Chest
Laboratory and Animal InvestigationsAntibiotic Levels in Empyemic Pleural Fluid
Section snippets
Materials and Methods
This project was approved by the Animal Subjects Committee of the Veterans Affairs Medical Center, Long Beach, prior to the start of the study. Twelve New Zealand male white rabbits weighing from 2.0 to 3.0 kg were utilized for this study. Two rabbits each were used to study the pleural fluid antibiotic levels after the administration of each of the following six antibiotics: penicillin, metronidazole, ceftriaxone, clindamycin, vancomycin, and gentamicin.
Results
All rabbits developed empyema after the intrapleural injection of 108P multocida bacteria (Table 1). The pleural fluid was thick and grossly opaque. The pleural fluid pH was < 7.10 and the pleural fluid glucose level was < 20 mg/dL in all rabbits. The pleural fluid culture results were positive in all rabbits.
The relationships between the pleural fluid antibiotic levels and the serum antibiotic levels varied from one antibiotic to another (Fig 1). These relationships were primarily evaluated in
Discussion
The present study shows that penetration of antibiotics into infected pleural fluid and equilibration between the serum and pleural fluid varies from one antibiotic to another, using this experimental model of empyema in the rabbit.
Penicillin was the most effective agent in penetrating into the pleural space, followed by metronidazole. The antibiotics ceftriaxone, vancomycin, and clindamycin were of similar effectiveness, with gentamicin being the least effective penetrator.
Equilibration of
ACKNOWLEDGMENT
The authors would like to acknowledge the assistance of Dr. Dong-Sheng Cheng in preparing Figure 1, Ms. Sheila Rupp in preparing and editing the manuscript, and Patrick Chan (from Microbiological Reference Laboratories).
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Dr. Teixeira is supported by Fundacao De Amparo a Pesquisa Do Estado de Sao Paulo, Brazil.