Cyst Fluid Antibiotic Concentrations in Autosomal-Dominant Polycystic Kidney Disease

William M. Bennett, Lawrence Elzinga, Joseph P. Pulliam, Abdel L. Rashad, John M. Barry

Research output: Contribution to journalArticle

45 Scopus citations

Abstract

• Infections involving cysts of patients with autosomal-dominant polycystic kidney disease (PCKD) are often refractory to therapy possibly because of poor penetration of antibiotics into cyst fluid. Ten patients with PCKD had blood urine and cyst fluid sampled at surgery or autopsy for antibiotic concentrations. Cysts were categorized as to their nephron site of origin by cyst fluid sodium concentrations. Drugs active against anaerobes such as metronidazole and clindamycin were present in therapeutic concentrations in both proximal and distal cysts. Ampicillin and trimethoprim-sulfamethoxazole had the best profiles considering likely infecting organisms and the antibiotic concentrations achieved in both type of cysts. It is likely that prolonged therapy with both of these drugs is necessary to insure therapeutic success. Other drugs that can be detected in cysts are lipid soluble, undergo tubular secretion, or have high pKa values. These include erythromycin, vancomycin, and cefotaxime. Aminogly­cosides because of their predominant glomerular filtration and thus low filtration rate per single cystic nephron are undetectable in both proximal and distal cysts. Clinically, alternatives to aminoglycosides should be chosen for infected cysts in PCKD.

Original languageEnglish (US)
Pages (from-to)400-404
Number of pages5
JournalAmerican Journal of Kidney Diseases
Volume6
Issue number6
DOIs
StatePublished - Jan 1 1985

Keywords

  • Antibiotics
  • cyst fluid
  • polycystic kidneys
  • renal infection

ASJC Scopus subject areas

  • Nephrology

Fingerprint Dive into the research topics of 'Cyst Fluid Antibiotic Concentrations in Autosomal-Dominant Polycystic Kidney Disease'. Together they form a unique fingerprint.

  • Cite this