Clinical Findings and Tissue Penetration of Garenoxacin in Patients with Peritonsillar Abscess

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  • Ohori Junichiro
    Department of Otolaryngology, Faculty of Medicine, Kagoshima University
  • Miyashita Keiichi
    Department of Otolaryngology, Faculty of Medicine, Kagoshima University
  • Makise Takaho
    Department of Otolaryngology, Faculty of Medicine, Kagoshima University
  • Nagano Hiromi
    Department of Otolaryngology, Faculty of Medicine, Kagoshima University
  • Kawabata Masaki
    Department of Otolaryngology, Faculty of Medicine, Kagoshima University
  • Harada Mizue
    Department of Otolaryngology, Faculty of Medicine, Kagoshima University
  • Umakoshi Shizuo
    Department of Otolaryngology, Faculty of Medicine, Kagoshima University
  • Kurono Yuichi
    Department of Otolaryngology, Faculty of Medicine, Kagoshima University

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Other Title
  • 扁桃周囲膿瘍の臨床所見とガレノキサシンの組織移行性の比較
  • ヘントウ シュウイ ノウヨウ ノ リンショウ ショケン ト ガレノキサシン ノ ソシキ イコウセイ ノ ヒカク

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Abstract

<p>Clinical findings of patients with peritonsillar abscesses were compared to the penetration of garenoxacin (GRNX) into the serum, abscesses, and palatine tonsil to determine the factors that reduce the efficacy of antibiotics toward this disease. Ten patients who underwent abscess tonsillectomies were enrolled in the study. After the oral administration of GRNX, general anesthesia was induced and samples of blood, pus from the abscess, and a part of the palatine tonsil were obtained prior to surgery for the measurement of GRNX concentration. Correlations between the concentrations of GRNX in the samples and the levels of C-reactive protein (CRP), white blood cell (WBC) count, size of the abscess and presence of ring enhancement estimated using computed tomography (CT), and the duration of the illness before surgery (in days) were examined. The data showed that the concentrations of GRNX in the abscess and serum were significantly decreased in patients with high levels of CRP (≥11 mg/dL). In patients with high WBC (≥19,000 cells/μL) counts, the concentrations were significantly decreased in the tonsil and serum. The concentrations of GRNX in the abscess were significantly lowered in patients with large abscesses (≥25 mm). The concentrations of GRNX in the abscess and tonsils were lowered when the abscess was without ring enhancement and when the illness persisted for longer than 7 days before surgery. These results indicate that severe inflammation reduces the penetration of antibiotics into the abscess and tonsils. In addition to the high levels of CRP and the high WBC count, a large abscess without ring enhancement and a short duration of illness might be indications for surgical drainage. Moreover, it is suggested that antibiotics with good tissue penetration should be used for the treatment of a peritonsillar abscess. </p>

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