This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Klekner, A.
Right arrow Articles by Szabo, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Klekner, A.
Right arrow Articles by Szabo, J.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, September 2006, p. 3418-3421, Vol. 44, No. 9
0095-1137/06/$08.00+0     doi:10.1128/JCM.00893-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Effectiveness of Cephalosporins in the Sputum of Patients with Nosocomial Bronchopneumonia

Almos Klekner,1* Kinga Bagyi,2 Laszlo Bognar,1 Attila Gaspar,3 Melinda Andrasi,3 and Judit Szabo4

Department of Neurosurgery, Medical and Health Science Center, University of Debrecen, Nagyerdei krt. 98, 4012 Debrecen, Hungary,1 Faculty of Dentistry, Medical and Health Science Center, University of Debrecen, Nagyerdei krt. 98, 4012 Debrecen, Hungary,2 Department of Inorganic and Analytical Chemistry, University of Debrecen, Nagyerdei krt. 98, 4012 Debrecen, Hungary,3 Institute of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Nagyerdei krt. 98, 4012 Debrecen, Hungary4

Received 28 April 2006/ Returned for modification 3 May 2006/ Accepted 31 May 2006

Nosocomial bronchopneumonia is a frequent complication in patients with chronic intratracheal intubation. Despite targeted antibiotic treatment, production of abundant bronchial secretion containing pathogen bacteria often tends to be chronic, and so mortality drastically increases. This problem led to an investigation of the penetration of five cephalosporin antibiotics into the sputum. Serum and sputum were collected from 24 chronically intubated patients having purulent nosocomial bronchopneumonia treated in an intensive care unit (ICU). Patients received the following doses intravenously every 24 h: five received 70 mg/kg of body weight cefuroxime, four received 110 mg/kg cefamandole, six received 80 mg/kg ceftriaxone, four received 80 mg/kg ceftazidime, and five received 80 mg/kg cefepime. Antibiotic concentrations in the serum and sputum were evaluated by capillary electrophoresis. MICs were determined for bacteria isolated from the purulent bronchial secretions. The mean levels of the cephalosporins in the sputum did not reach the MICs for the bacteria isolated from the same samples. Ceftriaxone was the only one of the investigated five cephalosporins that had a measurable concentration in the sputum (1.4 ± 1.2 mg/liter). The low concentration of antibiotics in the purulent tracheobronchial secretion can be one of the many reasons for ineffective therapy of nosocomial bronchopneumonia in intubated patients in the ICUs. In the case of intubated or mechanically ventilated patients having chronic bronchopneumonia, determination of drug concentration in the bronchial secretion might be considered when selecting an antibiotic for treatment.

* Corresponding author. Mailing address: Department of Neurosurgery, MHSC, University of Debrecen, Nagyerdei krt. 98, 4012 Debrecen, Hungary. Phone and fax: 36-52-419-418. E-mail: aklekner{at}yahoo.com.

Journal of Clinical Microbiology, September 2006, p. 3418-3421, Vol. 44, No. 9
0095-1137/06/$08.00+0     doi:10.1128/JCM.00893-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.





Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»