Tissue penetration of antimicrobials: Difference between revisions
From IDWiki
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! colspan="7" |Antibiotics: Ξ²-Lactams |
! colspan="7" |Antibiotics: Ξ²-Lactams |
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β | | rowspan="3" |Penicillins |
+ | | rowspan="3" |[[Penicillins]] |
|Ξ²-lactamase inhibitors |
|Ξ²-lactamase inhibitors |
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β | | rowspan="5" |Cephalosporins |
+ | | rowspan="5" |[[Cephalosporins]] |
|first-generation cephalosporins |
|first-generation cephalosporins |
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β | | rowspan="2" |Cephamycins |
+ | | rowspan="2" |[[Cephamycins]] |
|[[cephamycins]] |
|[[cephamycins]] |
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| style="text-align:center" |β |
| style="text-align:center" |β |
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β | |Carbapenems |
+ | |[[Carbapenems]] |
|[[imipenem]] |
|[[imipenem]] |
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! colspan="7" |Antibiotics: Non-Ξ²-Lactams |
! colspan="7" |Antibiotics: Non-Ξ²-Lactams |
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β | |Aminoglycosides |
+ | |[[Aminoglycosides]] |
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| style="text-align:center" |β |
| style="text-align:center" |β |
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β | |Chloramphenicol |
+ | |[[Chloramphenicol]] |
|[[chloramphenicol]] |
|[[chloramphenicol]] |
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β | |Fluoroquinolones |
+ | |[[Fluoroquinolones]] |
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β | |Fosfomycin |
+ | |[[Fosfomycin]] |
|[[fosfomycin]] |
|[[fosfomycin]] |
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β | |Lincosamides |
+ | |[[Lincosamides]] |
|[[clindamycin]] |
|[[clindamycin]] |
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β | |Macrolides |
+ | |[[Macrolides]] |
|[[macrolides]] |
|[[macrolides]] |
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β | |Nitrofurans |
+ | |[[Nitrofurans]] |
|[[nitrofurantoin]] |
|[[nitrofurantoin]] |
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| style="text-align:center" |β |
| style="text-align:center" |β |
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| style="text-align:center" |β |
| style="text-align:center" |β |
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β | |Nitroimidazoles |
+ | |[[Nitroimidazoles]] |
|[[metronidazole]] |
|[[metronidazole]] |
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β | |Rifamycins |
+ | |[[Rifamycins]] |
|[[rifampin]] |
|[[rifampin]] |
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β | |Sulfonamides |
+ | |[[Sulfonamides]] |
|[[trimethoprim-sulfamethoxazole]] |
|[[trimethoprim-sulfamethoxazole]] |
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β | | rowspan="2" |Tetracyclines |
+ | | rowspan="2" |[[Tetracyclines]] |
|[[tetracyclines]] |
|[[tetracyclines]] |
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! colspan="7" |Antifungals |
! colspan="7" |Antifungals |
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β | |Azoles |
+ | |[[Azoles]] |
|[[fluconazole]] |
|[[fluconazole]] |
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+ | |- |
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+ | |[[Echinocandins]] |
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!Class |
!Class |
Revision as of 14:46, 16 September 2020
Summary
Class | Antimicrobial | Blood | CNS | Urine | Prostate | Necrotic |
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Antibiotics: Ξ²-Lactams | ||||||
Penicillins | Ξ²-lactamase inhibitors | β | ||||
ampicillin | + | β | ||||
piperacillin-tazobactam | +β | |||||
Cephalosporins | first-generation cephalosporins | β | β | |||
second-generation cephalosporins | β | |||||
third-generation cephalosporins | +β | |||||
cefepime | + | |||||
ceftazidime | + | + | ||||
Cephamycins | cephamycins | β | ||||
cefoxitin | β | |||||
Carbapenems | imipenem | + | ||||
Antibiotics: Non-Ξ²-Lactams | ||||||
Aminoglycosides | β | |||||
Chloramphenicol | chloramphenicol | + | ||||
Fluoroquinolones | β? | + | + | |||
Fosfomycin | fosfomycin | + | ||||
Lincosamides | clindamycin | β | + | |||
Macrolides | macrolides | β | + | |||
Nitrofurans | nitrofurantoin | β | β | + | β | β |
Nitroimidazoles | metronidazole | + | ||||
Rifamycins | rifampin | + | ||||
Sulfonamides | trimethoprim-sulfamethoxazole | + | ||||
Tetracyclines | tetracyclines | β | + | |||
doxycycline | + | + | ||||
Antifungals | ||||||
Azoles | fluconazole | + | ||||
Echinocandins | + | β | ||||
Class | Antimicrobial | Blood | CNS | Urine | Prostate | Necrotic |
- β if inflammation present
Prostate
- Poorly penetrated by most antibiotics
- Penetration is higher with a high concentration gradient, high lipid solubility, low degree of ionization, high dissociation constant, low protein binding, and small molecular size
- Fluoroquinolones are the mainstay of therapy, though there is increasing resistance
- TMP-SMX often used, though conflicting data about its penetration into the prostate
- Minocycline, doxycycline, and macrolides achieve high levels in the prostate but are rarely indicated for the causative organisms
- Third-generation cephalosporins and carbapenems can be used
- Piperacillin, aztreonam, imipenem, and some aminoglycosides are likely useful
References
- ^ Cornelia B. Landersdorfer, JΓΌrgen B. Bulitta, Martina Kinzig, Ulrike Holzgrabe, Fritz SΓΆrgel. Penetration of Antibacterials into Bone. Clinical Pharmacokinetics. 2009;48(2):89-124. doi:10.2165/00003088-200948020-00002.
- a b c d e f g h i j k l m n o p q r L. Brockhaus, D. Goldblum, L. Eggenschwiler, S. Zimmerli, C. Marzolini. Revisiting systemic treatment of bacterial endophthalmitis: a review of intravitreal penetration of systemic antibiotics. Clinical Microbiology and Infection. 2019;25(11):1364-1369. doi:10.1016/j.cmi.2019.01.017.
- a b Takashi Suzuki, Toshihiko Uno, Guangming Chen, Yuichi Ohashi. Ocular distribution of intravenously administered micafungin in rabbits. Journal of Infection and Chemotherapy. 2008;14(3):204-207. doi:10.1007/s10156-008-0612-5.
- a b c d e f g h Timothy Felton, Peter F. Troke, William W. Hope. Tissue Penetration of Antifungal Agents. Clinical Microbiology Reviews. 2014;27(1):68-88. doi:10.1128/cmr.00046-13.