Intravegetation antimicrobial distribution in endocarditis: a numerical model and establishment of the conditions for an in-vitro test.

Two problems appear when it is desired to get good knowledge concerning transfer of matter through a material, and especially the penetration of antibiotics into vegetations on heart valves. One is to build a numerical model to describe and simulate the process and thus to gain a fuller insight into the nature of the transfer. The other is to develop an in vitro test to represent the in vivo process, with simple operational conditions and accurate measurements.

[Aminoglycoside determinations calculated in endocarditis vegetations. Relations with clinical practices during infectious endocarditis treatment with amikacin].

Using a new computer program SPHERE, amikacin concentrations have been computed at various layers of simulated endocardial vegetations. Inputs are the computed serum (central compartment) concentrations of either population pharmacokinetic models or of individualized patient-specific models utilizing Bayesian fitting to data of doses given and measured serum levels, using the USC*PACK PC Clinical Programs. The vegetation is modeled as an isotropic homogeneous sphere.