Panitsa G, Panitsas A, Potamianou A, Messari J, Vovou J, Tesseromatis C
Eur J Drug Metab Pharmacokinet. 2010 Sep;35(1-2):23-7. doi: 10.1007/s13318-010-0004-y.
Facial injuries are critical conditions, leading to serious complications, such as occult facial infections. Infectious endophthalmitis occurs despite of antibiotics use during implantation of intraocular lenses and is generally resistant to antibiotic therapy. It is a crucial situation in ophthalmology, since it often induces a substantial reduction of visual acuity and in some cases the loss of the eye despite treatment. It is, therefore, important to obtain drug levels able to exert antimicrobial effect in the diseased organ. The distribution of a drug depends on the binding extent to both plasma proteins and tissues and only the free drug is capable to be transported/diffused across membranes from blood vessels into tissues, in order to achieve its effect on the target organ. Hyperlipidaemia and consequent enhanced concentration of free fatty acid can modify binding pharmacokinetics of antibiotics through antagonism for the same binding sites. Cefotaxime, the third generation cephalosporin with easy penetration in a variety of tissues and body fluids and low incidence of adverse effects, can obtain adequate concentration in blood, eye bulb, and in the orbital bones. Its levels are influenced by hyperlipidaemia with clinical impact.
面部损伤是危急情况,可导致严重并发症,如隐匿性面部感染。尽管在人工晶状体植入期间使用了抗生素,但仍会发生感染性眼内炎,并且通常对抗生素治疗耐药。这在眼科中是一种危急情况,因为它常常导致视力大幅下降,在某些情况下即使经过治疗仍会导致失明。因此,获得能够在患病器官中发挥抗菌作用的药物浓度非常重要。药物的分布取决于其与血浆蛋白和组织的结合程度,只有游离药物才能从血管穿过膜转运/扩散到组织中,从而对靶器官产生作用。高脂血症以及随之而来的游离脂肪酸浓度升高可通过对相同结合位点的拮抗作用改变抗生素的结合药代动力学。头孢噻肟是第三代头孢菌素,能轻易穿透各种组织和体液,不良反应发生率低,可在血液、眼球和眶骨中达到足够浓度。其血药浓度受高脂血症影响,具有临床意义。