Ruedy J
Can Med Assoc J. 1966 Feb 5;94(6):257-61.
Seven patients with acute or chronic renal failure who were receiving intermittent peritoneal dialysis and who required parenteral oxacillin, ampicillin or tetracycline were studied to determine the disposition of these antibiotics in severe renal disease and the effects of peritoneal dialysis. While severe renal impairment markedly prolongs persistence in the serum of ampicillin and tetracycline, there is little effect on oxacillin. Whereas required doses of ampicillin and tetracycline are lower in the presence of severe renal disease, oxacillin should be given in doses equivalent to those used for patients with normal renal function. Peritoneal dialysis does not alter these dosage requirements.Four patients receiving ampicillin or tetracycline in the infusing solution during peritoneal dialysis were studied to determine the amount of systemic absorption. Local prophylaxis alone is not achieved with this method of administration, since small amounts of both antibiotics are absorbed systemically from the infusing solution. The serum concentration of tetracycline attained is inadequate for treatment of systemic infections but is probably significant, with repeated use in intermittent dialysis, in causing adverse effects. Tetracycline should be abandoned in the local prophylaxis of peritonitis during peritoneal dialysis.
对7例接受间歇性腹膜透析且需要胃肠外使用苯唑西林、氨苄西林或四环素的急性或慢性肾衰竭患者进行了研究，以确定这些抗生素在严重肾脏疾病中的处置情况以及腹膜透析的影响。虽然严重肾功能损害显著延长了氨苄西林和四环素在血清中的持续时间，但对苯唑西林影响不大。严重肾脏疾病患者所需的氨苄西林和四环素剂量较低，而苯唑西林的给药剂量应与肾功能正常患者使用的剂量相当。腹膜透析不会改变这些剂量要求。对4例在腹膜透析期间于输注溶液中接受氨苄西林或四环素的患者进行了研究，以确定全身吸收量。采用这种给药方法不能仅实现局部预防，因为两种抗生素均有少量从输注溶液中被全身吸收。所达到的四环素血清浓度不足以治疗全身感染，但在间歇性透析中反复使用时，可能会显著导致不良反应。在腹膜透析期间局部预防腹膜炎时应放弃使用四环素。
