Tissue Penetration of Meropenem in Patients Undergoing Gynecologic Surgery

• Published in: Clinical infectious diseases Vol. 24; no. Supplement-2; pp. S178 - S180
• Main Authors: Gall, Stanley, Hemsell, David L., McGregor, James A., Martens, Mark G., Pitkin, Donald, Allen, Sarah
• Format: Journal Article
• Language: English
• Published: Chicago, IL University of Chicago Press 01-02-1997
• Subjects: Adult; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - pharmacokinetics; Anti-Bacterial Agents - pharmacology; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Ascitic Fluid; Bacteroides fragilis - drug effects; Biological and medical sciences; Carbapenems; Cervix Uteri - metabolism; Dosage; Elective Surgical Procedures; Endometrium - metabolism; Enterococcus faecalis - drug effects; Escherichia coli - drug effects; Fallopian Tubes - metabolism; Female; Gynecologic surgical procedures; Gynecology; Hospitalization; Humans; Infections; Medical sciences; Meropenem; Microbial Sensitivity Tests; Middle Aged; Myometrium - metabolism; Neisseria gonorrhoeae - drug effects; Obstetrics; Ovary - metabolism; Pathogens; Peptostreptococcus - drug effects; Pharmacology. Drug treatments; Plasma - metabolism; Streptococcus agalactiae - drug effects; Thienamycins - administration & dosage; Thienamycins - pharmacokinetics; Thienamycins - pharmacology; Tissue samples; Uterus - metabolism; Human; Chemoprophylaxis; Intravenous administration; β-Lactams; Bioavailability; Concentration; Female genital diseases; Peritoneal fluid; Penicillin derivatives; Tissue; Antibiotic; Carbapenem derivatives; Penetration; Surgery; Female genital system; Female; Meropenem; Antibacterial agent; Pharmacokinetics
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/clinids/24.Supplement_2.S178

The purpose of this study was to assess the tissue-penetrating ability of a new β-lactam antibiotic, meropenem, in 64 patients undergoing elective gynecologic surgery. Patients received a single 500-mg dose intravenously before surgery. Plasma and tissue concentrations of meropenem were highest at ∼1 hour, and good tissue penetration was seen in the variety of specimens evaluated. The median plasma concentration at ∼1 hour was 13.3 µg/mL. The median fluid and tissue concentrations at ∼1 hour were as follows: cervix, 8.5 µg/g; endometrium, 2.3 µg/g; fallopian tube, 1.9 µg/g; myometrium, 3.6 µg/g; ovary, 2.3 µg/g; and uterus, 2.3 µg/g. These tissue concentrations exceed the MICs of meropenem for 90% of typical pathogens associated with gynecologic infections. Meropenem readily penetrates gynecologic tissue. A single 500-mg dose provides adequate tissue concentrations for treatment of gynecologic infections caused by susceptible pathogens.