Craft J C, Holt E A, Tan S H
Department of Pediatrics, School of Medicine, Tulane University, New Orleans, LA 70112.
Pediatr Infect Dis J. 1987 Sep;6(9):832-6. doi: 10.1097/00006454-198709000-00009.
We observed unexplained treatment failures in 13 patients with serious infections and apparent incidental giardiasis. Antibiotic concentrations were assayed in the serum from patients before initiating anti-Giardia therapy and again 2 to 3 weeks after therapy. The peak serum concentrations of antibiotics were higher after treatment for giardiasis. The rat model of giardiasis was used to examine the hypothesis that oral antibiotics are malabsorbed during Giardia lamblia infection. Twenty-eight-day-old Sprague-Dawley rats were fed amoxicillin (50 mg/kg/dose), ampicillin (50 mg/kg/dose), cefaclor (50 mg/kg/dose), cephalexin (50 mg/kg/dose), erythromycin (50 mg/kg/dose), penicillin V (50 mg/kg/dose) or sulfamethoxazole (20 mg/kg/dose) and sera were assayed for antibiotics at 1, 2, 4, 6 and 12 hours after therapy. The same rats were fed 10(5) G. lamblia cysts on 4 consecutive days. On Day 7 of infection the rats were fed the same antibiotic and sera were assayed for antibiotics at 1, 2, 4, 6 and 12 hours after therapy. The mean peak serum concentrations for all drugs except sulfamethoxazole were significantly higher in the rats before infection with G. lamblia. These data suggest that oral antibiotic therapy maybe compromised by decreased absorption in the presence of giardiasis.
我们观察到13例严重感染且明显合并偶发性贾第虫病的患者出现了不明原因的治疗失败。在开始抗贾第虫治疗前以及治疗2至3周后，对患者血清中的抗生素浓度进行了检测。治疗贾第虫病后，抗生素的血清峰值浓度更高。利用贾第虫病大鼠模型来检验以下假设：在感染蓝氏贾第鞭毛虫期间口服抗生素吸收不良。给28日龄的斯普拉格-道利大鼠喂食阿莫西林（50毫克/千克/剂量）、氨苄西林（50毫克/千克/剂量）、头孢克洛（50毫克/千克/剂量）、头孢氨苄（50毫克/千克/剂量）、红霉素（50毫克/千克/剂量）、青霉素V（50毫克/千克/剂量）或磺胺甲恶唑（20毫克/千克/剂量），并在治疗后1、2、4、6和12小时检测血清中的抗生素。对同一批大鼠连续4天喂食10(5)个蓝氏贾第鞭毛虫包囊。在感染第7天，给大鼠喂食相同的抗生素，并在治疗后1、2、4、6和12小时检测血清中的抗生素。除磺胺甲恶唑外，所有药物在大鼠感染蓝氏贾第鞭毛虫之前的平均血清峰值浓度显著更高。这些数据表明，在存在贾第虫病的情况下，口服抗生素治疗可能会因吸收减少而受到影响。
