Quinolones News

#14 May 2, 2017

Optimising prophylactic levofloxacin for prostatic biopsy using new clinically useful method to determine concentrations in plasma and prostate

Although prophylactic fluoroquinolones are routinely administered for preventing bacterial infections after prostatic biopsy, recent studies have shown an increasing incidence of resistant pathogens. Measurement of fluoroquinolone activity in this setting is currently based on identifying the MIC of the causative pathogen, but researchers from Poland set out to improve on this by developing a reliable method for quantifying levofloxacin concentrations in plasma and prostatic tissue. They described this ultra-high performance liquid chromatography-diode method as having greater sensitivity and specificity, enabling the clinician to optimise prophylactic regimens based on concentrations of antimicrobials actually attained in tissue. They also performed a correlation study, evaluating the link between plasma and prostatic tissue concentrations to enhance the clinical utility of this new measurement.

The retention time, peak symmetry and resolution of levofloxacin and ciprofloxacin peak concentrations was identified, along with significant factors affecting levofloxacin extraction from the prostatic tissue. Results confirmed a linear correlation using this methodology for plasma and prostate tissue (over the range of 0.030-10μg/mL and 0.300-30μg/g, respectively), with less than 10% intra-day and inter-day variability for levofloxacin. The detection limit in plasma and prostatic tissue was 0.01μg/mL and 0.1μg/g, respectively and quantification limit was 0.03μg/mL and 0.3μg/g, respectively.

The researchers then used this detection method to examine prostate tissue and plasma samples from 140 hospitalized patients 12 hours after being treated with prophylactic oral levofloxacin 500mg. The mean concentration achieved in prostatic tissue was 6.22±3.52μg/g and 2.54±1.14μg/mL in plasma.

The researchers concluded that this technique provides a simple and reliable method to monitor levofloxacin concentrations in plasma and prostate tissue, and is a useful clinical tool to optimise treatment while avoiding the development of resistance.

PMID: 27423043

J Chromatogr B Analyt Technol Biomed Life Sci. 2016 Sep 1;1029-1030:48-59. doi: 10.1016/j.jchromb.2016.06.051.

Source: =Abstract

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