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我们在结直肠手术中使用的甲硝唑剂量是否正确?

Are we using the correct dose of metronidazole in colorectal surgery?

作者信息

Hobbiss J H, Carr N D, Schofield P F

机构信息

University Hospital of South Manchester.

出版信息

J R Soc Med. 1988 Feb;81(2):95-6. doi: 10.1177/014107688808100215.

DOI:10.1177/014107688808100215
PMID:3346865
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1291475/
Abstract

In a series of 20 patients undergoing elective colorectal surgery, 10 received an infusion of metronidazole 500 mg and 10 an infusion of 1500 mg commencing at the induction of anaesthesia. The concentrations of metronidazole in the plasma, rectus muscle and colon of the two groups during the course of the operation were compared. In those patients who received 1500 mg, the plasma and tissue concentrations were all well above the minimum inhibitory concentration (MIC) of metronidazole against Bacteroides fragilis. In those patients who received 500 mg, serum and tissue concentrations were at or only just above the MIC. It may be that 1500 mg would be a more effective dose of metronidazole for prophylactic use in colorectal surgery.

摘要

在一组20例行择期结直肠手术的患者中,10例在麻醉诱导时输注500毫克甲硝唑,10例输注1500毫克甲硝唑。比较了两组患者在手术过程中血浆、腹直肌和结肠中甲硝唑的浓度。在接受1500毫克甲硝唑的患者中,血浆和组织浓度均远高于甲硝唑对脆弱拟杆菌的最低抑菌浓度(MIC)。在接受500毫克甲硝唑的患者中,血清和组织浓度处于或仅略高于MIC。在结直肠手术预防性使用中,1500毫克甲硝唑可能是更有效的剂量。

相似文献

1
Are we using the correct dose of metronidazole in colorectal surgery?我们在结直肠手术中使用的甲硝唑剂量是否正确?
J R Soc Med. 1988 Feb;81(2):95-6. doi: 10.1177/014107688808100215.
2
Comparison of two prophylactic single-dose intravenous antibiotic regimes in the treatment of patients undergoing elective colorectal surgery in a district general hospital.在一家地区综合医院对接受择期结直肠手术患者使用两种预防性单剂量静脉注射抗生素方案的比较。
J R Coll Surg Edinb. 1989 Aug;34(4):208-11.
3
The significance of timing of metronidazole prophylaxis and addition of fosfomycin in colorectal surgery. An experimental study in rats.甲硝唑预防时机及磷霉素添加在结直肠手术中的意义:一项大鼠实验研究
Acta Chir Scand. 1990 Jan;156(1):105-10.
4
Metronidazole in the chemoprophylaxis of colon and rectum operations.甲硝唑在结肠和直肠手术的化学预防中的应用。
Acta Chir Acad Sci Hung. 1982;23(3):135-43.
5
[Antimicrobial chemoprevention in colorectal interventions: a single parenteral dose at the start of surgery is adequate].
Chirurg. 1986 Jun;57(6):406-10.
6
[Preoperative oral antimicrobial bowel preparations in elective colorectal surgery].
Nihon Geka Gakkai Zasshi. 1990 Aug;91(8):972-9.
7
[Preoperative topical antibiotics in patients subjected to short term prophylaxis for colorectal surgery].
Minerva Chir. 1989 Mar 31;44(6):1029-31.
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A prospective randomized trial to compare triple dose mezlocillin with triple dose cefuroxime plus metronidazole as prophylaxis in colorectal surgery.一项前瞻性随机试验,比较三联剂量美洛西林与三联剂量头孢呋辛加甲硝唑在结直肠手术中作为预防用药的效果。
J Hosp Infect. 1988 Oct;12(3):215-9. doi: 10.1016/0195-6701(88)90009-6.
9
Prophylactic metronidazole in electrive colo-rectal surgery.择期结直肠手术中的预防性甲硝唑应用
Acta Chir Scand. 1980;146(1):71-5.
10
Inadequate levels of metronidazole in subcutaneous fat after standard prophylaxis.标准预防措施后皮下脂肪中甲硝唑水平不足。
Br J Surg. 1995 Apr;82(4):479-82. doi: 10.1002/bjs.1800820417.

引用本文的文献

1
Antimicrobial prophylaxis for colorectal surgery.结直肠手术的抗菌预防
Cochrane Database Syst Rev. 2014 May 9;2014(5):CD001181. doi: 10.1002/14651858.CD001181.pub4.

本文引用的文献

1
Pre-operation single-dose cefuroxime antimicrobial prophylaxis with and without metronidazole in elective gastrointestinal surgery.在择期胃肠手术中使用头孢呋辛进行术前单剂量抗菌药物预防,联合或不联合甲硝唑。
J Antimicrob Chemother. 1980 May;6(3):393-9. doi: 10.1093/jac/6.3.393.
2
A rapid and specific semi-micro method involving high-pressure liquid chromatography for the assay of metronidazole in plasma, saliva, serum, urine and whole blood.一种快速且特异的半微量方法,该方法涉及高压液相色谱法,用于测定血浆、唾液、血清、尿液和全血中的甲硝唑。
Br J Clin Pharmacol. 1980 May;9(5):528-9. doi: 10.1111/j.1365-2125.1980.tb05856.x.
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Pharmacokinetics of intravenous metronidazole in man.静脉注射甲硝唑在人体中的药代动力学。
Acta Pharmacol Toxicol (Copenh). 1982 Aug;51(2):132-5. doi: 10.1111/j.1600-0773.1982.tb01003.x.
4
Metronidazole in the prevention of wound sepsis after elective colorectal surgery.甲硝唑在择期结直肠手术后预防伤口感染中的应用
J R Coll Surg Edinb. 1984 May;29(3):139-42.
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The place of antibiotics in colonic surgery: a clinical study.
Br J Surg. 1969 Sep;56(9):679-84. doi: 10.1002/bjs.1800560911.
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Metronidazole versus anaerobes. In vitro data and initial clinical observations.甲硝唑与厌氧菌。体外数据及初步临床观察。
Calif Med. 1972 Dec;117(6):22-6.
7
Postoperative wound infection in colonic and rectal surgery.结肠和直肠手术中的术后伤口感染
Br J Surg. 1973 May;60(5):363-5. doi: 10.1002/bjs.1800600512.
8
Metronidazole in prevention and treatment of bacteroides infections in elective colonic surgery.甲硝唑在择期结肠手术中预防和治疗拟杆菌感染的应用
Br Med J. 1977 Mar 5;1(6061):607-10. doi: 10.1136/bmj.1.6061.607.
9
Prophylactic peroperative intravenous metronidazole in elective colorectal surgery.择期结直肠手术中预防性术中静脉注射甲硝唑
Lancet. 1979 Oct 13;2(8146):761-4. doi: 10.1016/s0140-6736(79)92114-7.
10
Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgery.结直肠手术中全身预防性使用抗菌药物与口服预防性使用抗菌药物的比较。
Lancet. 1979 Apr 28;1(8122):894-7. doi: 10.1016/s0140-6736(79)91373-4.