title: Penetration of ertapenem into different pulmonary compartments of patients undergoing lung surgery.
abstract: Ertapenem is approved for the treatment of community-acquired pneumonia (CAP), but its in vivo penetration into lung tissue (LT), epithelial lining fluid (ELF), and alveolar cells (AC) is unknown. Fifteen patients undergoing thoracotomy were treated with 1 g intravenously for perioperative prophylaxis. Bronchoalveolar lavage was performed 1, 3, and 5 hours after ertapenem infusion. Normal LT was sampled at the time of lung extraction. Blood was collected before and at different time points up to 24 hours after infusion. Mean concentrations of ertapenem in plasma, ELF, and AC were at 1.0 hour, 63.1, 4.06, 0.004 mg/L; at 3.0 hours, 39.7, 2.59, 0.003 mg/L; and at 5.0 hours, 27.2, 2.83, 0.007 mg/L. Mean (range) concentration in LT was 7.60 (2.5-19.4) mg/kg tissue 1.5 to 4.5 hours after infusion. In plasma, ertapenem exhibited a Cmax of 94.7 +/- 23.3 mg/L and an AUC(0-last) of 501.1 +/- 266.3 mg x h/L. These results, combined with the reported (MIC)90 of most CAP bacteria, support the previously observed clinical efficacy of ertapenem in the treatment of CAP.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University Otto-von-Guericke, Magdeburg, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Burkhardt
authors.forename: Jolanta
authors.initials: J
authors.lastname: Majcher-Peszynska
authors.forename: Klaus
authors.initials: K
authors.lastname: Borner
authors.forename: Ralf
authors.initials: R
authors.lastname: Mundkowski
authors.forename: Bernd
authors.initials: B
authors.lastname: Drewelow
authors.forename: Hartmut
authors.initials: H
authors.lastname: Derendorf
authors.forename: Tobias
authors.initials: T
authors.lastname: Welte
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D004334:Drug Administration Schedule; D000077727:Ertapenem; D005260:Female; D006207:Half-Life; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000737:chemistry / Q000166:cytology / Q000187:drug effects*; D020545:Respiratory Mucosa / Q000737:chemistry / Q000187:drug effects; D013908:Thoracotomy; D047090:beta-Lactams / Q000032:analysis* / Q000493:pharmacokinetics / Q000494:pharmacology*
chemical_list: D047090:beta-Lactams; D000077727:Ertapenem