JAC Advance Access published online on January 6, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dgk056
© 2003 by The British Society for Antimicrobial Chemotherapy
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Brief report
1 Institute of Hygiene,
University of Heidelberg, Im Neuenheimer Feld 324, D-69120 Heidelberg; Pharmacy Department, University
of Heidelberg, Im Neuenheimer Feld 670, D-69120 Heidelberg
* Corresponding author. E-mail: StefanieSwoboda{at}med.uni-heidelberg.de.
Received 25 June 2002
; revised 12 September 2002
; accepted 23 October 2002
Objectives: Levofloxacin is a third-generation
fluoroquinolone with a broad spectrum of antibacterial activity,
comprising enterobacteria, non-fermenters, Gram-positive cocci and
some anaerobic species. Members of these species are common pathogens
in acute and chronic cholecystitis. This suggests that levofloxacin
may be used as peri-operative prophylaxis in gall-bladder surgery.
The purpose of our study was to determine serum and tissue levels
of levofloxacin in cholecystectomy patients following pre-operative
dosing. Patients and methods: Patients with gall-bladder
surgery were given levofloxacin 500 mg as a single dose either intravenously
(iv) or orally pre-operatively, at the treating physician's decision.
Gall-bladder tissue and serum samples were collected, and drug concentrations
were determined by HPLC with fluorescence detection. Additionally,
all tissue samples underwent routine microbiological diagnostics.
MICs for aerobic isolates were determined using the Etest. Results: A total of 61 patients (48 female,
13 male) were included. The medians of the levofloxacin concentrations
in serum were 11.37 mg/L (iv) and 9.65 mg/L (oral), and in gall-bladder tissue
they were 15.61 mg/kg (iv) and 17.93 mg/kg (oral). Eleven pathogens
were isolated from gall-bladder samples. Post-operative wound infection
was observed in two of the 61 patients. Conclusion: Our data suggest that levofloxacin
may be considered for peri-operative prophylaxis in biliary tract
surgery.
Keywords: quinolones, pharmacokinetics, pharmacodynamics,
cholecystitis, wound infection
Tissue and serum concentrations of levofloxacin
500 mg administered intravenously or orally for antibiotic prophylaxis
in biliary surgery
2 Institute of Hygiene,
University of Heidelberg, Im Neuenheimer Feld 324, D-69120 Heidelberg
3 Department of Surgery, Krankenhaus
Salem, Zeppelinstrasse 11-13, D-69121 Heidelberg, Germany
4 Pharmacy Department, University
of Heidelberg, Im Neuenheimer Feld 670, D-69120 Heidelberg
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