Ciprofloxacin concentrations in pleural fluid after pneumonectomy under systemic application

Postpneumonectomy empyema represents a frequently lethal complication. It r emains unsolved whether prophylactic antibiotics achieve a bactericidal con centration in the pleural cavity after pneumonectomy. 12 patients undergoin g pneumonectomy received ciprofloxacin intravenously (2 x 200 mu g/d) and o rally (2 x 500 mu mg/d) during the first and second postoperative week, res pectively. 1, 6, 9 and 14 days after the operation the ciprofloxacin concen tration was measured in the pleural fluid and serum. Already after 24 hours bactericidal levels (0.56 mu g/ml) were found in the pleural fluid, rising to 1.11 mu g/ml on day 14 under the higher oral dosage. Thus, it could be demonstrated that during the first two weeks after pneumonectomy high conce ntrations of an antibiotic similar to the levels in the serum can be achiev ed in the pleural fluid.