEDLINE    
A reversible cardiogenic shock model in pigs investigated shock-induced changes in the pharmacokinetics and tissue distribution of ampicillin-sulbactam and the efficacy of this antibiotic regimen in eliminating enteric bacterial translocation. Sixteen pigs were randomly allocated to 3 groups: group I (shock, ampicillin-sulbactam, n = 6), group II (no shock, ampicillin-sulbactam, n = 6), and group III (shock, no ampicillin-sulbactam, n = 4). Nalidixic acid-resistant E. coli (60 x 10(6) CFU) were instilled into a jejunal loop created in each pig, and bacterial cultures were taken from thoracic duct lymph, periportal, and mesenteric lymph nodes. Ampicillin-sulbactam was administered intravenously at a standard dose of 3 g. Results showed that 1) ampicillin and sulbactam concentrations generally increase during cardiogenic shock; 2) cardiogenic shock does not increase ampicillin concentrations in jejunum and liver; 3) during resuscitation, thoracic duct lymph ampicillin concentrations decrease; and 4) during and immediately after cardiogenic shock, standard doses of ampicillin-sulbactam appear efficacious in eliminating translocated bacteria.
W A Arden; D E Barker; W E Strodel; K Record; G Leader; M Derbin; G Gellin; R W Schwartz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulatory shock     Volume:  44     ISSN:  0092-6213     ISO Abbreviation:  Circ. Shock     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1995-08-09     Completed Date:  1995-08-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0414112     Medline TA:  Circ Shock     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  138-47     Citation Subset:  IM    
Division of General Surgery, University of Kentucky, College of Medicine, Lexington, USA.
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MeSH Terms
Ampicillin / pharmacokinetics,  therapeutic use
Ascitic Fluid / metabolism
Bacteria / isolation & purification
Cardiac Output
Drug Therapy, Combination / pharmacokinetics*,  therapeutic use
Escherichia coli Infections / drug therapy
Intestines / metabolism
Liver / metabolism
Lung / metabolism
Lymph / metabolism,  microbiology
Lymph Nodes / microbiology
Portal System / metabolism,  microbiology
Shock, Cardiogenic / metabolism*,  microbiology
Sulbactam / pharmacokinetics,  therapeutic use
Tissue Distribution
Grant Support
Reg. No./Substance:
68373-14-8/Sulbactam; 69-53-4/Ampicillin; 76497-13-7/sultamicillin

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