Intravenous versus Nebulized Ceftazidime in Ventilated Piglets with and without Experimental Bronchopneumonia

Marc Tonnellier, Fabio Ferrari, Ivan Goldstein, Alfonso Sartorius, Charles-Hugo Marquette, Jean-Jacques Rouby
2005 Anesthesiology  
Lung deposition of intravenous cephalosporins is low. The lung deposition of equivalent doses of ceftazidime administered either intravenously or by ultrasonic nebulization using either nitrogen-oxygen or helium-oxygen as the carrying gas of the aerosol was compared in ventilated piglets with and without experimental bronchopneumonia. Methods: Five piglets with noninfected lungs and 5 piglets with Pseudomonas aeruginosa experimental bronchopneumonia received 33 mg/kg ceftazidime intravenously.
more » ... ime intravenously. Ten piglets with noninfected lungs and 10 others with experimental P. aeruginosa bronchopneumonia received 50 mg/kg ceftazidime by ultrasonic nebulization. In each group, the ventilator was operated in half of the animals with a 65%/35% helium-oxygen or nitrogen-oxygen mixture. Animals were killed, and multiple lung specimens were sampled for measuring ceftazidime lung tissue concentrations by high-performance liquid chromatography. Results: As compared with intravenous administration, nebulization of ceftazidime significantly increased lung tissue concentrations (17 ؎ 13 vs. 383 ؎ 84 g/g in noninfected piglets and 10 ؎ 3 vs. 129 ؎ 108 g/g in piglets with experimental bronchopneumonia; P < 0.001). The use of a 65%/35% heliumoxygen mixture induced a 33% additional increase in lung tissue concentrations in noninfected piglets (576 ؎ 141 g/g; P < 0.001) and no significant change in infected piglets (111 ؎ 104 g/g). Conclusion: Nebulization of ceftazidime induced a 5-to 30fold increase in lung tissue concentrations as compared with intravenous administration. Using a helium-oxygen mixture as the carrying gas of the aerosol induced a substantial additional increase in lung deposition in noninfected piglets but not in piglets with experimental bronchopneumonia.
doi:10.1097/00000542-200505000-00019 pmid:15851887 fatcat:rkwnkpey65fdnnivlmnza6xmlm