What question did this study set out to answer?

Determine the rate and extent to which various systemic antibiotics penetrate into the pericardial space under both noninfected and infected conditions.

January 1, 1974Journal of Clinical InvestigationOpen Access

Antibiotic Levels in Pericardial Fluid

Q: What is the clinical evidence from this study?

Study design: Other. Population: Pericarditis with pericardial effusion (n=4). Intervention: Antibiotics (Penicillin G, Penicillin V, Cephalothin, Gentamicin) vs. Serum levels. Primary outcome: Pericardial fluid to serum antibiotic concentration ratio.

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Key result

Pericardial antibiotic levels measured at least 2 hours after administration are almost identical to concurrent blood levels in both human patients and a canine model.

Why the study?

Does systemic antibiotic administration achieve therapeutic levels in pericardial fluid in dogs and humans?

Population

Adult mongrel dogs and 4 human patients with pericarditis and persistent reaccumulation of pericardial fluid.

Design

Preclinical

Follow-up

Up to 48 hours

Authors

JTJames S. TanBallarat Health Services JHJohn C. HolmesAnimal and Plant Health Inspection Service NFNoble O. FowlerCincinnati Children's Hospital Medical Center

Discussion

Member takes

Implication

Systemic antibiotics may achieve therapeutic pericardial levels; hypothesis-generating in Level 5 data, requires prospective human confirmation.

Key Points

Determine the rate and extent to which various systemic antibiotics penetrate into the pericardial space under both noninfected and infected conditions.
Administered penicillin G, methicillin, cephaloridine, streptomycin, or gentamicin to adult mongrel dogs and measured serum and pericardial fluid levels at serial intervals in noninfected and infected states.
Sampled and analyzed matched serum and pericardial fluid antibiotic levels in clinical patients treated with penicillin G, penicillin V, cephalothin, or gentamicin.
In noninfected canine models, clinically adequate antibiotic levels emerged in pericardial fluid within 1 hour and approached or exceeded serum levels within 2 to 4 hours.
Canine pericardial fluid with active infection achieved higher antibiotic concentrations than noninfected fluid.
Pericardial fluid antibiotic concentrations obtained at least 2 hours after dosing were almost identical to concurrent blood levels in both canine and human subjects.

Structured PICO

Does systemic antibiotic administration achieve therapeutic levels in pericardial fluid in dogs and humans?

Population

4 patients with pericarditis and persistent reaccumulation of pericardial fluid, alongside an experimental dog model, evaluated for antibiotic penetration into the pericardial space.

Intervention

Systemic administration (intramuscular or oral) of antibiotics including penicillin G, methicillin, cephaloridine, streptomycin, gentamicin, penicillin V, or cephalothin.

Outcome

Pericardial fluid and serum antibiotic concentrations measured at intervals up to 6 hours (and up to 48 hours in some patients).surrogate

Systemically administered antibiotics readily diffuse into pericardial fluid, achieving concentrations similar to serum levels within 2 hours, suggesting systemic therapy is adequate for treating pericardial infections.

Limitations

Small sample size in human studies (4 patients)
Limited serial observations in humans

Cite This Study

Tan et al. (1974) studied Pericarditis with pericardial effusion (n=4). Antibiotics (Penicillin G, Penicillin V, Cephalothin, Gentamicin) vs. Serum levels was evaluated on Pericardial fluid to serum antibiotic concentration ratio. Pericardial antibiotic levels measured at least 2 hours after administration are almost identical to concurrent blood levels in both human patients and a canine model.

synapsesocial.com/papers/6a9b4aee9fa83f7ab06be70f https://doi.org/10.1172/jci107561

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Implication

Systemic antibiotics may achieve therapeutic pericardial levels; hypothesis-generating in Level 5 data, requires prospective human confirmation.

Antibiotic Levels in Pericardial Fluid

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Antibiotic Levels in Pericardial Fluid

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider