Fillastre J P, Moulin B, Josse S, Frelon J H
Service de Néphrologie, UER de Médecine, Rouen.
Pathol Biol (Paris). 1988 Jun;36(5 Pt 2):694-8.
Apalcilline is a new semi-synthetic penicillin. More than 4,000 patients were treated with this antibiotic but an increase level of serum creatinine was noted in 18 cases. Responsibility of apalcilline in this side effect could be possible in 5 cases, doubtful in 13 cases. We decided to study renal function of normal volunteers treated with 4 gr apalcilline. Three periods were realised: a control period (80 min), a treatment period (60 min), a post-treatment period (40 min). Inulin and PAH infusion lasted during all these three periods. After the control period 2 gr apalcilline was injected as a bolus followed by a 2 gr apalcilline perfusion for one hour. Urinary volume was measured every 20 min. Creatinine, inulin, PAH clearances, sodium, potassium, calcium, magnesium urinary excretion were calculated for each period. Urinary B2-microglobulin excretion was also appreciated. Analysis of variance was done. We did not observe any variation of creatinine, inulin clearances or variation of urinary electrolytes output PAH clearance was significantly decreased during alpacilline infusion. Apalcilline seems competitive with PAH for proximal tubular secretion. Nevertheless apalcilline did not induce any more renal dysfunction.
阿帕西林是一种新型半合成青霉素。超过4000名患者使用了这种抗生素，但有18例患者血清肌酐水平升高。在5例中，阿帕西林可能是这种副作用的原因，在13例中存疑。我们决定研究用4克阿帕西林治疗的正常志愿者的肾功能。实验分为三个阶段：一个对照期（80分钟）、一个治疗期（60分钟）、一个治疗后期（40分钟）。在这三个阶段中均持续输注菊粉和对氨基马尿酸。在对照期后，静脉推注2克阿帕西林，随后以每小时2克的速度输注阿帕西林。每20分钟测量一次尿量。计算每个阶段的肌酐、菊粉、对氨基马尿酸清除率以及钠、钾、钙、镁的尿排泄量。还评估了尿β2-微球蛋白排泄量。进行了方差分析。我们未观察到肌酐、菊粉清除率有任何变化，也未观察到尿电解质排出量有变化，但在输注阿帕西林期间对氨基马尿酸清除率显著降低。阿帕西林似乎在近端肾小管分泌方面与对氨基马尿酸存在竞争。然而，阿帕西林并未引发更多的肾功能障碍。
