Cyst fluid antibiotic concentrations in autosomal-dominant polycystic kidney disease

W. M. Bennett, L. Elzinga, J. P. Pulliam, A. L. Rashad, John Barry

Research output: Contribution to journalArticle

45 Citations (Scopus)

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
StatePublished - 1985

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Cyst Fluid
Autosomal Dominant Polycystic Kidney
Cysts
Anti-Bacterial Agents
Polycystic Kidney Diseases
Nephrons
Aminoglycosides
Pharmaceutical Preparations
Cefotaxime
Clindamycin
Metronidazole
Sulfamethoxazole Drug Combination Trimethoprim
Erythromycin
Vancomycin
Therapeutics
Ampicillin
Autopsy
Sodium
Urine
Lipids

ASJC Scopus subject areas

  • Nephrology

Cite this

Cyst fluid antibiotic concentrations in autosomal-dominant polycystic kidney disease. / Bennett, W. M.; Elzinga, L.; Pulliam, J. P.; Rashad, A. L.; Barry, John.

In: American Journal of Kidney Diseases, Vol. 6, No. 6, 1985, p. 400-404.

Research output: Contribution to journalArticle

Bennett, WM, Elzinga, L, Pulliam, JP, Rashad, AL & Barry, J 1985, 'Cyst fluid antibiotic concentrations in autosomal-dominant polycystic kidney disease', American Journal of Kidney Diseases, vol. 6, no. 6, pp. 400-404.
Bennett, W. M. ; Elzinga, L. ; Pulliam, J. P. ; Rashad, A. L. ; Barry, John. / Cyst fluid antibiotic concentrations in autosomal-dominant polycystic kidney disease. In: American Journal of Kidney Diseases. 1985 ; Vol. 6, No. 6. pp. 400-404.
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