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氨曲南在儿科领域的临床评价及其脑脊液渗透的基础研究

[Clinical evaluation on aztreonam in pediatric field and fundamental study on its penetration into cerebrospinal fluid].

作者信息

Okada T, Furukawa S

出版信息

Jpn J Antibiot. 1985 Nov;38(11):3323-33.

PMID:4094065
Abstract

The penetration of aztreonam (AZT), a new synthetic monobactam, into cerebrospinal fluid (CSF) and the clinical studies for bacterial infections were carried out. The following results were obtained. The concentrations of AZT in CSF were less than 0.31 microgram/ml and 0.42 microgram/ml, respectively, at 1 hour after intravenous administration of 34 mg/kg and 71 mg/kg in 2 cases of aseptic meningitis at the acute stage. The concentration of AZT in CSF was 6.9 micrograms/ml at 1 hour after intravenous administration of 100 mg/kg in 1 case of purulent meningitis at the acute stage and was 0.62-0.98 micrograms/ml even at the recovering stage. At each stage, its concentration was more than the minimum inhibitory concentration of E. coli (0.10, less than 0.05 microgram/ml; at inoculum size of 10(8), 10(6) cells/ml). Clinical efficacy of AZT was good in 2 cases of purulent meningitis, excellent in 1 case of septicemia, excellent in 5 cases of urinary tract infection, excellent in 1 case and good in 3 cases out of 4 cases of gastroenteritis, excellent in 4 cases and poor in 2 cases out of 6 cases of pneumonia and bronchitis, excellent in 2 cases and good in 1 case out of 3 cases of tonsillitis. No side effects and no abnormal laboratory findings were observed except 1 case of mild diarrhea out of 21 cases.

摘要

对新型合成单环β-内酰胺类药物氨曲南(AZT)穿透脑脊液(CSF)的情况以及针对细菌感染的临床研究进行了开展。获得了以下结果。在2例急性期无菌性脑膜炎患者中,静脉注射34mg/kg和71mg/kg后1小时,脑脊液中AZT的浓度分别低于0.31μg/ml和0.42μg/ml。在1例急性期化脓性脑膜炎患者中,静脉注射100mg/kg后1小时,脑脊液中AZT的浓度为6.9μg/ml,即使在恢复期也为0.62 - 0.98μg/ml。在每个阶段,其浓度均高于大肠杆菌的最低抑菌浓度(接种量为10⁸、10⁶个细胞/ml时,分别为0.10、低于0.05μg/ml)。AZT对2例化脓性脑膜炎临床疗效良好,对1例败血症疗效优异,对5例尿路感染疗效优异,在4例肠胃炎患者中,1例疗效优异,3例疗效良好,在6例肺炎和支气管炎患者中,4例疗效优异,2例疗效不佳,在3例扁桃体炎患者中,2例疗效优异,1例疗效良好。21例患者中除1例出现轻度腹泻外,未观察到副作用及实验室检查异常。

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