Document Detail


Tissue concentration of clindamycin and gentamicin near ischaemic ulcers with transvenous injection in Bier's arterial arrest.
MedLine Citation:
PMID:  8813984     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In the treatment of patients with inflamed ischaemic ulcers in peripheral arterial occlusive disease, high tissue concentrations of antibiotics (TCA) are important. With local transvenous pressure injection in Biers' arterial arrest (TVA-Bier) higher TCAs are assumed to be obtained but they have not been measured. METHODS: Two groups of 16 patients each with ischaemic foot ulcers were studied. In one group, patients received a mean of 284 (SD 116) mg gentamicin and in the other, 1200 mg clindamycin. The antibiotics were given intravenously, intra-arterially, and by TVA-Bier in a randomised order at intervals of 48 hours. Biopsy samples were taken from the edge of the ulcers 20 minutes and 3 hours after TVA-Bier, and 1 hour and 3 hours after intravenous and intra-arterial injection. At the same times blood samples were taken. FINDINGS: TCAs of gentamicin and clindamycin with TVA-Bier were significantly higher compared with intravenous or intra-arterial injection. Median TCA-enhancing factor of clindamycin achieved by TVA-Bier at 20 min 1 hour was 18.3 and 14.1 versus intravenous and intra-arterial infusion, respectively, and at 3 hours 7.3 and 5.6, respectively. The median TCA-enhancing factor for gentamicin by TVA-Bier versus intravenous and intra-arterial application was, at 1 hour 20 min, 9.4 and 9.7, respectively, and at 3 hours 1.2 and 1.7, respectively. INTERPRETATION: Higher TCAs could be achieved with TVA-Bier than with intravenous or intra-arterial infusion. TCAs were lower when using gentamicin and higher with clindamycin.
Authors:
H Burgmann; A Georgopoulos; W Graninger; R Koppensteiner; T Maca; E Minar; B Schneider; A Stümpflen; H Ehringer
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Lancet     Volume:  348     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1996 Sep 
Date Detail:
Created Date:  1996-10-31     Completed Date:  1996-10-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  781-3     Citation Subset:  AIM; IM    
Affiliation:
Division of Medical Angiology, Vienna General Hospital, University of Vienna, Austria.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Bacterial Agents / administration & dosage*,  pharmacokinetics*
Clindamycin / administration & dosage*,  pharmacokinetics*
Female
Gentamicins / administration & dosage*,  pharmacokinetics*
Humans
Injections, Intra-Arterial
Injections, Intravenous
Male
Middle Aged
Time Factors
Tissue Distribution
Tourniquets
Varicose Ulcer / drug therapy*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Gentamicins; 18323-44-9/Clindamycin

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