title: Amoxicillin/clavulanate in chronic rhinosinusitis: tissue and serum distribution.
abstract: Amoxicillin/clavulanate in chronic rhinosinusitis: tissue and serum distribution.
  
  
  OBJECTIVE
  The aim of the present study is to determine the concentrations of coamoxiclav in the sinusal mucosa of patients undergoing surgery for chronic sinusitis in comparison to serum levels after single oral administration.
  
  
  METHODS
  24 patients affected by chronic sinusitis, undergoing sinus surgery, were divided into three groups receiving an oral dose of 1 g of coamoxiclav (875 mg amoxicillin, 125 g of clavulanic acid, 7:1 ratio) at 2 h (first group), 4 h (second group) and 6 h (third group) before surgery. The mean concentration of amoxicillin and clavulanic acid were determined biologically in serum and in tissues.
  
  
  RESULTS
  The highest concentrations of coamoxiclav both in serum and tissues were observed in the group which received the antibiotic 2 hours before surgery. However the tissue levels of both amoxicillin and clavulanic acid in the time period within 2-6 h after administration were higher than the Minimum Inhibitory Concentration (MIC) for the most frequent causative pathogens of sinus bacterial infections.
  
  
  CONCLUSIONS
  Since penicillins need to maintain concentrations above the MIC for at least 40 to 60% of the interval time between administrations to be potentially effective, the Authors concluded that since both amoxicillin and clavulanic acid spread well in the ENT tissues, 1 g twice a day of the combination seems to be clinically effective even in patients suffering from acute episodes of chronic rhinosinusitis.
authors.affiliation: E.N.T. Department, University of Siena Medical School, Sienna, Italy. Passali@unisi.it
authors.forename: D
authors.initials: D
authors.lastname: Passàli
authors.forename: T
authors.initials: T
authors.lastname: Mazzei
authors.forename: A
authors.initials: A
authors.lastname: Novelli
authors.forename: S
authors.initials: S
authors.lastname: Fallani
authors.forename: P
authors.initials: P
authors.lastname: Dentico
authors.forename: C
authors.initials: C
authors.lastname: Mezzedimi
authors.forename: G C
authors.initials: GC
authors.lastname: Passàli
authors.forename: L
authors.initials: L
authors.lastname: Bellussi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000378:metabolism / Q000627:therapeutic use*; D002908:Chronic Disease; D004359:Drug Therapy, Combination / Q000378:metabolism / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000378:metabolism; D012220:Rhinitis / Q000097:blood / Q000188:drug therapy*; D012852:Sinusitis / Q000188:drug therapy*; D013997:Time Factors
chemical_list: D019980:Amoxicillin-Potassium Clavulanate Combination