Evidence map›Paper›PMID 39508371›Full record

Trial reportThe Journal of antimicrobial chemotherapy2025

Liver cyst penetration of antibiotics at the target site of infection: a randomized pharmacokinetic trial.

Lucas H P Bernts, Roger J M Brüggemann, Anouk M E Jansen, Nynke G L Jager, Heiman F L Wertheim, Joost P H Drenth, Marten A Lantinga

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Liver Cyst Infection Outcomes in Patients With ADPKD.Kidney international reports · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lucas H P BerntsDepartment of Gastroenterology and Hepatology, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0003-0945-5004
Roger J M BrüggemannDepartment of Pharmacy, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-7618-725X
Anouk M E JansenDepartment of Pharmacy, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-4736-6515
Nynke G L JagerDepartment of Pharmacy, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-4524-9892
Heiman F L WertheimDepartment of Medical Microbiology, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
Joost P H DrenthDepartment of Gastroenterology and Hepatology, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
Marten A LantingaDepartment of Gastroenterology and Hepatology, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.

Funding

Radboud University Medical CenterStichting Dr. C.J. Vaillantfonds
6 · The paper itself

Abstract

backgroundThe EASL cystic liver disease guideline states that drug penetration at the site of infection (liver cyst) is essential for successful treatment, but pharmacokinetic (PK) data on cyst penetration are limited.

objectivesThis study aims to investigate tissue penetration of four antibiotics in non-infected liver cysts and explores influencing factors.

methodsWe performed a prospective, randomized single-dose PK-study. Before percutaneous drainage of a non-infected liver cyst, an intravenous (IV) dose of either ciprofloxacin and piperacillin/tazobactam (group 1); or co-trimoxazole (trimethoprim/sulfamethoxazole) and doxycycline (group 2) was given. Cyst fluid was collected during drainage. Blood samples were obtained before, during and after drainage (within 12 h). Drug concentrations were measured with a validated LC-MS/MS. Primary outcome was liver cyst penetration, defined as the cyst-fluid-to-plasma concentration ratio (%) expressed as median (IQR).

resultsWe included 20 patients, and 21 liver cysts were drained (group 1: n = 11, group 2: n = 10). Median drained cyst volume was 700 mL. Median time between infusion and drainage was 139 min (IQR 120-188 min). Median cyst-fluid-to-plasma concentration ratio was 4.2% (IQR 1.6%-8.9%) for ciprofloxacin, 0.3% (IQR 0.0%-1.3%) for piperacillin, 0.2% (IQR 0.0%-1.3%) for tazobactam, 12.2% (IQR 6.3%-16.1%) for trimethoprim, 0.4% (IQR 0.2%-3.8%) for sulfamethoxazole and 1.6% (IQR 0.9%-2.3%) for doxycycline. Time between trimethoprim infusion and cyst drainage was correlated with increased cyst-fluid-to-plasma concentration ratio (P < 0.01).

conclusionsTrimethoprim and ciprofloxacin have the highest penetration ratios amongst antibiotics tested. We found that liver cyst penetration varies widely between drugs after a single IV dose. CLINICAL TRIAL NUMBER: NTR8499The trial was originally registered in the Netherlands Trial Register (ID: NL7290), which was converted to the International Clinical Trials Registry Platform in 2022.

Indexed as

Anti-Bacterial AgentsCystsDoxycyclineTrimethoprim, Sulfamethoxazole Drug CombinationAdultAgedCiprofloxacinDrainageFemaleHumansLiver DiseasesMaleMiddle AgedPiperacillin, Tazobactam Drug CombinationProspective StudiesAnti-Bacterial AgentsCiprofloxacinDoxycyclinePiperacillin, Tazobactam Drug CombinationTrimethoprim, Sulfamethoxazole Drug Combination

Identifiers

PMID39508371
PMCPMC11695873

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.