title: Factors Affecting Penetration of Ciprofloxacin in Lower Extremity Ischemic Tissues.
abstract: The aims of this study were to evaluate factors influencing the distribution of ciprofloxacin in tissue of patients suffering from varying degrees of peripheral arterial disease (PAD). Blood and tissue samples were collected from patients undergoing debridement or amputation procedures and the amount of ciprofloxacin in them was determined using high-performance liquid chromatography. All patients were administered a 200-mg dose of intravenous ciprofloxacin prior to the debridement or amputation procedure. Data, including patient gender, age, type of diabetes, presence of neuropathy, medications taken, and severity of PAD were collected. These data were then analyzed to determine factors influencing the concentrations of ciprofloxacin in tissue of the lower limbs. The Kruskal-Wallis test, Spearman correlation, and chi-square test were used to relate covariates and fixed factors with the concentration of ciprofloxacin in tissue. Following bivariate analysis, a 3-predictor regression model was fitted to predict tissue concentrations of ciprofloxacin given information about these predictors. Blood and tissue samples were collected from 50 patients having an average age of 68 years. Thirty-three patients were males and 35 patients suffered from type 2 diabetes. The average number of medications that these patients were taking was 10. The majority of patients (n = 35) were suffering from severe PAD. Tissue concentrations of ciprofloxacin were mainly related to plasma concentrations of ciprofloxacin, number of medications that the patients were taking and severity of PAD.
authors.affiliation: University of Malta, Msida, Malta janis.vella@um.edu.mt.
authors.forename: Janis
authors.initials: J
authors.lastname: Vella
authors.affiliation: University of Malta, Msida, Malta.
authors.forename: Maria
authors.initials: M
authors.lastname: Vella
authors.affiliation: University of Malta, Msida, Malta.
authors.forename: Kevin
authors.initials: K
authors.lastname: Cassar
authors.affiliation: University of Malta, Msida, Malta.
authors.forename: Liberato
authors.initials: L
authors.lastname: Camilleri
authors.affiliation: University of Malta, Msida, Malta.
authors.forename: Anthony
authors.initials: A
authors.lastname: Serracino-Inglott
authors.affiliation: University of Malta, Msida, Malta.
authors.forename: Lilian M
authors.initials: LM
authors.lastname: Azzopardi
authors.affiliation: University of Malta, Msida, Malta.
authors.forename: Godfrey
authors.initials: G
authors.lastname: LaFerla
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000379:methods; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D002853:Chromatography, Liquid / Q000379:methods; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000493:pharmacokinetics; D003646:Debridement / Q000379:methods; D005260:Female; D006801:Humans; D007511:Ischemia / Q000378:metabolism / Q000473:pathology; D007871:Leg Ulcer / Q000209:etiology / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D035002:Lower Extremity; D008297:Male; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000175:diagnosis; D011300:Preoperative Care / Q000379:methods; D012720:Severity of Illness Index; D014018:Tissue Distribution
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin
keywords: ciprofloxacin; concentration in tissue; debridement and amputation procedures; diabetes; peripheral arterial disease