Jehanne M
Centre Hélio-Marin, Roscoff.
Pathol Biol (Paris). 1989 May;37(5):500-3.
Cefsulodin is a third generation cephalosporin with specific antipseudomonas activity. We used cefsulodin in combination with aminoglycosides in 15 cystic fibrosis patients treatments. There were 13 children or adolescents, 4 to 19 years old with chronic Pseudomonas aeruginosa lung infections: 9 patients had acute exacerbations of infection with occasionally important respiratory insufficiency and 5 patients had a regimen of regular treatment every 3 months. Cefsulodin was given after record of bacterial sensitivity to antibiotics, at the mean posology of 100 mg/kg, IV, tid. The combination with aminoglycosides was systematic: tobramycin (6 mg/kg/day), netilmicin (6 mg/kg/day) or amikacin (30 mg/kg/day). Duration of treatment was 9 to 15 days.
--clinical improvement in all patients, important in 13 patients and moderate in 2 patients;--respiratory function improvement in 11 patients;--pulmonary radiography improvement in 10 patients;--Pseudomonas were eradicated in 8 patients but temporarily and were found after treatment in 7 patients, 5 with lower number, 2 with higher number. Clinical and biological tolerance was excellent. The present study shows the interest of cefsulodin use in combination with aminoglycosides in this pathology.
头孢磺啶是一种具有特定抗假单胞菌活性的第三代头孢菌素。我们将头孢磺啶与氨基糖苷类药物联合用于15例囊性纤维化患者的治疗。有13名儿童或青少年,年龄在4至19岁,患有慢性铜绿假单胞菌肺部感染:9例患者感染急性加重,偶尔伴有严重呼吸功能不全,5例患者每3个月接受一次常规治疗方案。在记录细菌对抗生素的敏感性后给予头孢磺啶,平均剂量为100mg/kg,静脉注射,每日三次。与氨基糖苷类药物的联合使用是系统性的:妥布霉素(6mg/kg/天)、奈替米星(6mg/kg/天)或阿米卡星(30mg/kg/天)。治疗持续时间为9至15天。
——所有患者临床症状均有改善,13例改善显著,2例改善中等;——11例患者呼吸功能改善;——10例患者肺部影像学改善;——8例患者的假单胞菌被根除,但为暂时性,治疗后7例患者再次检出,5例数量减少,2例数量增加。临床和生物学耐受性良好。本研究表明在这种病理情况下,头孢磺啶与氨基糖苷类药物联合使用具有益处。