Shcherbakova E G, Popov E P, Rachkov V M, Raevskiĭ V P, Polinov A V
Antibiotiki. 1984 Apr;29(4):286-91.
The efficacy of endolymphatic route of gentamicin and ceporin administration was studied in 89 patients with neurosurgical pathological processes complicated by acute pneumonia (80 patients) and meningoencephalitis (9 patients) usually after ineffective antibiotic therapy according to the routine methods. The antibiotics were used in accordance with the antibiograms of the causative agents isolated from the bronchial tree or CSF. The endolymphatic use of gentamicin or ceporin once a day in doses of 80 mg or 1 g respectively provided rapid sanation and arresting of the inflammatory foci, lowering of the intoxication level, more rapid promotion of the positive time course of the clinico-roentgenological and laboratory indices and decreasing of the recovery periods by 1.5-2 times in 86 per cent of the patients with pneumonia. The endolymphatic administration of gentamicin in a dose of 80 mg twice a day or ceporin in a dose of 1 g twice a day allowed one to maintain the antibiotic therapeutic levels in the cerebrospinal fluid and to obtain satisfactory clinical results in the combined treatment of meningoencephalitis. The endolymphatic administration of the drugs was well tolerated by the patients and no adverse reactions were observed. This route of administration of antibiotics and in particular broad spectrum antibiotics may be recommended for urgent antibacterial therapy of especially severe neurosurgical patients with pyo-inflammatory complications and patients who did not respond to the routine antibiotic therapy.
对89例神经外科病理过程并发急性肺炎(80例)和脑膜脑炎(9例)的患者,在常规抗生素治疗无效后,研究了庆大霉素和头孢泊肟经内淋巴途径给药的疗效。抗生素根据从支气管树或脑脊液中分离出的病原体的抗菌谱使用。庆大霉素或头孢泊肟经内淋巴途径给药,每日1次,剂量分别为80mg或1g,能迅速消除炎症病灶、阻止炎症发展,降低中毒水平,更快促进临床-放射学和实验室指标向阳性转归,86%的肺炎患者恢复期缩短1.5 - 2倍。庆大霉素80mg每日2次或头孢泊肟1g每日2次经内淋巴途径给药,可使脑脊液中维持抗生素治疗水平,并在脑膜脑炎的联合治疗中取得满意的临床效果。患者对药物经内淋巴途径给药耐受性良好,未观察到不良反应。这种抗生素给药途径,尤其是广谱抗生素给药途径,可推荐用于有脓性炎症并发症的特别严重的神经外科患者以及对常规抗生素治疗无反应的患者的紧急抗菌治疗。