Eneroth C M, Lundberg C, Wretlind B
Chemotherapy. 1975;21 Suppl 1:1-7. doi: 10.1159/000221885.
In maxillary sinusitis, the blood circulation is supposed to be impaired in the oedematous sinus mucosa, and in such cases the transport of antibiotics into the maxillary sinus should be reduced. To prove the accuracy of this assumption a comparison has been made between the concentrations of penicillin and doxycycline (Vibramycin, Pfizer) in sinus mucosa and secretions and the serum concentrations in patients under treatment with these antibiotics. Measureable concentrations of penicillin (greater than 0.2 mug/ml) were reached in the secretions only if the serum concentration was high (greater than 4-5 mug/ml). In contrast, measurable concentrations of doxycycline were achieved in both mucosa and secretions in all patients treated with this antibiotic. This must depend on the fact that doxycycline, due to its optimal lipid solubility, was able to penetrate poorly vascularized tissue. In most cases, the concentrations of doxycycline far exceeded the minimum inhibitory concentrations of the isolated organisms, and in some cases the local concentrations were higher than those found in the serum. The clinical response to doxycycline was good and correlated well to the laboratory data.
在上颌窦炎中，水肿的窦黏膜血液循环被认为会受损，在这种情况下，抗生素进入上颌窦的转运应该会减少。为了证明这一假设的准确性，对使用这些抗生素治疗的患者窦黏膜和分泌物中青霉素和多西环素（强力霉素，辉瑞公司）的浓度与血清浓度进行了比较。只有当血清浓度较高（大于4 - 5微克/毫升）时，分泌物中才能达到可测量的青霉素浓度（大于0.2微克/毫升）。相比之下，在所有使用这种抗生素治疗的患者中，黏膜和分泌物中均达到了可测量的多西环素浓度。这一定是因为多西环素由于其最佳的脂溶性，能够穿透血管化不良的组织。在大多数情况下，多西环素的浓度远远超过分离出的微生物的最低抑菌浓度，在某些情况下，局部浓度高于血清中的浓度。对多西环素的临床反应良好，且与实验室数据相关性良好。
