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Vuotto F, Bru JP, Canoui E, Caseris M, Chopin MCC, Cohen R, Diamantis S, Dinh A, Fillatre P, Gauzit R, Gillet Y, Jonville-Bera AP, Lafaurie M, Lesprit P, Lorrot M, Lourtet J, Maulin L, Poitrenaud D, Pariente A, Raymond J, Strady C, Stahl JP, Varon E, Welker Y, Bonnet E. The latest updates on the proper use of fluoroquinolones - Actualisation 2025 update by the SPILF and the GPIP. Infect Dis Now 2025; 55:105062. [PMID: 40216161 DOI: 10.1016/j.idnow.2025.105062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2025] [Accepted: 04/08/2025] [Indexed: 04/27/2025]
Affiliation(s)
- F Vuotto
- Maladies Infectieuses, CHU Lille, Hôpital Huriez, 59 000 Lille, France.
| | - J P Bru
- Maladies Infectieuses, CH Annecy Genevois, 74374 Pringy, France
| | - E Canoui
- Équipe mobile d'infectiologie, CHU Cochin, APHP, 75014 Paris, France
| | - M Caseris
- Équipe Opérationnelle d'Infectiologie, Hôpital mère enfant Robert Debré, APHP, 75019 Paris, France
| | - M C C Chopin
- Service de Maladies Infectieuses, CH Boulogne-sur-Mer, 62321 Boulogne-sur-Mer, France
| | - R Cohen
- Unité Petits Nourrissons, CHI, 94000 Créteil, France
| | - S Diamantis
- Maladies Infectieuses et Tropicales, groupe hospitalier Sud Ile de France, 77000 Melun, France
| | - A Dinh
- Maladies Infectieuses et Tropicales, Hôpitaux R. Poincaré-A. Paré, 92380 Garches, France
| | - P Fillatre
- Service de Réanimation Polyvalente, CH Yves Le Foll, 22000 Saint Brieuc, France
| | - R Gauzit
- Infectiologie transversale, CHU Cochin, APHP, 75014 Paris, France
| | - Y Gillet
- Service d'urgences et réanimation pédiatrique, équipe mobile d'infectiologie pédiatrique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, 69229 Lyon, France
| | | | - M Lafaurie
- Service des Maladies Infectieuses, Hôpital Saint-Louis, APHP, 75010 Paris, France
| | - P Lesprit
- Université Grenoble Alpes, Maladies Infectieuses et tropicales, CHU Grenoble Alpes, Grenoble, France
| | - M Lorrot
- Service de Pédiatrie Générale et Equipe d'infectiologie, Hôpital Armand Trousseau, AP-HP, Sorbonne Université. URMS 1123 ECEVE, 75019 Paris, France
| | - J Lourtet
- Service de Bactériologie, Hôpital Saint Antoine, 75012 Paris, France
| | - L Maulin
- Maladies Infectieuses et Tropicales, CHIAP, 13616 Aix en Provence, France
| | - D Poitrenaud
- Unité fonctionnelle d'Infectiologie Régionale, CH Ajaccio 20303 Ajaccio, France
| | - A Pariente
- Pharmacoépidémiologie et Bon Usage du Médicament, Service de Pharmacologie Médicale, Pôle de Santé Publique, CHU de Bordeaux, France
| | - J Raymond
- Bactériologie : Centre Hospitalier Bicêtre, 94270 Kremlin- Bicêtre, France
| | - C Strady
- Maladies Infectieuses et Tropicales, groupe hospitalier Sud Ile de France, 77000 Melun, France
| | - J P Stahl
- Infectiologie, Université Grenoble Alpes, 38700 La Tronche, France
| | - E Varon
- Laboratoire de Biologie Médicale et Centre National de Référence des Pneumocoques, France
| | - Y Welker
- Maladies Infectieuses, CHI, 78100 Saint Germain en Laye, France
| | - E Bonnet
- Maladies Infectieuses et Tropicales, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France
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Boumezrag M, Banovac F. Oncologic Interventions: Periprocedural Medications. Semin Intervent Radiol 2022; 39:406-410. [PMID: 36406027 PMCID: PMC9671681 DOI: 10.1055/s-0042-1758079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Significant advances in ablative and endovascular therapies have allowed interventional radiology to play a substantial role in the management of patients with malignant neoplasms. The evolution of these procedures and the optimization of patient outcomes and experience must take into account various elements of the periprocedural period. Some of the most important considerations within the periprocedural period are the pharmacologic agents used to avoid infectious complications, decrease pain, and manage side effects. In this article, we discuss some of the most commonly used medications in interventional oncology procedures including antibiotics, narcotics, sedatives, antiemetics, and others.
