sultamicillin and Shock--Cardiogenic

Topics: Ampicillin; Anti-Bacterial Agents; Drug Therapy, Combination; Humans; Kounis Syndrome; Shock, Cardiogenic; Sulbactam

A reversible cardiogenic shock model in pigs investigated shock-induced changes in the pharmacokinetics and tissue distribution of ampicillin-sulbactam and the efficacy of this antibiotic regimen in eliminating enteric bacterial translocation. Sixteen pigs were randomly allocated to 3 groups: group I (shock, ampicillin-sulbactam, n = 6), group II (no shock, ampicillin-sulbactam, n = 6), and group III (shock, no ampicillin-sulbactam, n = 4). Nalidixic acid-resistant E. coli (60 x 10(6) CFU) were instilled into a jejunal loop created in each pig, and bacterial cultures were taken from thoracic duct lymph, periportal, and mesenteric lymph nodes. Ampicillin-sulbactam was administered intravenously at a standard dose of 3 g. Results showed that 1) ampicillin and sulbactam concentrations generally increase during cardiogenic shock; 2) cardiogenic shock does not increase ampicillin concentrations in jejunum and liver; 3) during resuscitation, thoracic duct lymph ampicillin concentrations decrease; and 4) during and immediately after cardiogenic shock, standard doses of ampicillin-sulbactam appear efficacious in eliminating translocated bacteria.

Topics: Ampicillin; Animals; Ascitic Fluid; Bacteria; Cardiac Output; Drug Therapy, Combination; Escherichia coli Infections; Female; Intestinal Mucosa; Liver; Lung; Lymph; Lymph Nodes; Mesentery; Portal System; Shock, Cardiogenic; Sulbactam; Swine; Tissue Distribution