Digestive Diseases and Sciences

, Volume 36, Issue 12, pp 1782–1786

Ascitic fluid and serum cefotaxime and desacetyl cefotaxime levels in patients treated for bacterial peritonitis

  • B. A. Runyon
  • E. A. Akriviadis
  • F. R. Sattler
  • J. Cohen
Original Articles

DOI: 10.1007/BF01296625

Cite this article as:
Runyon, B.A., Akriviadis, E.A., Sattler, F.R. et al. Digest Dis Sci (1991) 36: 1782. doi:10.1007/BF01296625

Abstract

Forty-one episodes of ascitic fluid infection were treated with cefotaxime 2 g intravenously every 8 hr, and ascitic fluid and serum were sampled 6, 12, 24, 48, and 96 hr after the first dose of antibiotic. Concentrations of cefotaxime and desacetyl cefotaxime were measured in ascitic fluid and serum by high-performance liquid chromatography. There was essentially 100% penetration of cefotaxime and metabolite from serum into ascitic fluid at all time points. Ascitic fluid was sterilized in 94% of episodes after the first dose of antibiotic. The ascitic fluid concentration of cefotaxime 6 hr after the first dose of antibiotic was greater than 20 times the minimal inhibitory concentration of the drug for 90% of the isolated flora. This rapid ascitic fluid penetration of cefotaxime in high concentration explains the rapid sterilization of ascitic fluid by the drug in the setting of bacterial peritonitis and obviates the need to give a loading dose or intraperitoneal injection.

Key Words

spontaneous bacterial peritonitis cefotaxime ascitic fluid antibiotic concentration 

Copyright information

© Plenum Publishing Corporation 1991

Authors and Affiliations

  • B. A. Runyon
    • 1
  • E. A. Akriviadis
    • 1
  • F. R. Sattler
    • 1
  • J. Cohen
    • 1
  1. 1.Departments of Medicine, School of Medicine and School of PharmacyUniversity of Southern CaliforniaLos Angeles
  2. 2.University of Iowa College of MedicineIowa City
  3. 3.College of PharmacyUniversity of KentuckyLexington
  4. 4.Department of Internal Medicine, Division of Gastroenterology/HepatologyUniversity of Iowa Hospitals & ClinicsIowa City

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