JAC Advance Access published online on March 31, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh173
© 2004 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Department of General
Surgery, University of Heidelberg, Im Neuenheimer Feld 110, D-69120
Heidelberg;
* Corresponding author. E-mail: joerg_kleeff{at}med.uni-heidelberg.de.
Received 13 November 2003
; revised 31 January 2004
; accepted 6 February 2004
Objective: Moxifloxacin is a recently
developed fourth-generation methoxyquinolone with a broad spectrum of
activity against both Gram-positive and Gram-negative aerobic bacteria
and anaerobes. The aim of the present study was to assess the penetration
of moxifloxacin into gastrointestinal (GI) mucosal tissues to evaluate
its potential role as an antimicrobial drug in bacterial infections
of the GI tract. Patients and methods: Twenty-eight patients
undergoing GI-tract surgery received 400 mg of moxifloxacin twice
pre-operatively [eight patients orally (po) and 20 patients
intravenously (iv)], of whom 22 completed the study. Mucosal
tissues (three stomach, three small bowel and 16 colon) and serum
samples were collected and moxifloxacin concentrations were measured
by HPLC. Results: The highest tissue concentrations were
detected in the mucosa of the stomach (10.9 ± 5.1
mg/kg), followed by colon mucosa (7.8 ± 7.1
mg/kg after iv; 6.6 ± 3.6 mg/kg after
po) and small bowel mucosa (5.4 ± 0.5
mg/kg). The tissue-to-serum ratio of moxifloxacin was 2.0 ± 1.6
in the small bowel mucosa, 5.8 ± 3.4 and
6.8 ± 3.9 in the colon mucosa after
po and iv administration, respectively, and 9.7 ± 5.7
in the stomach mucosa. Conclusion: Moxifloxacin penetrates into and
accumulates in the mucosa of the stomach, small bowel and colon.
The clinical applicability of moxifloxacin administration for bacterial
GI-tract infections should be investigated in controlled trials.
Keywords: methoxyquinolone, bacterial infection, tissue
concentrations
Moxifloxacin penetration into human gastrointestinal
tissues
2 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, Germany
3 Institute of
Hygiene, University of Heidelberg, Im Neuenheimer Feld 324, D-69120
Heidelberg;
4 Pharmacy Department, University
of Heidelberg, Im Neuenheimer Feld 670, D-69120 Heidelberg, Germany
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