Penetration of Ciprofloxacin into Kidney, Fat, Muscle and Skin Tissue

Daschner, Franz; Westenfelder, M.; Dalhoff, A.

doi:10.1007/978-3-663-01930-5_26

Cited by 17 publications

(11 citation statements)

References 3 publications

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“…The fat/plasma concentration ratio slowly increases with time after drug administration, with fat levels rarely reaching plasma levels (Dalhoff et al 1987;Daschner et al 1986;Eickenberg & Dalhoff 1985;Malmborg & Rannikko 1988;Schmidt et al 1988). Peak levels in fat occur within 2 to 3 hours after administration and decline faster than in plasma.…”

Section: Fatmentioning

confidence: 96%

“…The penetration of ciprofloxacin and enoxacin into muscle was studied at different times after administration (Dalhoff et al 1987;Daschner et al 1986;Eickenberg & Dalhoff 1985;Malmborg & Rannikko 1988;Schmidt et al 1988). The muscle/ plasma concentration ratio increased during the first 2 hours, with muscle levels exceeding plasma levels I hour after aaministration.…”

Section: Musclementioning

confidence: 99%

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Pharmacokinetic Disposition of Quinolones in Human Body Fluids and Tissues

Sörgel

Jaehde

Naber³

et al. 1989

Clinical Pharmacokinetics

103

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The unique pharmacokinetic properties as well as the body fluid and tissue penetration of quinolones are discussed.Quinolones are well absorbed from the gastrointestinal tract and are eliminated with considerable d{fJerences in their terminal half-lives. The major elimination pathways of quinolones are renal excretion and hepatic metabolism. Renally. these drugs undergo the potential excretion mechanisms (glomerular filtration. tubular secretion. reabsorption). In the liver. they are metabolised primarily by oxidation as well as by conjugative pathways. However. the metabolic pattern and extent of metabolism d{f!er significantly between individual agents.Alterations in the pharmacokinetic disposition of these agents in liver and renal failure as well as in elderly patients are observed as predicted from their excretion pattern. In addition. quinolones can interact with a number of other compounds at hepatic (e.g. with xanthine derivatives). renal (with probenecid) and gastrointestinal (with antacids) sites.The volume of distribution of quinolones is considerably higher than body volume. which suggests intracellular penetration. Studies on tissue penetration show that concentrations exceeding plasma levels are obtained in most tissues. The highest tissue/plasma concentration ratios are achieved in lung and kidney. whereas concentrations in fat are considerably lower than in plasma.Body fluid penetration is introduced as a new approach to evaluate distribution kinetics of quinolones. With the exception of those in nasal secretions and ejaculate. body flUid levels of these drugs rarely reach plasma levels. The body fluid penetration model allows for d{f!erentiation among individual agents. There is no apparent relationship between d{f!erences in body fluid penetration of quinolones and d{f!erences in volume of distribution. For the clinical use of these drugs it is important that the concentrations achieved in body fluids and tissues are sufficient to kill most pathogens. A discussion on the relationship between plasma and tissue levels and the MICs of quinolones is. however. beyond the scope of this article.

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Section: Fatmentioning

confidence: 96%

Section: Musclementioning

confidence: 99%

Pharmacokinetic Disposition of Quinolones in Human Body Fluids and Tissues

Sörgel

Jaehde

Naber³

et al. 1989

Clinical Pharmacokinetics

103

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“…Ciprofloxacin is the first of the new quinolone antimicrobial agents which can be considered for treatment of skin and soft tissue infections because it maintains adequate levels in blood and tissue of most organs (1,2). Because of its established in vitro activity for gram-positive organisms (11), it appeared logical to use this agent to treat infections caused by MRSA or to eradicate the carrier state involving MRSA.…”

Section: Discussionmentioning

confidence: 99%

Ciprofloxacin therapy for methicillin-resistant Staphylococcus aureus infections or colonizations

Smith

Eng

Tecson-Tumang

1989

Antimicrob Agents Chemother

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Thirty patients were treated for colonization or for skin and soft tissue infections caused by methicilinresistant Staphylococcus aureus. Three treatment regimens were evaluated, each progressively more aggressive. One regimen was 750 mg of ciprofloxacin twice daily for 5 days, the second regimen was 750 mg of ciprofloxacin twice daily for 10 to 14 days, and the final regimen was 750 mg of ciprofloxacin twice daily plus 300 mg of rifampin twice daily for 21 days. It appears that ciprofloxacin alone produced an initial eradication rate in at least one site in 50% of the patients, regardless of whether the treatment was for 5 or up to 14 days. All of the patients with eradication became recolonized within 1 week posttherapy. When rifampin was combined with ciprofloxacin, the eradication rate was 100% when the isolates were susceptible to both agents, and these patients remained free of methicillin-resistant S. aureus at 1-week and 1-month follow-ups.Methicillin-resistant Staphylococcus aureus (MRSA) has recently emerged as both a colonizing organism and a pathogen among many hospitalized patients. The therapy of infections caused by this organism or the eradication of colonization is particularly difficult. None of the beta-lactam antibiotics appears to be clinically effective; chloramphenicol has not proven effective for the treatment of staphylococcal infection in the past; erythromycin therapy produced rapid emergence of resistance and treatment failures; and finally, the use of aminoglycosides has resulted in the rapid emergence of resistant small-colony variants. Bacitracin, although active against this organism, cannot be applied to the upper nares comfortably to enable eradication of the carrier state. Although vancomcyin has proven effective for treating staphylococcal infections in many body sites, this therapy is expensive. Furthermore, vancomcyin is ineffective for those body sites in which vancomycin does not penetrate well, such as the nares.With the availability of the newer quinolone compounds, many of which show adequate to good in vitro activity against both methicillin-susceptible and methicillin-resistant staphylococci (9, 10), enthusiasm for use of the quinolones for treatment of infection or colonization by MRSA seems justified. We therefore evaluated the effectiveness of ciprofloxacin for treatment of skin and soft tissue infections and for eradication of MRSA carriage. MATERIALS AND METHODSPatient population. Patients identified by the primary care physicians or infection control staff as infected or colonized with MRSA as the primary or sole pathogen were evaluated for entrance into the study. All patients were interviewed and clinically reevaluated by the principal investigator (R.H.K.E.) and informed consent was obtained prior to enrollment. Cultures of the skin structures were obtained by aspiration from the leading edge of the infection. Cultures of groin and perirectal areas were obtained by using salinesoaked cotton-tipped swabs over an area of at least 10 cm2. Cultures of the nares w...

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“…Sparfloxacin aus der Gruppe III hat wegen seiner geringen renalen Ausscheidung für die Therapie von Harnwegsinfektionen keine Bedeutung [35]. In Gruppe IV [13].…”

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Fluorchinolone: Einsatz bei Infektionen der Nieren und des Urogenitaltrakts

Farker¹,

Naber

Fünfstück³

2001

Med Klin

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The purpose of this review is to give an introduction in the class of fluoroquinolones, which has become a large class of substances, and to discuss the use, role, and place of these drugs in the treatment of urinary tract infections. The classification of the fluoroquinolones contains four groups. Antibacterial spectrum, pharmacokinetics, and indications are the main criteria. The various fluoroquinolones differ in their antibacterial spectrum, the antibacterial activity, and pharmacokinetic properties. Therefore selection, use, and dosage regime of the substances should be carried out under respective clinical requirements and medical points of view. The physician has to consider the specific indications for each substance in each individual case. Fluoroquinolones are suitable antibacterial agents for various urinary tract infections and are a valuable and useful addition to the antimicrobial treatment.

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Penetration of Ciprofloxacin into Kidney, Fat, Muscle and Skin Tissue

Cited by 17 publications

References 3 publications

Pharmacokinetic Disposition of Quinolones in Human Body Fluids and Tissues

Pharmacokinetic Disposition of Quinolones in Human Body Fluids and Tissues

Ciprofloxacin therapy for methicillin-resistant Staphylococcus aureus infections or colonizations

Fluorchinolone: Einsatz bei Infektionen der Nieren und des Urogenitaltrakts

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