Journal of Antimicrobial Chemotherapy (1996) 38, 865-869
© 1996 The British Society for Antimicrobial Chemotherapy
brief-report |
Penetration of vancomycin into human lung tissue
aInstitute of Immunology and Infectious Diseases Italy bDepartment of Thoracic Surgery Italy cInstitute of Clinical Chemistry, University of Verona Italy d1st Department of Infectious Diseases, School of Medicine, University of Genoa Italy eB. T. Biotecnica, Milan Italy
Received 8 December 1995; returned 22 April 1996; accepted 13 June 1996
*Corresponding address: Clinica di Malattie Infettive-Pad 9 F, Ospedale San Martino; Viale Benedetto XV 10, 16132 Genova, Italy. Tel: +39 10 353 7677; Fax: +39 10 353 7680
Vancomycin penetration into lung tissue was evaluated in thirty patients following the administration of 1 g of vancomycin as a 1 h iv infusion. Mean concentrations (range) of vancomycin in lung tissue were 9.6 (6.3–12.1) mg/kg at 1 h, 5.7 (4.7–7.4) mg/kg at 2 h, 4.2 (0.8–6.5) mg/kg at 3–4 h, 2.4 (1.4–4.7) mg/kg at 6 h, and 2.8 (0.9–7.8) mg/kg at 12 h after the end of infusion. Ratios of lung tissue to serum concentration ranged 0.24 to 0.41 at 1 and 12 h, respectively. One of six patients observed at 6 h, and 3 of 7 patients at 12 h did not have detectable levels of vancomycin in lung tissue. A 1 h iv infusion of a 1 g dose of vancomycin does not achieve sustained lung concentrations above the MIC for susceptible staphylococci over a dosing interval of 12 h. Therefore, a more appropriate modality of administration, such as continuous infusion, should be considered.
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