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Affiliation(s)
- Maryam Boumezrag
- Department of Radiology, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Filip Banovac
- Division of Interventional Oncology, Department of Radiology, MedStar Georgetown University Hospital, Washington, District of Columbia
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Thabit AK. Antibiotics in the Biliary Tract: A Review of the Pharmacokinetics and Clinical Outcomes of Antibiotics Penetrating the Bile and Gallbladder Wall. Pharmacotherapy 2020; 40:672-691. [PMID: 32485056 DOI: 10.1002/phar.2431] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Biliary tract infections (BTIs), including cholangitis and cholecystitis, are common causes of bacteremia. Bacteremic BTIs are associated with a mortality rate of 9-12%. The extent to which antibiotics are excreted in the bile and the ratio of their exposure to the minimum inhibitory concentration of the infecting organism are among the important factors for the treatment of BTIs. This review updates health care professionals on the distribution of antibiotics in the common bile duct, gallbladder, and gallbladder wall. Antibiotic efficacy in treating BTIs based on the latest available clinical studies is also discussed. The efficacy and pharmacokinetics of 50 antibiotics are discussed. Overall, most antibiotic classes exhibit biliary penetration that translates into clinical efficacy. Only seven antibiotics (amoxicillin, cefadroxil, cefoxitin, ertapenem, gentamicin, amikacin, and trimethoprim/sulfamethoxazole) had poor biliary penetration profiles. Three antibiotics (ceftibuten, ceftolozane/tazobactam, and doripenem) had positive clinical outcomes despite the lack of pharmacokinetic studies on their penetration into the biliary tract. Conflicting efficacy data were reported for ampicillin despite adequate biliary penetration, whereas conflicting pharmacokinetic data were reported with cefaclor and moxifloxacin. Even in the absence of supportive clinical studies, antibiotics with good biliary penetration profiles may have a place in the treatment of BTIs.
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Affiliation(s)
- Abrar K Thabit
- Pharmacy Practice Department, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
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Kim NH, Kim HJ, Bang KB. Prospective comparison of prophylactic antibiotic use between intravenous moxifloxacin and ceftriaxone for high-risk patients with post-ERCP cholangitis. Hepatobiliary Pancreat Dis Int 2017; 16:512-518. [PMID: 28992884 DOI: 10.1016/s1499-3872(17)60056-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 06/06/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND The use of prophylactic antibiotics before endoscopic retrograde cholangiopancreatography (ERCP) is recommended by all major international gastroenterological societies, especially in the presence of an obstructed biliary system. This study compared the occurrence rate of post-procedural complications, including cholangitis and septicemia, between prophylactic intravenous moxifloxacin and ceftriaxone in patients with bile duct obstruction scheduled for therapeutic ERCP. METHODS From November 2013 to July 2015, 86 consecutive patients with biliary obstruction with one or more factors predicting benefits of antibiotic prophylaxis prior to ERCP were included in the current randomized open-label non-inferiority trial (ClinicalTrial.gov identifier NCT02098486). Intravenous moxifloxacin (400 mg/day) or ceftriaxone (2 g/day) were given 90 minutes before ERCP, and were administered for more than 3 days if the patient developed symptoms and signs of cholangitis or septicemia. Recalcitrant cholangitis was defined as persistence of cholangitis for more than 5 days after ERCP or recurrence of cholangitis within 30 days after ERCP. RESULTS Recalcitrant cholangitis occurred in 1 (2.3%) and 2 (4.8%) patients receiving intravenous moxifloxacin and ceftriaxone group, respectively (P=0.612). Septicemia was noted in 1 (2.3%) and 1 (2.4%) patient in intravenous moxifloxacin and ceftriaxone group, respectively (P=1.0). The mean hospital stay was also not significantly different between the moxifloxacin and ceftriaxone groups (8.8±7.2 vs 9.1±9.4 days, P=0.867). Antibiotic resistance of the isolated pathogens by in vitro activity assay was noted in 1 (2.3%) and 2 (4.8%) patients in the moxifloxacin and ceftriaxone group, respectively (P=0.612). CONCLUSION Intravenous moxifloxacin is not inferior to intravenous ceftriaxone for the prophylactic treatment of post-ERCP cholangitis and cholangitis-associated morbidity.
