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Pleural penetration of amoxicillin and metronidazole during pleural infection: An ambispective cohort study

Luque-Paz, David ; Verdier, Marie-Clémence ; Lefèvre, Charles R. ; Chauvin, Pierre ; Goter, Thomas ; Armange, Lucas ; Bayeh, Betsega ; Lalanne, Sébastien ; Tattevin, Pierre ; Jouneau, Stéphane

International journal of antimicrobial agents, 2023-12, Vol.62 (6), p.107004-107004, Article 107004 [Periódico revisado por pares]

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  • Título:
    Pleural penetration of amoxicillin and metronidazole during pleural infection: An ambispective cohort study
  • Autor: Luque-Paz, David ; Verdier, Marie-Clémence ; Lefèvre, Charles R. ; Chauvin, Pierre ; Goter, Thomas ; Armange, Lucas ; Bayeh, Betsega ; Lalanne, Sébastien ; Tattevin, Pierre ; Jouneau, Stéphane
  • É parte de: International journal of antimicrobial agents, 2023-12, Vol.62 (6), p.107004-107004, Article 107004
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: OBJECTIVESThe pharmacokinetics of antibiotics in pleural fluid during pleural infections has been poorly described. This study aimed to explore amoxicillin and metronidazole diffusion into the pleural space.METHODSThis was an ambispective, single-centre study that included patients with complicated parapneumonic effusion or pleural empyema managed with repeated therapeutic thoracentesis as first-line treatment between 2014 and 2022. Pleural steady-state or trough concentrations of amoxicillin and metronidazole were measured, with a lower limit of quantification of 5 mg/L.RESULTSSeventy paired blood and pleural samples were analysed from 40 patients. The median (interquartile range) patient age was 55 years (45-67 years) and 88% were male. The median patient weight was 65.8 kg (57.3-82 kg) and median plasma albumin concentration was 29.7 g/L (23.7-33.9 g/L). Median creatinine clearance was 106 mL/min (95-117 mL/min). Median amoxicillin pleural concentrations in patients treated with oral, bolus and continuous intravenous administrations (6 g/day) were, respectively, 5.2 (<5-6.4), 9.4 (8-13.1) and 10.8 (7.1-13.1) mg/L. Pleural concentrations were <5 mg/L in 5/11 samples (45%) with oral treatment and 6/59 (10%) with intravenous treatment. Median metronidazole pleural concentrations were 18.4 (15.7-22.8) mg/L, with all patients being treated orally (1.5 g/day).CONCLUSIONSOral metronidazole (1.5 g/day) and intravenous amoxicillin (6 g/day) achieved therapeutic targets in pleural fluid in most cases, but oral amoxicillin did not.
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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