The penetration of ciprofloxacin into human pancreatic and peripancreatic necroses in acute necrotizing pancreatitis.
BACKGROUND
Antibiotic prophylaxis in necrotizing pancreatitis has recently gained acceptance. Published studies, however, used different antibiotic regimes and some antibiotics penetrated pancreatic tissue or pancreatic necroses only poorly. The aim of this study was to assess the penetration of ciprofloxacin (CIP) into necrotic pancreatic and peripancreatic tissue.


METHODS
Serum, pancreatic necroses, peripancreatic fat tissue necroses and infected omental fluid levels of CIP were measured after 51 operations in 14 patients.


RESULTS
The median penetration ratio of CIP was 137.5% (range 11-196%) in infected omental bursa fluid, 59.6% (3-214%) in pancreatic necroses and 67.1% (1-250%) in peripancreatic necroses. Chemotherapeutical ratios of CIP as a marker for antimicrobial potency were high against most relevant pathogens in necrotizing pancreatitis.


CONCLUSIONS
Due to its antimicrobial spectrum and the good penetration into the relevant compartments, CIP may be useful in preventing local infection in necrotizing pancreatitis.
Adam
U
U
Dept. of Surgery, University of Freiburg, Germany. adam@chir.ukl.uni-freiburg.de
Herms
S
S
Werner
U
U
Strubelt
H
H
Makowiec
F
F
Hopt
U T
UT
Drewelow
B
B
D000328:Adult; D000890:Anti-Infective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000494:pharmacology* / Q000627:therapeutic use; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000187:drug effects*; D019283:Pancreatitis, Acute Necrotizing / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D002939:Ciprofloxacin