Motohiro T, Tanaka K, Koga T, Shimada Y, Tomita N, Sakata Y, Fujimoto T, Nishiyama T, Ishimoto K, Tominaga K
Jpn J Antibiot. 1984 Oct;37(10):1898-918.
To 6 cases of children in 2 groups of 3 each, newly developed sulbactam/cefoperazone (SBT/CPZ) was given at 20 and 40 mg/kg by intravenous bolus injection, respectively, and the serum and urinary concentrations and recoveries of SBT and CPZ were determined. To 1 case of purulent meningitis, this drug was given at 40 mg/kg by intravenous bolus injection, and the cerebrospinal fluid and serum concentrations of SBT and CPZ were determined. Susceptibility tests to SBT/CPZ and CPZ of total 289 strains were conducted; Gram-positive cocci tested consisted of 26 S. aureus strains, 20 S. pyogenes strains and 21 S. pneumoniae strains, and Gram-negative bacilli consisted of 24 H. influenzae strains, 22 E. coli strains, 26 K. pneumoniae strains, 24 E. cloacae strains, 21 E. aerogenes strains, 19 Citrobacter sp. strains, 20 S. marcescens strains, 23 P. mirabilis strains, 23 indole-positive Proteus sp. strains and 20 P. aeruginosa strains. SBT/CPZ was given to total 43 cases at a mean daily dosage of 80.4 mg/kg, in 3 or 4 divided doses (6 cases in 3 and 37 cases in 4), 1 case receiving the drug by drip infusion over 30 minutes (in 3 divided doses) and all the other 42 cases by intravenous bolus injection, for 7 days on an average. They consisted of 2 cases of tonsillitis, 1 case of otitis media, 1 case of otitis media associated with mastoiditis, 30 cases of pneumonia, 1 case of suspected septicemia, 1 case of purulent meningitis, 5 cases of urinary tract infection, 1 case of purulent lymphadenitis and 1 case of submaxillaritis. And the clinical and bacteriological effects were evaluated. Also, side reactions and laboratory examinations for abnormal values due to administration of this drug were made on 47 cases including 4 drop-outs. The following results were obtained: After administration of this drug to 2 groups of 3 children each at 20 and 40 mg/kg by intravenous bolus injection, mean serum concentrations of both SBT and CPZ reached the peaks in 5 minutes; SBT levels were 60.9 and 124.7 micrograms/ml for the 2 groups and CPZ levels were 105.0 and 214.1 micrograms/ml, respectively. In either group, CPZ levels were 1.7 times as high as SBT levels, and there was observed a dose-response in both. In the 20 mg/kg group, mean half-lives of SBT and CPZ were 0.96 and 1.24 hours, respectively, and in the 40 mg/kg group, they were 1.01 and 1.32 hours, CPZ values tending to be longer.(ABSTRACT TRUNCATED AT 400 WORDS)
将新研制的舒巴坦/头孢哌酮(SBT/CPZ)分别以20mg/kg和40mg/kg的剂量静脉推注给予两组各3例儿童,测定SBT和CPZ的血清及尿液浓度和回收率。对1例化脓性脑膜炎患儿以40mg/kg的剂量静脉推注该药,测定脑脊液和血清中SBT和CPZ的浓度。对总共289株菌株进行了SBT/CPZ和CPZ的药敏试验;测试的革兰氏阳性球菌包括26株金黄色葡萄球菌、20株化脓性链球菌和21株肺炎链球菌,革兰氏阴性杆菌包括24株流感嗜血杆菌、22株大肠杆菌、26株肺炎克雷伯菌、24株阴沟肠杆菌、21株产气肠杆菌、19株柠檬酸杆菌属菌株、20株粘质沙雷氏菌、23株奇异变形杆菌、23株吲哚阳性变形杆菌属菌株和20株铜绿假单胞菌。总共43例患者接受SBT/CPZ治疗,平均日剂量为80.4mg/kg,分3或4次给药(3次给药6例,4次给药37例),1例患者30分钟内静脉滴注给药(分3次),其余42例均静脉推注给药,平均给药7天。患者包括2例扁桃体炎、1例中耳炎、1例伴乳突炎的中耳炎、30例肺炎、1例疑似败血症、1例化脓性脑膜炎、5例尿路感染、1例化脓性淋巴结炎和1例颌下腺炎。并评估了临床和细菌学效果。对包括4例退出者在内的47例患者进行了该药给药后的不良反应及实验室异常值检查。结果如下:分别以20mg/kg和40mg/kg的剂量静脉推注给予两组各3例儿童该药后,SBT和CPZ血清平均浓度均在5分钟时达到峰值;两组SBT水平分别为60.9和124.7μg/ml,CPZ水平分别为105.0和214.1μg/ml。两组中CPZ水平均为SBT水平的1.7倍,且二者均呈现剂量反应关系。在20mg/kg组中,SBT和CPZ的平均半衰期分别为0.96小时和1.24小时,在40mg/kg组中,它们分别为1.01小时和1.32小时,CPZ值有延长趋势。(摘要截于400字)