Petitjean A, Astier A, Louchahi M, Perret G, Karsenti P, Jacquot C, Petitjean O
Pathol Biol (Paris). 1983 May;31(5):399-403.
Aminoglycosides and in particular gentamicin are still largely used in the treatment of spontaneous bacterial peritonitis in the decompensed alcoholic cirrhotic patient. For that matter, we decided to study the various passage of gentamicin in the ascites after its administration through IM injection (80 mg in 6 patients and 120 mg in 6 other patients) and through IV injection (120 mg in 6 other patients). What could possibly be the best protocol to replace the daily intraperitoneal injections? We found out that no matter what the style of injection is, the peritoneal levels are only exceptionnaly higher than 3 mg/g at the highest peak period. These results brought us to analyze the passage of gentamicin in the blood when injected intraperitonealy (160 mg in 6 patients), and then to propose a therapeutic protocol combining on the first day, to the peritoneal injection a loading dose of an IP injection of 160 mg, the relay been taken over later with a peritoneal injection of 80 or 120 mg repeated 2 or 3 times daily. For each of the protocol the pharmacokinetic coefficients of gentamicin were calculated.
氨基糖苷类药物，尤其是庆大霉素，在失代偿期酒精性肝硬化患者自发性细菌性腹膜炎的治疗中仍被大量使用。为此，我们决定研究庆大霉素在通过肌肉注射（6例患者注射80毫克，另外6例患者注射120毫克）和静脉注射（另外6例患者注射120毫克）给药后在腹水中的各种情况。用什么方案有可能最好地替代每日腹腔注射呢？我们发现，无论注射方式如何，在最高峰期腹腔内药物水平仅偶尔高于3毫克/克。这些结果促使我们分析庆大霉素经腹腔注射（6例患者注射160毫克）后在血液中的情况，然后提出一种治疗方案，即在第一天，在腹腔注射的同时给予160毫克的腹腔注射负荷剂量，随后改为每天重复2至3次注射80或120毫克的腹腔注射。针对每个方案计算了庆大霉素的药代动力学系数。
