Dan M, Keynan O, Feldbrin Z, Poch F
Infectious Diseases Unit, The E. Wolfson Hospital, Holon, Israel.
Diagn Microbiol Infect Dis. 2004 Apr;48(4):283-6. doi: 10.1016/j.diagmicrobio.2003.10.013.
Three doses of moxifloxacin 400 mg qd were administered orally to 20 candidates for knee arthroscopy (mean age, 71.2 years). The procedure was scheduled at four different points of time after the last dose: 2, 6, 12, and 24 h. Five patients were studied at each point of time. Drug levels were determined by the bioassay method. Bactericidal activity against four bacterial pathogens (two strains of each) was studied on serum and synovial fluid samples obtained during arthroscopy using the NCCLS guidelines. Mean (+/-S.D.) peak serum and synovial fluid concentrations were 3.46 +/- 0.78 mg/L and 3.42 +/- 0.51 mg/L, respectively. Levels above 1.0 mg/L were detected as long as 24 h. The peak bactericidal titers were (in serum and synovial fluid, respectively) 1:18.3 and 1:32 against Staphylococcus aureus, 1:18.3 and 1:22.6 against Streptococcus pyogenes, 1:45.2 and 1:64.0 against Klebsiella pneumoniae, and 1:2.3 and 1:1.7 against Pseudomonas aeruginosa. Bactericidal titers >1:2 were documented against the first three pathogens up to 24 h after dosing. On the basis of its pharmacokinetic and pharmacodynamic characteristics, moxifloxacin seems to be an excellent candidate for the treatment of joint infections, except those caused by P. aeruginosa.
对20名膝关节镜检查候选患者（平均年龄71.2岁）口服给予三剂莫西沙星，400毫克，每日一次。该手术安排在最后一剂后的四个不同时间点进行：2、6、12和24小时。每个时间点研究5名患者。通过生物测定法测定药物水平。根据美国国家临床实验室标准委员会（NCCLS）指南，对关节镜检查期间采集的血清和滑液样本进行了针对四种细菌病原体（每种各两株）的杀菌活性研究。血清和滑液的平均（±标准差）峰值浓度分别为3.46±0.78毫克/升和3.42±0.51毫克/升。长达24小时都检测到浓度高于1.0毫克/升。针对金黄色葡萄球菌，血清和滑液中的峰值杀菌滴度分别为1:18.3和1:32；针对化脓性链球菌，分别为1:18.3和1:22.6；针对肺炎克雷伯菌，分别为1:45.2和1:64.0；针对铜绿假单胞菌，分别为1:2.3和1:1.7。给药后长达24小时，针对前三种病原体记录到杀菌滴度>1:2。基于其药代动力学和药效学特征，莫西沙星似乎是治疗关节感染的极佳候选药物，但由铜绿假单胞菌引起的感染除外。
