Kildoo C W, Harralson A F, Folli H L, Kelly P C, Nussbaum E
Drug Intell Clin Pharm. 1987 Jul-Aug;21(7-8):639-42. doi: 10.1177/1060028087021007-815.
Studies performed in patients with cystic fibrosis (CF) have suggested altered pharmacokinetic parameters for aminoglycosides. Specifically, increased plasma clearance (Cl) of aminoglycosides and increased apparent volume of distribution have been noted. In the present study, tobramycin Cl is determined by both serum concentration data and direct renal clearance (Clren). Tobramycin Clren appeared to be directly correlated to the measured creatinine clearance (Clcr) (r = 0.93, p less than 0.01). The tobramycin Cl, by both methods of determination, was not elevated in comparison to the Clcr or expected values for patients without the disease. These results appear to corroborate a recent study in which the renal and plasma Cl of gentamicin was measured in patients with mild-to-moderate CF and were not noted to be elevated. It is suggested that standard doses of tobramycin be used initially in patients with mild-to-moderate CF with dosage adjustment based on serum concentration data to achieve the desired goals.
针对囊性纤维化（CF）患者开展的研究表明，氨基糖苷类药物的药代动力学参数发生了改变。具体而言，已注意到氨基糖苷类药物的血浆清除率（Cl）增加，且表观分布容积增大。在本研究中，妥布霉素的Cl通过血清浓度数据和直接肾脏清除率（Clren）来确定。妥布霉素的Clren似乎与测得的肌酐清除率（Clcr）直接相关（r = 0.93，p < 0.01）。通过两种测定方法得出的妥布霉素Cl，与无该疾病患者的Clcr或预期值相比并未升高。这些结果似乎证实了最近一项研究，该研究对轻度至中度CF患者的庆大霉素肾脏和血浆Cl进行了测量，未发现其升高。建议轻度至中度CF患者最初使用标准剂量的妥布霉素，并根据血清浓度数据调整剂量以实现预期目标。
