A problem in the interpretation of beta-lactam antibiotic levels in tissues

Abstract

Ceftazidime was injected iv to rabbits (25 mg/kg). Samples of the whole muscle and muscle tissue fluid were removed at 0.25, 0.5, 1, 1.5, 2, 2.5 h for assay. Muscle tissue fluid was obtained using implanted cotton threads and freshly applied paper discs. The levels of ceftazidime in muscle fluid were similar to concurrent serum levels at all times tested. Ceftazidime levels in small pieces of excised muscle were significantly lower (ten-fold) than concurrent serum or tissue fluid levels. This difference between ceftazidime levels in whole tissue and tissue fluid is explained by the fact that not all antibiotics penetrate into the cellular mass of tissue but some remain confined to the much smaller interstitial tissue fluid compartment. The assumption that antibiotics will diffuse evenly throughout a tissue is an error to be avoided in the interpretation of antibiotic levels in tissues.