Bergogne-Berezin E
Presse Med. 1986 Dec 20;15(46):2324-7.
High serum levels and low degree of protein binding are the main factors which confer upon piperacillin a good distribution in tissues and biological fluids. In CSF, interstitial fluid, pleural and peritoneal fluids, piperacillin levels varied depending on the dose and on local inflammatory conditions; they reached high values ranging from 20 to 50 micrograms/ml corresponding to 18 to 25% of simultaneous serum levels. In bile, high and early levels of piperacillin were achieved, reaching about 1.200 to 3.200 micrograms/ml 100 min after i.v. injection of 2 or 4 g of the drug; in gallbladder wall more than 500 micrograms/g were measured. High tissue concentrations were found after 4 g i.v. of the drug in the renal cortex: 23 to 115 micrograms/g; in prostatic tissue: 70 micrograms/g; in bone: 15 micrograms/g; in cardiac tissue, especially myocardial tissue: 113 micrograms/g. In the female genital tract, the penetration of piperacillin was noticeable; levels of 15 to 45 micrograms/g were measured in uterus, ovary and salpinx: in contrast, placental transfer of piperacillin was limited. In the respiratory tract, the distribution of piperacillin was rapid, and concentrations of 12 to 30 micrograms/ml and 25 to 55 micrograms/g were found in bronchial secretions and bronchial mucosa respectively a 4 g i.v. dose. Studies of piperacillin distribution in the human body indicate that the drug reaches therapeutic levels in most tissues and biological fluids.
高血清水平和低蛋白结合率是哌拉西林在组织和生物体液中分布良好的主要因素。在脑脊液、组织间液、胸膜和腹膜液中,哌拉西林的水平因剂量和局部炎症情况而异;它们达到较高值,范围为20至50微克/毫升,相当于同期血清水平的18%至25%。在胆汁中,哌拉西林可迅速达到较高水平,静脉注射2克或4克药物后100分钟,胆汁中药物浓度达到约1200至3200微克/毫升;胆囊壁中测得的药物浓度超过500微克/克。静脉注射4克药物后,在肾皮质中发现较高的组织浓度:23至115微克/克;前列腺组织中:70微克/克;骨组织中:15微克/克;心脏组织,尤其是心肌组织中:113微克/克。在女性生殖道中,哌拉西林的渗透较为明显;在子宫、卵巢和输卵管中测得的药物浓度为15至45微克/克;相比之下,哌拉西林的胎盘转运有限。在呼吸道中,哌拉西林分布迅速,静脉注射4克剂量后,支气管分泌物和支气管黏膜中的药物浓度分别为12至30微克/毫升和25至55微克/克。对哌拉西林在人体中分布的研究表明,该药物在大多数组织和生物体液中可达到治疗水平。