Intraabdominal tissue concentration of ertapenem.
OBJECTIVE
Ertapenem, a class I carbapenem, is approved for the treatment of mild to severe intraabdominal infections, but its in vivo concentrations in intraabdominal tissues are unknown. The purpose of this study was to determine the concentration of ertapenem in intraabdominal tissue.


METHODS
After informed consent 48 patients, 23 female and 25 male with a median age of 58 years (34-81), requiring surgical intervention at intraabdominal organs were enrolled. Patients received 1 g of ertapenem intravenously for perioperative prophylaxis. Tissue samples were taken after resection of parts of the organs. Plasma samples were taken when tissue samples were taken. Drug concentrations were determined by liquid chromatography/mass spectrometry. An ANCOVA test (analysis of covariance) was performed to assess organ-specific differences in ertapenem concentration and penetration ratios.


RESULTS
Mean+/-SD ertapenem tissue concentration (mg/kg) was 16.0+/-8.8 in the gall bladder, 12.1+/-5.3 in the colon, 7.0+/-5.7 in the small bowel, 4.5+/-2.3 in the liver and 3.4+/-2.9 in the pancreas. The mean tissue/plasma ratio was 0.19 (colon), 0.17 (small bowel), 0.17 (gall bladder), 0.088 (liver) and 0.095 (pancreas). The ANCOVA test revealed statistically significant organ-specific differences in ertapenem tissue concentration in the gall bladder versus liver/pancreas and in tissue penetration for the colon versus liver/pancreas.


CONCLUSIONS
These pharmacokinetic results support the assumption that ertapenem is suitable for the treatment of intraabdominal infections.
Wittau
M
M
University of Ulm, Department of Visceral Surgery, Steinhövelstrasse 9, 89075 Ulm, Germany. mathias.wittau@web.de
Wagner
E
E
Kaever
V
V
Koal
T
T
Henne-Bruns
D
D
Isenmann
R
R
D000005:Abdomen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D002851:Chromatography, High Pressure Liquid; D000077727:Ertapenem; D005260:Female; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D011446:Prospective Studies; D047090:beta-Lactams / Q000008:administration & dosage / Q000493:pharmacokinetics*
D047090:beta-Lactams; D000077727:Ertapenem