每日单次使用阿米卡星与头孢噻肟对肝硬化患者自发性细菌性腹膜炎的短程治疗效果比较
Single daily amikacin versus cefotaxime in the short-course treatment of spontaneous bacterial peritonitis in cirrhotics.
作者信息
Chen Tai-An, Lo Gin-Ho, Lai Kwok-Hung, Lin Whey-Jen
机构信息
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan, China.
出版信息
World J Gastroenterol. 2005 Nov 21;11(43):6823-7. doi: 10.3748/wjg.v11.i43.6823.
AIM
To compare the efficacy and safety of single daily amikacin vs. cefotaxime in the 5-d treatment of spontaneous bacterial peritonitis (SBP).
METHODS
Thirty-seven cirrhotic patients with SBP, 19 in group A and 18 in group B, were studied. Group A received 1 g of cefotaxime every 6 h, and group B received 500 mg of amikacin qd. Both antibiotics were administered up to 5 d and the responses were compared.
RESULTS
Infection was cured in 15 of 19 patients (78.9%) treated with cefotaxime and in 11 of 18 (61.1%) treated with amikacin. Four patients of the Cefotaxime group (21.1%) and five patients of the Amikacin group (27.8%) died. Two in each group (10.5% vs 11.1%) had renal impairment during study period. One in each group (5.3% vs 5.6%) may be considered to suffer from nephrotoxicity due to increased urinary beta(2)-microglobulin concentration.
CONCLUSION
In this study, single daily doses of amikacin in the treatment of SBP in cirrhotics were not associated with an increased incidence of renal impairment or nephrotoxicity. However, a 5-d regimen of amikacin is less effective than a 5-d regimen of cefotaxime in the SBP treatment.
目的
比较每日单次使用阿米卡星与头孢噻肟治疗自发性细菌性腹膜炎（SBP）5天的疗效和安全性。
方法
对37例肝硬化合并SBP患者进行研究，其中A组19例，B组18例。A组每6小时给予1g头孢噻肟，B组每日给予500mg阿米卡星。两种抗生素均使用5天，比较疗效。
结果
头孢噻肟治疗的19例患者中有15例（78.9%）感染治愈，阿米卡星治疗的18例中有11例（61.1%）感染治愈。头孢噻肟组4例患者（21.1%）和阿米卡星组5例患者（27.8%）死亡。两组各有2例（10.5%对11.1%）在研究期间出现肾功能损害。两组各有1例（5.3%对5.6%）因尿β2微球蛋白浓度升高可被认为患有肾毒性。
结论
在本研究中，每日单次剂量的阿米卡星治疗肝硬化患者的SBP与肾功能损害或肾毒性发生率增加无关。然而，在SBP治疗中，5天的阿米卡星治疗方案不如5天的头孢噻肟治疗方案有效。
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