Gagaeva E V, Firsov A A, Egorenko G G, Danilova V I, Shtegel'man L A
Antibiot Med Biotekhnol. 1986 Oct;31(10):785-90.
The action of cefazolin on the pharmacokinetics and nephrotoxic effect of sisomicin was studied on Wistar rats. Sisomicin in doses of 12.5 and 25 mg/kg alone or in combination with cefazolin in doses of 90 and 360 mg/kg was administered intramuscularly to the animals daily for 16 days. It was shown that in both the doses cefazolin had no noticeable action on the level of the functional and morphological changes in the kidneys. Consequently, there were no significant changes in the levels of sisomicin in serum and the site of the nephrotoxic effect (cortical layer of the kidneys) and in the half-life of the aminoglycoside in the kidney cortical layer under the action of cefazolin. At the same time there was observed a marked individual variability of the levels of urea nitrogen and sisomicin in serum of the rats treated with the aminoglycoside alone or in combination with cefazolin. Analysis of the dependence of the nephrotoxic effect on concentration of sisomicin in serum after its use alone or in combination with cefazolin revealed that the changes in the individual intensity of the effect in all the cases were mainly induced by the changes in the sisomicin blood levels. Therefore, control of the blood levels of the aminoglycoside should provide prevention of the development of its nephrotoxic effect not only in monotherapy but also in the use of aminoglycosides in combination with cefazolin.
在Wistar大鼠身上研究了头孢唑林对西索米星药代动力学及肾毒性作用的影响。分别以12.5和25mg/kg的剂量单独给予西索米星,或以90和360mg/kg的剂量与头孢唑林联合给予西索米星,每日对动物进行肌肉注射,持续16天。结果表明,两种剂量的头孢唑林对肾脏功能和形态学变化水平均无明显作用。因此,在头孢唑林作用下,血清中西索米星水平、肾毒性作用部位(肾皮质层)以及氨基糖苷类药物在肾皮质层的半衰期均无显著变化。同时,观察到单独使用氨基糖苷类药物或与头孢唑林联合使用时,大鼠血清中尿素氮和西索米星水平存在明显的个体差异。分析单独使用或与头孢唑林联合使用西索米星后肾毒性作用与血清中西索米星浓度的相关性发现,在所有情况下,个体效应强度的变化主要由西索米星血药浓度的变化引起。因此,控制氨基糖苷类药物的血药浓度不仅应预防其在单一疗法中的肾毒性作用,还应预防其与头孢唑林联合使用时的肾毒性作用。