Kleinschmidt R, Rommelsheim K, Exner M, Vogel F
Medizinische Klinik, Universität Bonn.
Anasth Intensivther Notfallmed. 1989 Jun;24(3):143-6.
In 199 artificially ventilated patients of an internal intensive care unit clinical, bacteriological and pharmacological effects of endotracheally administered gentamicin were investigated. The dose schedule was 2-4 x 40 mg gentamicin/day. The incidence of secondary achieved pneumonia was reduced from 70% to 18%. The endotracheal colonization of pathogenic microorganisms reached 29.6% concerning bacterial microorganisms and 61% concerning fungi, 51.8% of all specimen were sterile. During 4 years of investigation there were found 19 secondary resistances of different bacteria, 12 persisted. Serum concentrations of gentamicin under endotracheal administration of 40 mg in 6-h-intervals didn't reach therapeutic values. In case of renal disorder the dose interval should be prolonged to twelve hours.
对内科重症监护病房的199例人工通气患者,研究了气管内给予庆大霉素的临床、细菌学及药理学效果。给药方案为每天2 - 4次,每次40mg庆大霉素。继发性肺炎的发生率从70%降至18%。致病微生物的气管内定植情况为:细菌微生物达29.6%,真菌达61%,51.8%的标本无菌。在4年的研究期间,发现了19种不同细菌的继发性耐药,其中12种持续存在。每隔6小时气管内给予40mg庆大霉素时,血清庆大霉素浓度未达到治疗值。肾功能障碍时,给药间隔应延长至12小时。