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舒他西林在儿童中的药代动力学、抗菌活性及临床疗效研究

[A study on pharmacokinetics, antimicrobial activity and clinical efficacy of sultamicillin in children].

作者信息

Okazaki H, Kitamura N, Hirabayashi Y, Higashino H, Kobayashi Y

机构信息

Department of Pediatrics, Kansai Medical University.

出版信息

Jpn J Antibiot. 1988 Dec;41(12):1940-6.

PMID:3249366
Abstract

Sultamicillin (SBTPC), a mutual prodrug for ampicillin (ABPC) and beta-lactamase inhibitor sulbactam (SBT), was evaluated for its antibacterial activity, pharmacokinetics and clinical efficacy. Pharmacokinetic studies were done in 2 subjects (a male and a female) following single oral administrations of 5 mg/kg and 10 mg/kg SBTPC fine granules after meal. Peak serum concentrations of ABPC and SBT in the 2 cases were 0.85 and 0.38 micrograms/ml and 3.74 and 3.79 micrograms/ml, respectively. Urinary excretion rates in 6 hours were 43.5-58.1% for ABPC and 33.6-53.6% for SBT. A total of 20 patients including 14 with respiratory infections, 1 with urinary tract infection and 5 with skin and soft tissue infections were treated with daily oral dose of 15.4-39.3 mg/kg SBTPC fine granules t.i.d. for 4 to 13 days. Responses were excellent in 5, good in 13 and fair in 2, hence the overall efficacy rate was 90.0%. Bacteriological responses were confirmed on 5 (62.5%) out of 8 strains which were eradicated by the treatment. SBTPC showed strong antibacterial activities against an ABPC-resistant strain of Escherichia coli. Side effects of the drug were observed in 3 patients: diarrhea in 2 and loose stool in 1. An abnormal laboratory test value, eosinophilia, was observed in only one patient.

摘要

舒他西林(SBTPC)是氨苄西林(ABPC)和β-内酰胺酶抑制剂舒巴坦(SBT)的共同前体药物,对其抗菌活性、药代动力学和临床疗效进行了评估。对2名受试者(1名男性和1名女性)进行了药代动力学研究,受试者餐后单次口服5mg/kg和10mg/kg舒他西林细颗粒。这2例受试者中氨苄西林和舒巴坦的血清峰值浓度分别为0.85和0.38微克/毫升以及3.74和3.79微克/毫升。6小时内氨苄西林的尿排泄率为43.5-58.1%,舒巴坦为33.6-53.6%。共有20例患者接受治疗,其中14例患有呼吸道感染,1例患有尿路感染,5例患有皮肤和软组织感染,每日口服剂量为15.4-39.3mg/kg舒他西林细颗粒,每日3次,持续4至13天。疗效优秀者5例,良好者13例,一般者2例,总有效率为90.0%。8株菌株中有5株(62.5%)经治疗后细菌学反应得到证实并被清除。舒他西林对一株耐氨苄西林的大肠杆菌显示出强大的抗菌活性。3例患者观察到药物副作用:2例腹泻,1例大便稀溏。仅1例患者实验室检查值异常,出现嗜酸性粒细胞增多。

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