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小儿静脉滴注舒巴坦/氨苄西林的临床与药代动力学研究

[Clinical and pharmacokinetic studies on intravenous administration of sulbactam/ampicillin in pediatrics].

作者信息

Sato H, Narita A, Suzuki H, Nakazawa S, Matsumoto K, Nakanishi Y, Niino K, Nakazawa S

机构信息

Department of Pediatrics, Tokyo Metropolitan Ebara General Hospital.

出版信息

Jpn J Antibiot. 1989 Mar;42(3):623-38.

PMID:2746846
Abstract

Intravenous administration of sulbactam/ampicillin (SBT/ABPC) was evaluated in pediatric patients. The serum half-lives of both ABPC and SBT were approximately 1 hour following the intravenous injection or intravenous drip infusion of 20-35 mg/kg, and 30-50% of ABPC and 30-70% of SBT were recovered in the urine 6 hours. Cerebrospinal fluid concentrations of ABPC and SBT were 0.76 and 0.68 micrograms/ml, respectively, at 1 hour after intravenous drip infusion of the 58 mg/kg, and concentration ratios of the drugs in cerebrospinal fluid/serum were 6.39 and 5.71%, respectively. Thirty-four pediatric patients were treated with intravenous drip infusion of SBT/ABPC in doses ranging from 54 to 150 mg/kg divided into 3 times a day. The rate of clinical efficacy was 93.5% and the bacterial elimination rate was 92.3%. The synergistic activity of sulbactam with ampicillin was demonstrated against beta-lactamase-producing Staphylococcus aureus and Haemophilus influenzae isolated from patients in the present study. The side effects of SBT/ABPC were observed in 6 patients (5 diarrheas; 1 diarrhea with vomiting) out of 34 patients administered. Eosinophilia (2 patients) and a slight elevation of GOT (1 patient), GPT and LDH (1 patient) were observed. The tolerance to the therapy, however, was good.

摘要

对儿科患者进行了舒巴坦/氨苄西林(SBT/ABPC)静脉给药评估。静脉注射或静脉滴注20 - 35mg/kg后,ABPC和SBT的血清半衰期均约为1小时,6小时后尿液中回收了30 - 50%的ABPC和30 - 70%的SBT。静脉滴注58mg/kg后1小时,脑脊液中ABPC和SBT的浓度分别为0.76和0.68μg/ml,脑脊液/血清中药物浓度比分别为6.39%和5.71%。34例儿科患者接受了SBT/ABPC静脉滴注治疗,剂量为54至150mg/kg,分3次给药。临床有效率为93.5%,细菌清除率为92.3%。在本研究中,舒巴坦与氨苄西林对从患者中分离出的产β-内酰胺酶的金黄色葡萄球菌和流感嗜血杆菌具有协同活性。34例给药患者中有6例出现SBT/ABPC的副作用(5例腹泻;1例腹泻伴呕吐)。观察到2例嗜酸性粒细胞增多和1例谷草转氨酶(GOT)轻度升高、1例谷丙转氨酶(GPT)和乳酸脱氢酶(LDH)轻度升高。然而,该治疗的耐受性良好。

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