Tissue penetration of moxifloxacin into human gallbladder wall in patients with biliary tract infections.
OBJECTIVE
Moxifloxacin, the newest fourth-generation fluoroquinolone, has a broad spectrum of antibacterial activity covering both Gram-positive and Gram-negative aerobic and anaerobic bacteria and is therefore very well suited for the treatment of biliary tract infections. The present study aimed to determine the penetration of moxifloxacin into gallbladder tissue to evaluate its antibiotic potential in this indication.


METHODS
Hospitalized patients with acute cholecystitis received a single, 1 h infusion of 400 mg of moxifloxacin before cholecystectomy. Serum and gallbladder wall tissue samples were collected during surgery, and the moxifloxacin concentrations were measured by HPLC.


RESULTS
Sixteen patients (eight men and eight women) were included between January 2007 and April 2008. The time between start of infusion and gallbladder removal ranged from 50 min to 21 h 10 min. The serum concentration at the time of cholecystectomy was between 0.39 and 4.37 mg/L, and the tissue concentration between 1.73 and 17.08 mg/kg. The tissue-to-serum concentration ratio ranged from 1.72 to 6.33.


CONCLUSIONS
The results show that moxifloxacin penetrates well into gallbladder tissue and is therefore a therapeutic option for biliary tract infection. The highest concentrations in serum and gallbladder tissue were measured shortly after the end of a 1 h infusion. As perioperative prophylaxis, moxifloxacin should therefore be administered 30-60 min before the first surgical incision.
Ober
Michael C
MC
Pharmacy Department, University Hospital of Heidelberg, Im Neuenheimer Feld 670, Heidelberg, Germany.
Hoppe-Tichy
Torsten
T
Köninger
Jörg
J
Schunter
Oliver
O
Sonntag
Hans-Günther
HG
Weigand
Markus A
MA
Encke
Jens
J
Gutt
Carsten
C
Swoboda
Stefanie
S
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001372:Aza Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy*; D001660:Biliary Tract Diseases / Q000188:drug therapy*; D002764:Cholecystitis / Q000188:drug therapy*; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D005260:Female; D024841:Fluoroquinolones; D005704:Gallbladder / Q000737:chemistry*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D011804:Quinolines / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D044967:Serum / Q000737:chemistry; D013997:Time Factors; D055815:Young Adult
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin