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Pharmacokinetics and Microbiological Effects

Ronald E. Polk, PharmD; C. Glen Mayhall, MD; Janice Smith; Gaye Hall; Berry J. Kline, PhD; Erik Swensson, MD; Boyd W. Haynes, MD

Arch Surg. 1983;118(3):295-302.

Abstract
• This study was designed to determine whether intravenously administered gentamicin sulfate and tobramycin sulfate penetrate into the eschar of patients with severe burns. In addition, each antibiotic's pharmacokinetics in serum and the effect on eschar microbiology were determined. Twenty patients with suspected burn wound sepsis received either gentamicin or tobramycin. The microbiology of the baseline eschar was determined and repeated on days 2, 4, and 7. All patients had measurable aminoglycoside tissue concentrations, and elimination from serum was not unusually rapid. Thirteen patients had baseline eschar cultures positive for Pseudomonas aeruginosa or Serratia marcescens; eight patients were initially bacteremic. Pseudomonas aeruginosa strains were sensitive to both antibiotics and usually declined in concentration with time or were eliminated; the more drug-resistant isolates of S marcescens persisted or caused superinfection and bacteremia. Aminoglycoside antibiotics penetrate into burn eschar and appear to have a substantial effect on eschar microbiology.

(Arch Surg 1983;118:295-302)

Author Affiliations
From the School of Pharmacy (Drs Polk and Kline and Ms Smith) and the Division of Infectious Diseases, Department of Medicine (Dr Mayhall and Ms Hall), and the Division of General and Trauma Surgery, Department of Surgery (Drs Haynes and Swensson), School of Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond.

Footnotes
Accepted for publication Sept 20, 1982.

Read before the second annual meeting of the Surgical Infection Society, Boston, April 20, 1982.

Reprint requests to Box 581, MCV Station, Richmond, VA 23298 (Dr Polk).

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