Department of Clinical Chemistry, Vejle County Hospital, Vejle, Denmark.
Clin Drug Investig. 1998;15(6):467-72. doi: 10.2165/00044011-199815060-00002.
This study was performed in order to assess whether 500mg of azithromycin given orally once per week could produce tonsil tissue concentrations above minimum inhibitory concentrations for key target pathogens in patients with recurrent tonsillitis. For the measurement of tissue concentrations an automated solid phase extraction (SPE) method for cleaning the tissue extracts was developed. Concomitantly, the influence of this treatment on the microbiological flora of the tonsillar surface was monitored. The mean concentration of azithromycin in the tonsillar tissue was 1.8 microg/g (0.4 microg/g to 5.1 microg/g), i.e. therapeutic concentrations of azithromycin were found in most tonsils 1 week after medication. The validated SPE method developed provided a clean extract for high performance liquid chromatographic determination of azithromycin. The surface microbiology of the tonsils at surgery showed the usual pathogens in most patients. In conclusion, therapeutic levels of azithromycin were present in tonsil tissue during weekly medication with minimal influence on surface microbiology. A placebo-controlled, double-blind study of long-term treatment is in progress.
本研究旨在评估每周口服 500 毫克阿奇霉素是否能使复发性扁桃体炎患者的扁桃体组织浓度达到关键靶病原体的最低抑菌浓度。为了测量组织浓度，开发了一种用于清洁组织提取物的自动化固相萃取 (SPE) 方法。同时，监测了这种治疗方法对扁桃体表面微生物区系的影响。扁桃体组织中阿奇霉素的平均浓度为 1.8 微克/克（0.4 微克/克至 5.1 微克/克），即在用药后 1 周，大多数扁桃体中都能达到阿奇霉素的治疗浓度。所开发的经验证的 SPE 方法提供了一种用于阿奇霉素高效液相色谱测定的清洁提取物。手术时扁桃体的表面微生物学显示出大多数患者的常见病原体。总之，在每周用药期间，扁桃体组织中存在治疗浓度的阿奇霉素，对表面微生物学的影响最小。目前正在进行一项安慰剂对照、双盲的长期治疗研究。