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Affiliation(s)
- Nam Hee Kim
- Department of Internal Medicine, Sungkyunkwan University Kangbuk Samsung Hospital, Seoul 03181, Korea
| | - Hong Joo Kim
- Department of Internal Medicine, Sungkyunkwan University Kangbuk Samsung Hospital, Seoul 03181, Korea.
| | - Ki Bae Bang
- Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea
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Jiang O, Zhou RX, Yang K, Cai CX, Liu Y, Cheng NS. Negative short-term impact of intraoperative biliary lavage in patients with hepatolithiasis. World J Gastroenterol 2016; 22:3234-3241. [PMID: 27004001 PMCID: PMC4789999 DOI: 10.3748/wjg.v22.i11.3234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/27/2015] [Accepted: 12/08/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate short-term outcomes following intraoperative biliary lavage for hepatolithiasis.
METHODS: A total of 932 patients who were admitted to the West China Medical Center of Sichuan University between January 2010 and January 2014 and underwent bile duct exploration and lithotomy were retrospectively included in our study. The patients were divided into the lavage group and the control group. Related pre-, intra-, and postoperative factors were recorded, analyzed, and compared between the two groups in order to verify the effects of biliary lavage on the short-term outcome of patients with hepatolithiasis.
RESULTS: Amongst the patients who were included, 678 patients with hepatolithiasis were included in the lavage group, and the other 254 patients were enrolled in the control group. Data analyses revealed that preoperative baseline and related intraoperative variables were not significantly different. However, patients who underwent intraoperative biliary lavage had prolonged postoperative hospital stays (6.67 d vs 7.82 d, P = 0.024), higher hospitalization fees (RMB 28437.1 vs RMB 32264.2, P = 0.043), higher positive rates of bacterial cultures from blood (13.3% vs 25.8%, P = 0.001) and bile (23.6% vs 40.7%, P = 0.001) samples, and increased usage of advanced antibiotics (26.3% vs 38.2%, P = 0.001). In addition, in the lavage group, more patients had fever (> 37.5 °C, 81.4% vs 91.1%, P = 0.001) and hyperthermia (> 38.5°C，39.7% vs 54.9%, P = 0.001), and higher white blood cell counts within 7 d after the operation compared to the control group.
CONCLUSION: Intraoperative biliary lavage might increase the risk of postoperative infection, while not significantly increasing gallstone removal rate.
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Zhu L, Yang J, Zhang Y, Wang Y, Zhang J, Zhao Y, Dong W. Prediction of Pharmacokinetics and Penetration of Moxifloxacin in Human with Intra-Abdominal Infection Based on Extrapolated PBPK Model. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2015; 19:99-104. [PMID: 25729270 PMCID: PMC4342742 DOI: 10.4196/kjpp.2015.19.2.99] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 11/25/2014] [Accepted: 12/17/2014] [Indexed: 11/30/2022]
Abstract
The aim of this study is to develop a physiologically based pharmacokinetic (PBPK) model in intra-abdominal infected rats, and extrapolate it to human to predict moxifloxacin pharmacokinetics profiles in various tissues in intra-abdominal infected human. 12 male rats with intra-abdominal infections, induced by Escherichia coli, received a single dose of 40 mg/kg body weight of moxifloxacin. Blood plasma was collected at 5, 10, 20, 30, 60, 120, 240, 480, 1440 min after drug injection. A PBPK model was developed in rats and extrapolated to human using GastroPlus software. The predictions were assessed by comparing predictions and observations. In the plasma concentration versus time profile of moxifloxcinin rats, Cmax was 11.151 µg/mL at 5 min after the intravenous injection and t1/2 was 2.936 h. Plasma concentration and kinetics in human were predicted and compared with observed datas. Moxifloxacin penetrated and accumulated with high concentrations in redmarrow, lung, skin, heart, liver, kidney, spleen, muscle tissues in human with intra-abdominal infection. The predicted tissue to plasma concentration ratios in abdominal viscera were between 1.1 and 2.2. When rat plasma concentrations were known, extrapolation of a PBPK model was a method to predict drug pharmacokinetics and penetration in human. Moxifloxacin has a good penetration into liver, kidney, spleen, as well as other tissues in intra-abdominal infected human. Close monitoring are necessary when using moxifloxacin due to its high concentration distribution. This pathological model extrapolation may provide reference to the PK/PD study of antibacterial agents.
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Affiliation(s)
- LiQin Zhu
- Tianjin First Central Hospital, Tianjin 300192, China
| | - JianWei Yang
- Tianjin Medical University, Tianjin 300070, China
| | - Yuan Zhang
- Tianjin First Central Hospital, Tianjin 300192, China. ; Tianjin Medical University, Tianjin 300070, China
| | | | - JianLei Zhang
- Tianjin First Central Hospital, Tianjin 300192, China
| | - YuanYuan Zhao
- The 153 Central Hospital of the Chinese People's Liberation Army, Henan 450000, China
| | - WeiLin Dong
- Tianjin Medical University, Tianjin 300070, China
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Liu D, Xu S, Xiao H, Wang Z, Mao N, Zhou J, Liu R, Huang Y. Quantitative determination of unbound levofloxacin by simultaneous microdialysis in rat pancreas after intravenous and oral doses. ACTA ACUST UNITED AC 2014; 66:1215-21. [PMID: 24961375 DOI: 10.1111/jphp.12252] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 03/02/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We compared the pharmacokinetic profile of unbound levofloxacin in rat pancreas after an oral dose with that after an intravenous dose to determine if oral administration of levofloxacin could potentially be used. METHOD Levofloxacin was administered either intravenously or orally into male Sprague-Dawley rats at the concentration of 42 mg/kg per day, mimicking the human dose of 400 mg/day. The concentrations of levofloxacin in extracellular fluid (ECF) of rat pancreatic tissues were determined using microdialysis coupled with high-performance liquid chromatography (HPLC). Levofloxacin was equally distributed into ECF of rat pancreatic tissues with either intravenous route (AUCpancreas /AUCblood , 0.97 ± 0.02) or oral route (AUCpancreas /AUCblood , 0.96 ± 0.03). KEY FINDINGS The penetration rates (PR) of pancreas-to-blood on the same target site between the two routes were the same. The intravenous antibiotic AUC/MIC ratios of common Gram-positive pancreatic bacteria ranged from 83.43 to 667.44; meanwhile, the ratio of common Gram-negative pancreatic bacteria ranged from 41.71 to 2669.74. The oral antibiotic AUC/MIC ratios for common gram-positive and Gram-negative pancreatic bacteria were from 78.54 to 628.31, and 39.27 to 2513.22, respectively (P > 0.05). CONCLUSIONS Intravenous administration had similar penetration efficacy to oral administration at an equivalent dose. Furthermore, levofloxacin had a good penetration through the blood-pancreas barrier.
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Affiliation(s)
- Deding Liu
- Department of Orthopedics, 153 Central Hospital of PLA, Zhengzhou, China
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Uegami S, Ikawa K, Ohge H, Nakashima A, Shigemoto N, Morikawa N, Murakami Y, Sueda T. Pharmacokinetics and pharmacodynamic target attainment of intravenous pazufloxacin in the bile of patients undergoing biliary pancreatic surgery. J Chemother 2014; 26:287-92. [DOI: 10.1179/1973947814y.0000000167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Chilet-Rosell E, Ruiz-Cantero MT, Pardo MA. Gender analysis of moxifloxacin clinical trials. J Womens Health (Larchmt) 2013; 23:77-104. [PMID: 24180298 DOI: 10.1089/jwh.2012.4171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To determine the inclusion of women and the sex-stratification of results in moxifloxacin Clinical Trials (CTs), and to establish whether these CTs considered issues that specifically affect women, such as pregnancy and use of hormonal therapies. Previous publications about women's inclusion in CTs have not specifically studied therapeutic drugs. Although this type of drug is taken by men and women at a similar rate, adverse effects occur more frequently in the latter. METHODS We reviewed 158 published moxifloxacin trials on humans, retrieved from MedLine and the Cochrane Library (1998-2010), to determine whether they complied with the gender recommendations published by U.S. Food and Drug Administration Guideline. RESULTS Of a total of 80,417 subjects included in the moxifloxacin CTs, only 33.7% were women in phase I, in contrast to phase II, where women accounted for 45%, phase III, where they represented 38.3% and phase IV, where 51.3% were women. About 40.9% (n=52) of trials were stratified by sex and 15.3% (n=13) and 9% (n=7) provided data by sex on efficacy and adverse effects, respectively. We found little information about the influence of issues that specifically affect women. Only 3 of the 59 journals that published the moxifloxacin CTs stated that authors should stratify their results by sex. CONCLUSIONS Women are under-represented in the published moxifloxacin trials, and this trend is more marked in phase I, as they comprise a higher proportion in the other phases. Data by sex on efficacy and adverse effects are scarce in moxifloxacin trials. These facts, together with the lack of data on women-specific issues, suggest that the therapeutic drug moxifloxacin is only a partially evidence-based medicine.
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Justinger C, Schilling MK, Kees MG, Kauffels A, Hirschmann K, Kopp B, Kees F, Kollmar O. Penetration of moxifloxacin into liver tissue. Int J Antimicrob Agents 2012; 39:505-9. [PMID: 22526014 DOI: 10.1016/j.ijantimicag.2012.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 01/25/2012] [Accepted: 01/26/2012] [Indexed: 12/12/2022]
Abstract
Moxifloxacin is considered for treatment of pyogenic liver abscesses as well as antibiotic prophylaxis in the case of hepatobiliary interventions. The aim of this study was to provide data on the pharmacokinetic (PK) profile of moxifloxacin in serum and liver tissue of patients undergoing liver resection due to primary or secondary tumours of the liver. Patients scheduled for liver resection (n=34) received moxifloxacin 400 mg at randomised time intervals prior to surgery. Blood and healthy liver tissue were sampled 1.5-26 h after administration of moxifloxacin. Immediately after centrifugation, plasma was separated, frozen and stored until analysis. In a subgroup of 19 patients, additional plasma specimens were obtained after 2, 4, 8, 12, 24, 36 and 48 h to assess the PK profile. PK parameters of moxifloxacin were calculated applying a two-compartment model. Median (interquartile range) PK parameters were as follows: peak concentration at the end of moxifloxacin infusion (C(max)), 6.0 mg/L (4.8-7.1 mg/L); area under the concentration-time curve extrapolated to infinity (AUC(0-∞)), 51.1 mgh/L (40.3-57.7 mgh/L); elimination half-life, 13.2h (11.0-14.1 h); volume of distribution at steady state (V(ss)), 138.7 L (102.7-168.5 L); and total body clearance (CL), 7.8 L/h (6.9-9.9L/h). Mean tissue concentrations were 9.13 mg/kg after 1.6-2.4 h, 7.62 mg/kg after 2.6-4.9h, 7.48 mg/kg after 5.6-10.0 h and 6.24 mg/kg after 22.9-26.5 h. Mean tissue:serum ratios were 2.9, 3.4, 5.0 and 12.3, respectively. The lowest tissue concentration found in the study at any time point was 2.8 mg/kg. In conclusion, moxifloxacin rapidly penetrates into the liver tissue where its concentration remains high following intravenous administration. Therefore, intravenously applied moxifloxacin might be used for the treatment of bacterial liver infections such as pyogenic liver abscess as well as in pre-operative prophylaxis.
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Affiliation(s)
- Christoph Justinger
- Department of General, Visceral, Vascular and Paediatric Surgery, University of Saarland, D-66421 Homburg/Saar, Germany
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Stein GE, Smith CL, Peloquin CA, Mosher B, Dybas L, Kepros JP. Bile and Gallbladder Tissue Concentrations of Moxifloxacin in Patients with Acute Cholecystitis. Ann Pharmacother 2010; 44:1346-7. [DOI: 10.1345/aph.1p100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Gary E Stein
- Professor of Medicine and Pharmacology Department of Medicine Michigan State University B323 Life Sciences Building East Lansing, MI 48824
| | - Curtis L Smith
- Professor of Pharmacy Practice College of Pharmacy Ferris State University Sparrow Health System Lansing, MI
| | - Charles A Peloquin
- Director Infectious Disease Pharmacokinetics Laboratory College of Pharmacy University of Florida Gainesville, FL
| | - Ben Mosher
- Assistant Professor of Surgery Department of Surgery Michigan State University
| | - Leslie Dybas
- Research Associate Department of Medicine Michigan State University
| | - John P Kepros
- Assistant Professor of Surgery Department of Surgery Michigan State University
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