title: Penetration of levofloxacin into paranasal sinuses mucosa of patients with chronic rhinosinusitis after a single 500 mg oral dose.
abstract: Respiratory fluoroquinolones are currently considered by several guidelines among the most effective antimicrobial agents for the treatment of acute bacterial rhinosinusitis. The aim of this study was to assess levofloxacin penetration into paranasal sinuses mucosa of 15 patients with chronic rhinosinusitis 1h (n = 4), 2 h (n = 5) and 3 h (n = 6) after a single 500 mg oral dose. Levofloxacin concentrations in plasma and tissue samples were assessed by means of HPLC. Median of mucosal concentrations were 0.96 mg l(-1) at 1 h, 2.50 mg l(-1) at 2 h, 5.84 mg l(-1) at 3 h. Average paranasal sinuses mucosa-to-plasma ratios raised from 1.46 at 1 h, to 1.81 at 2 h and to 2.56 at 3 h. These data are consistent with 500 mg oral levofloxacin ensuring appropriate therapeutic exposure in sinonasal tissue of patients with chronic rhinosinusitis, the concentrations between 1 and 3 h post-dosing being almost always higher than the MIC90 against the major bacterial pathogens responsible for upper respiratory tract infections.
authors.affiliation: Institute of Clinical Pharmacology & Toxicology, Department of Experimental and Clinical Pathology and Medicine, Medical School, University of Udine, Italy. federico.pea@med.uniud.it
authors.forename: Federico
authors.initials: F
authors.lastname: Pea
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
authors.forename: Federica
authors.initials: F
authors.lastname: Pavan
authors.forename: Claudia
authors.initials: C
authors.lastname: Staffieri
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bottin
authors.forename: Alberto
authors.initials: A
authors.lastname: Staffieri
authors.forename: Mario
authors.initials: M
authors.lastname: Furlanut
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D002851:Chromatography, High Pressure Liquid; D002908:Chronic Disease; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000378:metabolism; D015242:Ofloxacin / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D010256:Paranasal Sinuses / Q000378:metabolism*; D012220:Rhinitis / Q000378:metabolism*; D012852:Sinusitis / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin