AI Article Synopsis
- Antibiotic treatment is crucial for managing severe acute pancreatitis, and the study focuses on how well cefepime penetrates pancreatic tissue in two acute pancreatitis models.
- After inducing pancreatitis in animals and administering cefepime, the concentration of the drug in pancreatic tissue was significantly higher in both mild and severe cases compared to control animals.
- The study concludes that cefepime maintains effective levels in pancreatic tissue over time and significantly reduces infection rates, suggesting its potential for treating severe acute pancreatitis in patients.
Article Abstract
Introduction: Antibiotic treatment represents a cornerstone in the management of severe acute pancreatitis. However, different antibiotic substances are currently used. In this study, we analyzed penetration of cefepime into pancreatic tissue in two models of acute pancreatitis.
Aims And Methodology: Following induction of acute pancreatitis, animals were treated with a single intravenous dose of cefepime (0.1 mg/g of body weight). At two different time points, blood and tissue samples were obtained for determination of cefepime concentration and microbiologic analysis.
Results: Mean pancreatic tissue concentrations +/- SEM 30 minutes after drug administration were significantly higher in animals with either mild acute pancreatitis (113 +/- 22 mg/kg) or severe acute pancreatitis (75 +/- 22 mg/kg) than in control animals (30 +/- 6 mg/kg) (p < 0.005). The minimal inhibitory concentrations (MIC90) for organisms usually isolated from infected pancreatic necrosis vary between 0.05 and 8 mg/L, which is between nine and 1,500 times lower than the mean peak concentration found in necrotic pancreatic tissue. Seven hours 30 minutes after antibiotic administration, pancreatic cefepime concentrations were still above the MIC90 in 100% and 83% of animals with mild and severe disease, respectively. The infection rate of pancreatic tissue was significantly lower after antibiotic treatment and was similar after imipenem/cilastatin or cefepime treatment.
Conclusion: Because of its antibacterial coverage and proven tissue penetration in acute pancreatitis, cefepime should be studied in patients with severe acute pancreatitis.
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| http://dx.doi.org/10.1097/00006676-200303000-00005 | DOI Listing |
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