Sengoku K, Mure K, Sagawa T, Yamashita K, Shimizu T
Jpn J Antibiot. 1986 Aug;39(8):2214-8.
In a chemotherapy of perinatal infections, the safety of mothers and their neonates and the transfer of a drug to amniotic fluid and fetus as well as its bacteriological efficacy are some of the important factors. In the present study, the authors have carried out a pharmacokinetic evaluation on the transfer of ceftazidime (CAZ), a new cephalosporin, to amniotic fluid and umbilical cord serum, and also a clinical study on its efficacy and safety in 3 cases of perinatal infections. Transfer ratios of CAZ to umbilical serum and to amniotic fluid were 25.3-46.5% and 0.6-17.5% (of maternal serum), respectively, after 1 g of CAZ was administered by bolus intravenous injection, and 24.3-85.8% and 1.6-17.5% (of maternal serum), respectively, after 2 g of CAZ was administered by bolus intravenous injection. These levels were high enough to expect that CAZ is an effective antibiotic both for treatment and prophylaxis of intrauterine fetal infections. Out of the 3 cases treated with CAZ, clinical efficacy was good in 2 cases which did not respond to other antibiotics. CAZ was considered to be clinically effective, although the number of cases treated was small. No abnormalities were observed at all either in subjective symptoms or objective findings in laboratory findings such as hepatic and renal functions of mothers, or neonates. This confirmed the high safety of CAZ. As earlier reports indicate, CAZ has a broad-spectrum of antibacterial activity against various bacteria including Gram-negative organisms and anaerobes, and shows a good transfer into intrauterine tissues, and high clinical efficacy in the field of obstetrics and gynecology.(ABSTRACT TRUNCATED AT 250 WORDS)
在围产期感染的化疗中,母亲及其新生儿的安全性、药物向羊水和胎儿的转移以及其细菌学疗效是一些重要因素。在本研究中,作者对新型头孢菌素头孢他啶(CAZ)向羊水和脐血清的转移进行了药代动力学评估,并对其在3例围产期感染中的疗效和安全性进行了临床研究。静脉推注1g CAZ后,CAZ向脐血清和羊水的转移率分别为母体血清的25.3 - 46.5%和0.6 - 17.5%;静脉推注2g CAZ后,分别为母体血清的24.3 - 85.8%和1.6 - 17.5%。这些水平足以预期CAZ是治疗和预防宫内胎儿感染的有效抗生素。在接受CAZ治疗的3例病例中,2例对其他抗生素无反应的病例临床疗效良好。尽管治疗病例数较少,但CAZ被认为具有临床疗效。在母亲或新生儿的主观症状或客观检查结果(如肝肾功能等实验室检查结果)中均未观察到异常。这证实了CAZ的高安全性。如早期报告所示,CAZ对包括革兰氏阴性菌和厌氧菌在内的各种细菌具有广谱抗菌活性,在宫内组织中有良好的转移,在妇产科领域具有较高的临床疗效。(摘要截断于250字)