Liver cyst penetration of antibiotics at the target site of infection: a randomized pharmacokinetic trial
2024

Antibiotic Penetration in Liver Cysts

Sample size: 20 publication Evidence: moderate

Author Information

Author(s): Bernts Lucas H P, Brüggemann Roger J M, Jansen Anouk M E, Jager Nynke G L, Wertheim Heiman F L, Drenth Joost P H, Lantinga Marten A

Primary Institution: Radboud University Medical Center

Hypothesis

This study aims to investigate tissue penetration of four antibiotics in non-infected liver cysts and explores influencing factors.

Conclusion

Trimethoprim and ciprofloxacin have the highest penetration ratios amongst antibiotics tested, indicating that liver cyst penetration varies widely between drugs after a single IV dose.

Supporting Evidence

  • Trimethoprim had a median cyst-fluid-to-plasma concentration ratio of 12.2%.
  • Ciprofloxacin had a median cyst-fluid-to-plasma concentration ratio of 4.2%.
  • Median time between infusion and drainage was 139 minutes.
  • Most patients had a solitary liver cyst (55%).
  • 90% of participants were female.

Takeaway

This study looked at how well different antibiotics get into liver cysts. It found that some antibiotics work better than others at getting to the infection site.

Methodology

A prospective, randomized single-dose pharmacokinetic study was performed where patients received either ciprofloxacin and piperacillin/tazobactam or co-trimoxazole and doxycycline before cyst drainage.

Limitations

The study was limited by the drainage at a single time point, which does not allow a comprehensive pharmacokinetic analysis with time after drug administration as the dependent variable.

Participant Demographics

Most participants were female (90%), with a median age of 61 years, and 95% had adequate renal function.

Statistical Information

P-Value

p<0.01

Statistical Significance

p<0.01

Digital Object Identifier (DOI)

10.1093/jac/dkae394

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