Denis F, Mounier M, Ploy M C, Adenis J P, Maes S
Service de Bactériologie-Virologie, CHU Dupuytren, Limoges.
Pathol Biol (Paris). 1992 May;40(5):534-7.
Intraocular diffusion of piperacillin was studied in 42 patients scheduled for cataract surgery (n = 35) or vitrectomy (n = 7). Piperacillin was administered intravenously (4 g/injection). Thirty-four patients were given a single dose and 8 were given two doses 12 hours apart. Peak piperacillin levels in the aqueous (7.3 mg/l) occurred one hour after the injection; levels in the vitreous were low (less than 0.6 mg/l). Intraocular diffusion of piperacillin was also studied in rabbits with an experimental Staphylococcus epidermidis infection of one eye; the other eye served as the control. In pigmented rabbits (6 Fauve de Bourgogne animals), increased diffusion and decreased elimination of piperacillin were seen in the aqueous, iris and cornea of the infected eyes, as compared with uninfected control eyes. In albino rabbits (6 New Zealand animals), results were less conclusive, with a difference between the infected and healthy eyes appearing only during the second hour following the injection. The good diffusion of piperacillin in the aqueous, especially in infected eyes (at least in rabbits), suggests that this drug may be useful for the treatment of ocular infections provided it is initiated early and given in combination with another antimicrobial exhibiting good intraocular diffusion.
对42例计划进行白内障手术（n = 35）或玻璃体切除术（n = 7）的患者研究了哌拉西林的眼内扩散情况。哌拉西林通过静脉注射给药（4 g/次）。34例患者给予单剂量，8例患者间隔12小时给予两剂。注射后1小时房水中哌拉西林达到峰值水平（7.3 mg/l）；玻璃体内的水平较低（低于0.6 mg/l）。还对一只眼睛患有实验性表皮葡萄球菌感染的兔子研究了哌拉西林的眼内扩散情况；另一只眼睛作为对照。在有色兔（6只波尔多浅黄褐色兔）中，与未感染的对照眼相比，感染眼的房水、虹膜和角膜中哌拉西林的扩散增加且消除减少。在白化兔（6只新西兰兔）中，结果不太明确，仅在注射后的第二个小时感染眼和健康眼之间出现差异。哌拉西林在房水中的良好扩散，尤其是在感染眼中（至少在兔子中），表明该药物如果早期使用并与另一种眼内扩散良好的抗菌药物联合使用，可能对治疗眼部感染有用。
