title: Abscess penetration of cefpirome: concentrations and simulated pharmacokinetic profiles in pus.
abstract: OBJECTIVE
  Abscess patients frequently receive antibiotic therapy when incision cannot be performed or in addition to incision. However, antibiotic concentrations in human abscesses are widely unknown.
  
  
  METHODS
  Pharmacokinetics of cefpirome in 12 human abscesses located in different body regions was studied. Cefpirome (2 g) was administered as an intravenous short infusion, and concentrations were measured in plasma over an 8-h period and in abscesses at incision. A pharmacokinetic two-stage model was applied.
  
  
  RESULTS
  At abscess incision performed 158 ± 112 min after the start of the infusion, the cefpirome concentrations in the abscess fluid varied markedly, ranging from ≤0.1 (limit of quantification) to 47 (mean 8.4 ± 14.1 ) mg/L. Cefpirome was detectable in nine of 12 abscesses. Maximum concentrations were calculated to be 183 ± 106 mg/L in plasma and 12 ± 16 mg/L in the abscess. A cefpirome concentration of 2 mg/L, which is the minimum concentration inhibiting growth of 90% of the most relevant bacterial pathogens, was exceeded spontaneously in six of 12 abscesses after a single dose. Cefpirome concentrations in the abscess did not correlate with either the pH or the ratio of surface area to volume of the abscesses, nor with plasma pharmacokinetics.
  
  
  CONCLUSIONS
  Cefpirome may be useful to treat abscess patients because it was detectable in most abscesses after a single dose. However, the penetration of cefpirome into abscesses is extremely variable and cannot be predicted by measuring other available covariates.
authors.affiliation: Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. robert.sauermann@meduniwien.ac.at
authors.forename: Robert
authors.initials: R
authors.lastname: Sauermann
authors.forename: Thomas
authors.initials: T
authors.lastname: Feurstein
authors.forename: Rudolf
authors.initials: R
authors.lastname: Karch
authors.forename: Maria C
authors.initials: MC
authors.lastname: Kjellsson
authors.forename: Walter
authors.initials: W
authors.lastname: Jäger
authors.forename: Michaela
authors.initials: M
authors.lastname: Böhmdorfer
authors.forename: Andreas
authors.initials: A
authors.lastname: Püspök
authors.forename: Herbert
authors.initials: H
authors.lastname: Langenberger
authors.forename: Thomas
authors.initials: T
authors.lastname: Wild
authors.forename: Stefan
authors.initials: S
authors.lastname: Winkler
authors.forename: Markus
authors.initials: M
authors.lastname: Zeitlinger
mesh_terms: D000038:Abscess / Q000378:metabolism*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D019540:Area Under Curve; D001826:Body Fluids / Q000378:metabolism; D002511:Cephalosporins / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D013492:Suppuration / Q000378:metabolism*; D000097572:Cefpirome
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000097572:Cefpirome