Pulmonary Disposition of Moxalactam

Braude, A.C.; Cohen, Robert; Penner, J L; Preston, Mark A.; Rěbuck, A. S.

doi:10.1378/chest.86.6.881

Cited by 10 publications

(8 citation statements)

References 8 publications

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“…In the presence of inflammation, the distribution of amoxicillin may be altered because of increased membrane permeability 25,26. As observed in this and our previous study a high level of C-reactive protein, a marker of systemic inflammation, was related to higher amoxicillin levels 17.…”

Section: Discussionsupporting

confidence: 74%

Amoxicillin concentrations in relation to beta-lactamase activity in sputum during exacerbations of chronic obstructive pulmonary disease

Brusse-Keizer¹,

VanderValk²,

Zanden³

et al. 2015

COPD

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BackgroundAcute exacerbations of chronic obstructive pulmonary disease (COPD) are often treated with antibiotics. Theoretically, to be maximally effective, the antibiotic concentration at sites of infection should exceed the minimum inhibitory concentration at which 90% of the growth of potential pathogens is inhibited (MIC90). A previous study showed that most hospitalized COPD patients had sputum amoxicillin concentrations

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Section: Discussionsupporting

confidence: 74%

Amoxicillin concentrations in relation to beta-lactamase activity in sputum during exacerbations of chronic obstructive pulmonary disease

Brusse-Keizer¹,

VanderValk²,

Zanden³

et al. 2015

COPD

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“…The most important host-related factor is the integrity of the anatomical barriers which may be damaged by inflammation and mechanical injury (5). In the presence of inflammation, the distribution of antimicrobial agents in tissue compartments may be altered because of an increase in membrane permeability (19,20). Thus, for a drug such as amoxicillin clavulanic acid, a beta-lactam, which does not cross membranes readily, the penetration might increase in the presence of inflammation (5).…”

Section: Discussionmentioning

confidence: 99%

Relation Between Amoxicillin Concentration in Sputum of COPD Patients and Length of Hospitalization

Brusse-Keizer¹,

Bokum²,

Movig³

et al. 2011

COPD: Journal of Chronic Obstructive Pulmonary Disease

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Amoxicillin is a widely used antibiotic in COPD. Little is known about the transfer of amoxicillin into sputum of COPD patients. The objective was to investigate the relationship between the concentration of amoxicillin in sputum in hospitalized COPD patients and length of hospitalization. To be effective against bacterial pathogens, the amoxicillin concentration in target tissues should be higher than the Minimal Inhibiting Concentration (MIC) of 2 mg/l. Therefore, this was also used as the cut-off value for the amoxicillin concentration in sputum, as a marker for lung tissue concentration. Fifty-two COPD in-patients with an exacerbation, treated with amoxicillin clavulanic acid, were included in this cohort study. Of these patients 7 also had pneumonia. Patients were divided in patients with an amoxicillin sputum concentration ≥ 2 mg/l and < 2 mg/l. Furthermore, inflammation markers in sputum and serum and clinical parameters were obtained. Of the 33 patients with usable sputum, 11 had a concentration in sputum ≥ 2 mg/l. The mean length of hospitalization for patients with concentrations below the MIC90 to common respiratory pathogens was 11.0 days, while for patients with concentrations at or above the MIC90 this was 7.0 days (p = 0.005). COPD patients admitted for an acute exacerbation of COPD, with a sputum concentration of amoxicillin ≥ 2 mg/l had a markedly reduced length of hospitalization compared to patients with a concentration < 2 mg/l. It is worthwhile testing whether individualized treatment based on sputum amoxicillin concentrations of patients during hospitalization for acute exacerbations can effectively reduce hospital stay.

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“…The remaining three aliquots contain ELF and are pooled for analysis. The use of too little fluid (8) means that, at best, medium-sized airway fluid which is different from the ELF recovered by conventional lavage is sampled (51). Problems with the accurate quantification of ELF volume mean that previous workers' measurement of antimicrobial agent concentrations in ELF have been unreliable (48 there are few published data that were derived by using a method such as this one (2, 3), but it is important that all future studies address this problem and also that the recommended standardized BAL procedures are used to ensure that distal ELF is sampled (1, 33).…”

Section: Introductionmentioning

confidence: 99%