Y. Levy et al., PENETRATION OF CLINDAMYCIN AND METRONIDAZOLE INTO INFLAMED APPENDICEAL TISSUE, The European journal of surgery, 162(8), 1996, pp. 633-635
Objective: To calculate the penetration of clindamycin and metronidazo
le into inflamed appendiceal tissue. Design: Prospective study. Settin
g: Teaching hospital, Israel. Subjects: 20 Consecutive men and women o
perated on for acute appendicitis. Interventions: Appendicectomy. Each
patient was given three intravenous injections of gentamicin 80 mg co
mbined with either clindamycin 600 mg or metronidazole 500 mg immediat
ely before operation over a period of 15 minutes. Main outcome measure
s: Serum and tissue concentrations of the antibiotics. Results: There
was no significant difference between the mean serum concentrations of
the drugs (clindamycin 17.86 mu g/ml and metronidazole 9.75 mu g/ml)
but the mean tissue concentrations of clindamycin (10.41 mu g/g in the
base and 9.86 mu g/g in the tip of the appendix) were significantly h
igher than those of metronidazole (5.65 mu g/g in the base and 5.89 mu
g/g in the tip; p = 0.02 and p = 0.05, respectively). Tissue concentr
ations of clindamycin and serum concentration of both drugs were more
than twice their MIC(90). The tissue concentrations of metronidazole w
ere close to its MIC(90). Conclusions: Clinical trials are necessary b
efore any conclusion about therapeutic superiority of one or other age
nt can be drawn.