Padberg W M, Jäger E, Buhr J, Zimmermann T
Klinik für Allgemein- und Thoraxchirurgie, Justus Liebig-Universität Giessen.
Zentralbl Chir. 2000;125(5):450-3.
Postpneumonectomy empyema represents a frequently lethal complication. It remains unsolved whether prophylactic antibiotics achieve a bactericidal concentration in the pleural cavity after pneumonectomy. 12 patients undergoing pneumonectomy received ciprofloxacin intravenously (2 x 200 micrograms/d) and orally (2 x 500 micromilligrams/d) during the first and second postoperative week, respectively. 1, 6, 9 and 14 days after the operation the ciprofloxacin concentration was measured in the pleural fluid and serum. Already after 24 hours bactericidal levels (0.56 microgram/ml) were found in the pleural fluid, rising to 1.11 micrograms/ml on day 14 under the higher oral dosage. Thus, it could be demonstrated that during the first two weeks after pneumonectomy high concentrations of an antibiotic similar to the levels in the serum can be achieved in the pleural fluid.
肺切除术后脓胸是一种常见的致命并发症。肺切除术后预防性使用抗生素能否在胸腔内达到杀菌浓度仍未解决。12例接受肺切除术的患者在术后第一周和第二周分别静脉注射环丙沙星（2×200微克/天）和口服环丙沙星（2×500微克/天）。术后第1、6、9和14天测量胸腔积液和血清中的环丙沙星浓度。术后24小时胸腔积液中就已达到杀菌水平（0.56微克/毫升），在较高口服剂量下，第14天升至1.11微克/毫升。因此，可以证明在肺切除术后的前两周内，胸腔积液中可以达到与血清中相似水平的高浓度抗生素。
