Principles of antibiotic penetration into abscess fluid.
Although drainage is considered the gold standard in abscess treatment, abscesses of different sizes and locations have been successfully cured by means of antibiotic treatment alone. The penetration of an antibiotic into an encapsulated purulent lesion is limited and highly dependent on the degree of abscess maturation. In fact, in vivo pharmacokinetic data demonstrate that substantial antibiotic concentrations can be reached within abscesses in humans and animals, provided the choice of an appropriate agent and an optimal dosing regimen. However, the efficacy of antibiotics in pus may be hampered by various factors like low pH, protein binding and degradation by bacterial enzymes. This article provides a comprehensive review on conservative abscess treatment, presenting clinical data on success rates of antibiotic therapy. Antibiotic concentrations measured in abscesses of humans and animals are outlined, and theoretical considerations on the understanding of pharmacokinetics and efficacy of antibiotics in abscesses are discussed.
Wagner
Claudia
C
Division of Clinical Pharmacokinetics, Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Sauermann
Robert
R
Joukhadar
Christian
C
D000038:Abscess / Q000188:drug therapy / Q000378:metabolism*; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001826:Body Fluids / Q000378:metabolism*; D006801:Humans; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents