JAC Advance Access published online on May 13, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg262
© 2003 by The British Society for Antimicrobial Chemotherapy
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Brief report
1 Department of Respiratory
Medicine, Birmingham Heartlands Hospital, Bordesley Green East,
Birmingham
B9 5SS
* Corresponding author. E-mail: david.honeybourne{at}heartsol.wmids.nhs.uk.
Received 23 October 2002
; revised 6 December 2002
; accepted 19 March 2003
Objective: This study was designed
to measure the concentrations of linezolid in bronchial mucosa,
pulmonary macrophages and epithelial lining fluid and to compare
them with simultaneous blood levels. Methods: Ten adult patients undergoing bronchoscopy
for diagnostic purposes were given oral linezolid at a dosage of
600 mg twice a day for a total of six doses. Patients with active
lung infection were excluded from the study. Flexible bronchoscopy
was carried out between 2 and 8 h after the last dose
of linezolid. Bronchial biopsies and bronchoalveolar lavage were
carried out and a simultaneous blood sample obtained. Linezolid
levels were measured using high-performance liquid chromatography
(HPLC). Results: Mean concentrations of linezolid were
13.4 mg/L in serum, 10.7 mg/kg in mucosa, 8.1 mg/L in
alveolar macrophages and 25.1 mg/L in epithelial lining fluid. The
mean site/serum concentration ratios were 0.79 for bronchial mucosa,
0.71 for macrophages and 8.35 for epithelial lining fluid. Conclusions: The MIC90 (
Keywords: linezolid, lung penetration
Intrapulmonary penetration of linezolid
2 Department of Microbiology,
Southmead Hospital, Bristol
3 Department
of Medical Microbiology,
City Hospital, Birmingham, UK
4
mg/L) of linezolid for Staphylococcus aureus and Streptococcus pneumoniae was exceeded in serum
and bronchial mucosa in all subjects, in epithelial lining fluid
in nine subjects and in macrophages in six subjects.
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