Yang Rong-Hua, Rong Xin-Zhou, Zhang Tao, Hua Rong
Department of Burns, First People Hospital of Guangzhou, Guangzhou Medical College, Guangzhou 510180, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2007 Feb;27(2):172-4.
To investigate the changes of pharmacokinetic parameters of amikacin in the subeschar tissue fluid (STF) in the early stage of severe burns.
Amikacin concentration in the STF of 10 severely burned patients were determined by fluorescence polarization immunoassay (FPIA) at different time points after intravenous amikacin infusion of the initial dose of 400 mg given within 60 min. The pharmacokinetic parameters of amikacin were measured using 3P97 program and statistically analyzed with SPSS10.0 software.
After the initial dose of 400 mg of amikacin, the STF concentration-time curves of amikacin were fitted in two compartment model. The pharmacokinetic parameters of amikacin in the STF were: t(1/2alpha)=(4.35-/+1.66) h, t(1/2beta)= (80.04-/+9.52) h, Vc= (13.17-/+1.32) L, AUC= (1802.49-/+285.68) microg. h.ml(-1), and CLs= (0.2272-/+0.0383) L. h(-1), demonstrating significantly lower clearance and longer elimination half life of amikacin in the STF following amikacin administration in early stage of severe burns. Elimination half-life of amikacin in the STF in severely burned patients was 28.20-44.78 times longer than that in the serum of normal volunteers, and the effective inhibitory concentration of amikacin could maintain for at least 24 h, suggesting antibiotic retention in the third space after early and short-term use of potent antibiotics and formation of antibiotic barrier in the STF, which may help prevent bacterial infection of the wound.
探讨严重烧伤早期焦痂下组织液（STF）中阿米卡星药代动力学参数的变化。
对10例严重烧伤患者在60分钟内静脉输注初始剂量400mg阿米卡星后的不同时间点，采用荧光偏振免疫分析法（FPIA）测定STF中阿米卡星浓度。使用3P97程序测量阿米卡星的药代动力学参数，并采用SPSS10.0软件进行统计学分析。
初始剂量400mg阿米卡星后，阿米卡星在STF中的浓度-时间曲线符合二室模型。阿米卡星在STF中的药代动力学参数为：t(1/2α)=(4.35±1.66)小时，t(1/2β)=(80.04±9.52)小时，Vc=(13.17±1.32)升，AUC=(1802.49±285.68)微克·小时·毫升⁻¹，CLs=(0.2272±0.0383)升·小时⁻¹，表明严重烧伤早期给予阿米卡星后，STF中阿米卡星的清除率显著降低，消除半衰期延长。严重烧伤患者STF中阿米卡星的消除半衰期比正常志愿者血清中的长28.20 - 44.78倍，且阿米卡星的有效抑菌浓度可维持至少24小时，提示早期短期使用强效抗生素后抗生素在第三间隙潴留，并在STF中形成抗生素屏障，这可能有助于预防伤口细菌感染。
