Tessin I, Thiringer K, Trollfors B, Brorson J E
Department of Paediatrics, Mölndal Hospital, Sweden.
Eur J Pediatr. 1988 May;147(4):405-7. doi: 10.1007/BF00496420.
Peak and trough serum concentrations of ceftazidime and tobramycin were determined in neonates with suspected septicaemia in an open randomized study. Mean peak serum levels were 85 (+/- 4.4 SE) mg/l for ceftazidime and 5.8 (+/- 0.3 SE) mg/l for tobramycin. The peak serum levels of ceftazidime were well above the reported minimal inhibitory concentration (MIC)90 values of pathogenic bacteria encountered in neonates, while peak serum levels of tobramycin were lower than reported MIC90 values for Klebsiella, Pseudomonas, Enterobacter and Serratia species. Nine of 33 tobramycin-treated patients had potentially toxic trough serum levels (greater than 2 mg/l) and nine had subtherapeutic peak serum levels (less than 4 mg/l). The dosage of this antibiotic had to be changed frequently. In comparison only 2 of 29 ceftazidime-treated patients had subtherapeutic peak levels (less than 40 mg/l) and none had potentially toxic trough levels (greater than 40 mg/l). Ceftazidime, in comparison with tobramycin, has a more favourable antibacterial spectrum and routine determinations of peak and trough serum levels should not be necessary.
在一项开放性随机研究中，对疑似败血症的新生儿测定了头孢他啶和妥布霉素的血清峰浓度和谷浓度。头孢他啶的平均血清峰浓度为85（±4.4标准误）mg/l，妥布霉素为5.8（±0.3标准误）mg/l。头孢他啶的血清峰浓度远高于报道的新生儿中所遇病原菌的最低抑菌浓度（MIC）90值，而妥布霉素的血清峰浓度低于报道的克雷伯菌属、假单胞菌属、肠杆菌属和沙雷菌属的MIC90值。33例接受妥布霉素治疗的患者中有9例谷血清浓度可能有毒（大于2mg/l），9例峰血清浓度低于治疗水平（小于4mg/l）。这种抗生素的剂量必须经常调整。相比之下，29例接受头孢他啶治疗的患者中只有2例峰浓度低于治疗水平（小于40mg/l），无一例谷浓度可能有毒（大于40mg/l）。与妥布霉素相比，头孢他啶具有更有利的抗菌谱，常规测定血清峰浓度和谷浓度应该没有必要。
