Gerding D N, Kromhout J P, Sullivan J J, Hall W H
Antimicrob Agents Chemother. 1976 Nov;10(5):850-5. doi: 10.1128/AAC.10.5.850.
Antibiotic concentrations in ascitic fluid after parenteral therapy may be important in the treatment of peritonitis. We have created ascites in dogs by partial ligation of the inferior vena cava. Ascitic fluid volume was measured at the time each antibiotic was administered. Nine antibiotics were studied in the same three dogs. Antibiotic concentration in ascitic fluid was found to vary inversely with ascites volume. Percentage of penetration (ratio of ascites peak to serum peak x100) ranged from 5.8 to 65% among the drugs studied. Only metronidazole showed a statistically significant higher percentage of penetration than other antimicrobials. Concentrations in ascitic fluid after single doses of cephalothin (15 mg/kg) and the aminoglycosides (2 mg/kg, gentamicin and tobramycin; 7.5 mg/kg, amikacin and kanamycin) did not exceed the minimum inhibitory concentration of many gram-negative rods and may justify the use of higher than usual initial parenteral doses, or possibly initial intraperitoneal administration in seriously ill patients.
肠外给药后腹水中的抗生素浓度在腹膜炎治疗中可能很重要。我们通过部分结扎下腔静脉在犬身上制造了腹水。在每次给予每种抗生素时测量腹水量。对同三只犬研究了九种抗生素。发现腹水中的抗生素浓度与腹水容量呈反比。在所研究的药物中，渗透百分比（腹水峰值与血清峰值之比×100）范围为5.8%至65%。只有甲硝唑显示出比其他抗菌药物在统计学上有显著更高的渗透百分比。单次给予头孢噻吩（15mg/kg）和氨基糖苷类药物（庆大霉素和妥布霉素2mg/kg；阿米卡星和卡那霉素7.5mg/kg）后腹水中的浓度未超过许多革兰氏阴性杆菌的最低抑菌浓度，这可能说明在重症患者中使用高于通常初始肠外给药剂量或可能初始腹腔内给药是合理的。
