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阿米卡星静脉滴注在内科感染领域的临床评价

[Clinical evaluation of amikacin by intravenous drip infusion for infections in the field of internal medicine].

作者信息

Ito A, Maruta I, Ogawa K, Asada H, Matsuzaki M

出版信息

Jpn J Antibiot. 1985 Aug;38(8):2108-18.

PMID:4079002
Abstract

Amikacin (AMK) by intravenous drip infusion was given to patients with infections in the field of internal medicine and the results were followings: AMK was administered to 19 patients. Diagnosis included sepsis or suspected sepsis (11 cases), pneumonia (2 cases), chronic respiratory tract infections (3 cases) and urinary tract infections (3 cases). Underlying disease included hematologic disease (13 cases), lung fibrosis (1 case), chronic respiratory insufficiency (1 case), diabetes mellitus (1 case), hepatic coma and bronchial asthma (1 case) and prostatic hypertrophy (1 case). Nineteen episodes responded to single therapy (2 cases) or combined therapy with other antibiotics (17 cases). AMK by intravenous drip infusion (dissolved in not less than 100 ml of saline or glucose) was administered at the dose of 200 mg/day to 600 mg/day divided into 2 or 3 times, over 1 hour to 2 hours. The mean duration of therapy was 10 days and the mean total dose was 4.3 g. Clinical effects: Excellent in 7 cases, good in 7 cases, fair in 3 cases and poor in 2 cases, and efficacy rate was 74%. Bacteriological effects: Disappeared in 3 cases, partly disappeared and unchanged in 3 cases, superinfection in 1 case and newly appeared in 1 case. Four strains out of 7 cases of which were detected the causative bacteria were disappeared. GM resistant bacteria (S. marcescens in 2 strains and C. diversus in 1 strain) were disappeared by the administration of AMK, also some clinical symptoms and signs were improved. No side effects and no abnormalities in laboratory findings were noted in any cases attributed to AMK. In conclusion, high efficacy rate was obtained without any side effects, intravenous drip infusion of AMK seemed to be useful for infections in patients with bleeding tendency (e.g. leukemia) or malignant disease.

摘要

对内科感染患者静脉滴注阿米卡星(AMK),结果如下:19例患者接受了AMK治疗。诊断包括败血症或疑似败血症(11例)、肺炎(2例)、慢性呼吸道感染(3例)和尿路感染(3例)。基础疾病包括血液系统疾病(13例)、肺纤维化(1例)、慢性呼吸功能不全(1例)、糖尿病(1例)、肝昏迷和支气管哮喘(1例)以及前列腺肥大(1例)。19例单次治疗(2例)或与其他抗生素联合治疗(17例)有效。静脉滴注AMK(溶于不少于100ml生理盐水或葡萄糖中),剂量为200mg/天至600mg/天,分2或3次给药,持续1至2小时。平均治疗持续时间为10天,平均总剂量为4.3g。临床疗效:7例优,7例良,3例中,2例差,有效率为74%。细菌学疗效:3例病原菌消失,3例部分消失或未变,1例发生二重感染,1例新出现病原菌。7例检出病原菌的病例中,4株病原菌消失。给予AMK后,GM耐药菌(2株粘质沙雷菌和1株差异枸橼酸杆菌)消失,一些临床症状和体征也有所改善。所有病例均未发现归因于AMK的副作用及实验室检查异常。总之,静脉滴注AMK获得了高有效率且无任何副作用,似乎对有出血倾向(如白血病)或恶性疾病患者的感染有效。

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