Levofloxacin penetration into a renal cyst in a patient with autosomal dominant polycystic kidney disease

Am J Kidney Dis. 2006 Jan;47(1):e9-13. doi: 10.1053/j.ajkd.2005.09.021.

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disorder often complicated by cyst infection. Treatment becomes particularly challenging when the culprit organism is resistant to antibiotics known to sufficiently penetrate cysts. We present the case of a patient with ADPKD and suspected cyst infection caused by group B streptococcus who was treated successfully with levofloxacin and ampicillin. Although data support excellent cyst penetration with ciprofloxacin, its gram-positive antimicrobial activity is marginal. The newer quinolones have added gram-positive activity, but little is known about cyst penetration by these antibiotics. We simultaneously measured cyst and serum levels of levofloxacin and ampicillin and found levofloxacin to penetrate cysts well. Therefore, levofloxacin may be useful in the management of renal cyst infection, particularly for the treatment of gram-positive organisms.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Ampicillin / analysis
  • Ampicillin / pharmacokinetics
  • Ampicillin / therapeutic use
  • Anti-Bacterial Agents / analysis
  • Anti-Bacterial Agents / pharmacokinetics*
  • Anti-Bacterial Agents / therapeutic use
  • Biological Availability
  • Drug Therapy, Combination
  • Female
  • Humans
  • Levofloxacin*
  • Ofloxacin / analysis
  • Ofloxacin / pharmacokinetics*
  • Ofloxacin / therapeutic use
  • Polycystic Kidney, Autosomal Dominant / complications*
  • Pyelonephritis / complications
  • Pyelonephritis / drug therapy*
  • Streptococcal Infections / complications
  • Streptococcal Infections / drug therapy*
  • Streptococcus agalactiae*

Substances

  • Anti-Bacterial Agents
  • Levofloxacin
  • Ampicillin
  • Ofloxacin