[Pleural diffusion of amoxicillin 1 and vancomycin in patients treated for post-surgical empyema].
BACKGROUND
Treatment of post surgical thoracic empyema consists of chest tube drainage, antibiotic administration, and in some cases surgical lavage of infected spaces. Data in human on the diffusion of antibiotics in pleural cavity after post surgical empyema are lacking.


METHODS
We studied on 9 patients with post surgical thoracic empyema (including 6 pneumonectomy) the diffusion of 2 antibiotics commonly used in this situation: amoxicillin (for 7 patients) and vancomycin (for 2 patients). Antibiotics concentrations were measured after at least 3 days of treatment (3-12 days), in order to reach a plateau concentration in the pleural space.


RESULTS
The ratio pleural/plasma antibiotic concentration was 1.96 (range: 0.6-4.9). The pleural infection was cured for 8 on 9 patients. The last patients required thoracostomy, and the outcome was favorable after this procedure.


CONCLUSIONS
That the penetration of amoxicillin and vancomycin in pleural space after post surgical empyema is good. Pleural antibiotics concentrations are in the majority of cases higher than plasmatic concentrations.
Stern
J B
JB
Département Thoracique, Laboratoire de microbiologie, Institut Mutualiste Montsouris, Paris, France. jean-baptiste.stern@imm.fr
Péan
Y
Y
Girard
P
P
Kitzis
M D
MD
Caliandro
R
R
Grima
R
R
Gossot
D
D
Debrosse
D
D
Schussler
O
O
Magdeleinat
P
P
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015505:Chest Tubes; D004058:Diffusion; D016724:Empyema, Pleural / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D035422:Pleural Cavity / Q000187:drug effects*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000188:drug therapy*; D020775:Thoracic Surgery, Video-Assisted; D013907:Thoracostomy; D016896:Treatment Outcome; D014640:Vancomycin / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D000658:Amoxicillin