Penetration of antibiotics in diseased antral mucosa.
OBJECTIVE
To investigate extracellular concentrations of antibiotics in inflammatory diseased sinus mucosa in critically ill patients and to find out whether there were any correlations between the concentrations of antibiotics in extracellular tissue and the presence of bacterial infection.


METHODS
Prospective case series. Sinoscopic findings were used as the criterion standard.


METHODS
The general and the neurosurgical intensive care units of a tertiary care hospital.


METHODS
Critically ill patients, nasotracheally intubated or tracheotomized, who received ventilator treatment (> 7 days) and antibiotic therapy.


METHODS
Bilateral sinoscopies were performed; antral secretions were collected for bacterial cultures; and serum and tissue samples were obtained for bioassay of antibiotic concentrations.


RESULTS
The concentrations of all antibiotics found in extracellular fluid were lower than those found in serum samples.


CONCLUSIONS
Measurable extracellular tissue concentrations of antibiotics were found in the antral mucosa, demonstrating that inflammatory maxillary sinus disease does not impede the antibiotic penetration of the mucosa or antibiotic activity in the extracellular tissue.
Westergren
V
V
Department of Otorhinolaryngology-Head and Neck Surgery, Karolinska Hospital, Stockholm, Sweden.
Nilsson
M
M
Forsum
U
U
D000328:Adult; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy*; D016638:Critical Illness; D005110:Extracellular Space / Q000378:metabolism; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D007442:Intubation, Intratracheal; D008297:Male; D008443:Maxillary Sinus / Q000378:metabolism*; D015523:Maxillary Sinusitis / Q000188:drug therapy*; D008875:Middle Aged; D009092:Mucous Membrane / Q000378:metabolism; D011446:Prospective Studies
D000900:Anti-Bacterial Agents