Neville L O, Baillod R, Grady D, Brumfitt W, Hamilton-Miller J M
Department of Medical Microbiology, Royal Free Hospital School of Medicine, London, England.
Int J Clin Pharmacol Res. 1987;7(6):485-90.
A significant increase in the incidence of methicillin resistance was found in coagulase-negative staphylococci isolated from infected dialysis fluids in 1985 compared with the previous year. Vancomycin and teicoplanin were active against all these isolates, and had similar minimum inhibitory and bactericidal concentrations. The pharmacokinetic behaviour of teicoplanin in 23 dialysis patients was studied. A single, intravenous dose of teicoplanin was given to 11 patients on haemodialysis (HD) and seven patients on chronic ambulatory peritoneal dialysis (CAPD). In five CAPD patients, 40 mg was added to each 2 litre bag of dialysate for a five day period. Twenty such bags were exchanged. The study showed that a) teicoplanin was not removed from the body by HD or CAPD, b) less than 3% of the administered dose appeared in the urine, c) serum levels reached a plateau of 3-4 micrograms/ml after 40 hours and were maintained for at least five days, regardless of the route of administration or form of dialysis. These findings have obvious implications regarding appropriate treatment regimens in dialysis patients.
与前一年相比，1985年从感染的透析液中分离出的凝固酶阴性葡萄球菌对甲氧西林的耐药率显著增加。万古霉素和替考拉宁对所有这些分离株均有活性，且最低抑菌浓度和杀菌浓度相似。对23例透析患者中替考拉宁的药代动力学行为进行了研究。对11例血液透析（HD）患者和7例持续性非卧床腹膜透析（CAPD）患者静脉注射了单次剂量的替考拉宁。在5例CAPD患者中，每2升透析液中添加40毫克，持续5天。共更换了20袋这样的透析液。研究表明：a）HD或CAPD均不能将替考拉宁从体内清除；b）给药剂量中不到3%出现在尿液中；c）无论给药途径或透析方式如何，血清水平在40小时后达到3 - 4微克/毫升的平台期，并维持至少5天。这些发现对透析患者的适当治疗方案具有明显的意义。
