Smirnov G A, Fattakhova R M, Petrashevskaia V A
Antibiotiki. 1979 Feb;24(2):133-7.
Clinical tolerance of benzylpenicillin administered intramuscularly in doses of 2000000--3000000 units every 4--6hours (12000000 units a day) was studied in 253 patients with pneumonia. Satisfactory tolerance of sodium benzylpenicillin and pronounced painfulness at the site of injection of potassium benzylpenicillin were noted. General toxic side effects in the form of asthenia, dizziness, pain in the heart region were observed in a part of elderly patients. The benzylpenicillin serum levels after administration of 2000000 units were 6--10 times higher than those after administration of 200000 units. The efficiency of benzylpenicillin elevated doses was studied in 193 patients. In 101 of them the previous treatment with usual doses of benzylpenicillin, i. e. 200000 units every 4 hours was not sufficiently effective. The elevated doses of benzylpenicillin proved to be effective in 78 per cent of the cases, the effect being observed in all the cases with acute pneumonia, in 88.5 per cent of the cases with neglected state and in 83 per cent of the cases with chronic pneumonia. The therapeutic effect was also observed in most of the patients with benzylpenicillin resistant microflora in the sputum. On the basis of high efficiency of penicillin therapy it was concluded that gram-positive cocci played the main role in pneumonia etiology.
对253例肺炎患者进行了研究，观察肌肉注射苄青霉素的临床耐受性，剂量为每4 - 6小时2000000 - 3000000单位（每日12000000单位）。结果发现，患者对苄青霉素钠耐受性良好，但对苄青霉素钾注射部位疼痛明显。部分老年患者出现乏力、头晕、心前区疼痛等一般毒性副作用。注射2000000单位苄青霉素后的血清水平比注射200000单位后的血清水平高6 - 10倍。对193例患者研究了苄青霉素加大剂量的疗效。其中101例患者先前使用常规剂量苄青霉素（即每4小时200000单位）治疗效果不佳。加大剂量的苄青霉素在78%的病例中显示有效，在所有急性肺炎病例、88.5%的病情迁延病例和83%的慢性肺炎病例中均观察到疗效。大多数痰中对苄青霉素耐药菌群的患者也观察到了治疗效果。基于青霉素治疗的高效性得出结论，革兰氏阳性球菌在肺炎病因中起主要作用。
