title: Excretion of beta-lactam antibiotics in sweat--a neglected mechanism for development of antibiotic resistance?
abstract: The concentrations of beta-lactam antibiotics after standard doses were measured in blood and apocrine (axilla) and eccrine (forearm) sweat from six adult healthy persons. All persons had ceftazidime (axilla, 28.4 microg/ml; forearm, 11 microg/ml) and ceftriaxone (axilla, 8.9 microg/ml; forearm, 2.5 microg/ml) in sweat, and one person had cefuroxime in sweat (axilla, 7.8 microg/ml) (all data are mean peaks). Three persons had benzylpenicillin (axilla, 2.6 to 0.1 microg/ml) and one had phenoxymethylpenicillin (axilla, 0.4 microg/ml) in sweat. Excretion of beta-lactam antibiotics in the sweat may explain why staphylococci so rapidly become resistant to these drugs.
authors.affiliation: Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Denmark. hoiby@inet.uni2.dk
authors.forename: N
authors.initials: N
authors.lastname: Hoiby
authors.forename: C
authors.initials: C
authors.lastname: Pers
authors.forename: H K
authors.initials: HK
authors.lastname: Johansen
authors.forename: H
authors.initials: H
authors.lastname: Hansen
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000900:Anti-Bacterial Agents / Q000097:blood / Q000493:pharmacokinetics* / Q000494:pharmacology; D002442:Ceftazidime / Q000493:pharmacokinetics; D002443:Ceftriaxone / Q000493:pharmacokinetics; D002444:Cefuroxime / Q000493:pharmacokinetics; D002511:Cephalosporins / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000493:pharmacokinetics; D010404:Penicillin V / Q000493:pharmacokinetics; D010406:Penicillins / Q000493:pharmacokinetics; D013542:Sweat / Q000378:metabolism*; D018440:beta-Lactam Resistance / Q000502:physiology*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D002443:Ceftriaxone; D002442:Ceftazidime; D002444:Cefuroxime; D010400:Penicillin G; D010404:Penicillin V