Doxycycline Concentration in Plasma and Tissues after Intravenous Administration: With Special Reference to Acute Cholecystitis and Appendicitis

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Abstract
Intravenous doxycycline (Vibramycin Dry Fill Intravenous®, Pfizer) was administered to 20 patients, of whom 15 had inflammatory changes in the gallbladder or appendix and 5 suffered from various inflammatory diseases of the abdomen. The concentration of doxycycline was determined in plasma, gallbladder bile and wall, appendix, subcutis and some other tissues. The concentration of doxycycline in plasma 2 hours after infusion was not higher than that achieved after peroral administration, indicating a very rapid absorption from the gastrointestinal tract. The concentration in normally coloured gallbladder bile was about 8 times that in blood. In sequestrated decolourized gallbladder bile, however, very small amounts of doxycycline were found. In cholecystic wall and appendix tissue an average concentration of 2.7—2.9 μg/g was found, about 3/4 of the concentration in blood. Very high amounts of doxycycline (5.9—6.3 μg/g) were registered in the intestinal wall in 2 cases. Subcutaneous tissue contained small amounts of doxycycline (0.6 μg/g). Indications for intravenous administration of doxycycline in abdominal emergencies are discussed.