Penetration of Single-dose Levofloxacin into Intestinal Tissue

AIM: There is a trend toward severer peritonitis after perforation due to endoscopic submucosal dissection; however, the treatment regimen has not been fully established. This study investigated the indication of single-dose levofloxacin and its penetration ratio into the intestinal tissue. METHODS: This retrospective study included 13 patients receiving a single 500 mg dose of levofloxacin oral administration (p.o.) once daily (q.d.) for 2 days prior to endoscopic submucosal dissection and at 3 hours before endoscopic submucosal dissection. Levofloxacin concentrations in plasma and in intestinal tissue were measured from blood samples immediately before endoscopic submucosal dissection and normal intestinal tissue in the resected intestinal specimens. The ratio of levofloxacin concentration in intestinal tissue against levofloxacin concentration in plasma was calculated for the assessment of levofloxacin penetration. RESULTS: The mean drug concentrations in plasma and in intestinal tissue were 8.069±2.724 μg/mL at 262.8±80.2 minutes and 9.181± 4.638 μg/g at 338.2±88.0 minutes. The intestinal tissue / plasma ratio was 1.173±0.465. CONCLUSION: The penetration of a single 500 mg dose of levofloxacin p.o. q.d. to the intestinal tissue was relatively favorable. Since levofloxacin has a broad spectrum of activity, a single 500 mg dose of levofloxacin administration prior to endoscopic submucosal dissection might be effective in the prevention of penetration peritonitis and the treatment of infectious enteritis.