Rubin J
Department of Medicine, University of Mississippi Medical Center, Jackson.
Perit Dial Int. 1990;10(4):295-7.
Previous studies have found serum tobramycin concentrations greater than 8 mg/L among patients undergoing treatment for peritonitis using hourly dialysate exchanges containing 10 mg/L of tobramycin. In this study, tobramycin absorption from the peritoneal cavity was evaluated among patients treated with exchanges of 180 min. intraperitoneal duration. Six patients in each group were studied. Mass transfer coefficients [MTC (mL/min.)] were calculated for noninfected (C) and peritonitis (P) periods. The mean MTC for C was 6.5 +/- 2.1 (SD) mL/min., and for P, 18.5 +/- 8.2 (SD) mL/min. (p less than 0.01). Peritonitis increased the rate of uptake from the peritoneal cavity. In these acute studies, the total dose of tobramycin delivered was small, so that serum concentrations remained less than 0.2 mg/L among controls and 0.5 mg/L among patients with peritonitis. Prolonged exposure to tobramycin, in association with more rapid absorption from the peritoneal cavity, may lead to serum concentrations greater than 8 mg/L.
以往研究发现,在使用含10mg/L妥布霉素的透析液每小时进行一次交换治疗腹膜炎的患者中,血清妥布霉素浓度大于8mg/L。在本研究中,对接受180分钟腹腔内留置时间交换治疗的患者的腹腔妥布霉素吸收情况进行了评估。每组研究6例患者。计算了非感染期(C)和腹膜炎期(P)的传质系数[MTC(mL/min)]。C期的平均MTC为6.5±2.1(标准差)mL/min,P期为18.5±8.2(标准差)mL/min(p<0.01)。腹膜炎增加了腹腔摄取率。在这些急性研究中,妥布霉素的给药总量较小,因此对照组血清浓度低于0.2mg/L,腹膜炎患者低于0.5mg/L。长时间接触妥布霉素,再加上从腹腔吸收更快,可能导致血清浓度大于8mg/L。