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新型头孢霉素类抗生素头孢替坦在儿科的实验与临床评估

[Experimental and clinical evaluation of a new cephamycin antibiotic, cefotetan, in pediatrics].

作者信息

Nakazawa S, Sato H, Niino K, Suzuki H, Nakazawa S, Chikaoka H, Oka S, Hirama Y, Narita A

出版信息

Jpn J Antibiot. 1983 Jun;36(6):1219-32.

PMID:6581328
Abstract

A series of studies was performed on the use of cefotetan (CTT) in the field of pediatrics. The results that were obtained are described below. The minimum inhibitory concentrations (MICs) of CTT against strains of E. coli and K. oxytoca that were recently isolated from child patients were found to mostly be 0.78 micrograms/ml or less. Even strains that were highly resistant to the action of ABPC were sensitive to CTT. CTT was administered to pediatric patients by intravenous drip infusion or by one shot intravenous injection, and then the concentration of the drug in the serum was monitored. The same procedures and dosages were employed for CFX and CMZ. In comparison with these 2 antibiotics, CTT showed a higher peak concentration in the serum, and it was retained in the blood for a longer time. The half-life of the CTT serum concentration was 2 hours or more in most of the subjects. When CTT was administered in a dosage of 10 mg/kg by intravenous drip infusion, the drug could still be detected in the serum as long as 12 hours later in some cases. Repeated intravenous drip infusion administration of CTT was not found to result in any accumulation of this antibiotic in the serum. During the 8-hour period following intravenous injection of CTT, about 50 to 80% of the administered dose was found to be excreted in the urine in its active form. During the acute phase of meningitis, intravenously injected (one shot) CTT was found to be transferred to the cerebrospinal fluid in a concentration that was sufficient to kill those bacteria that were sensitive to the action of this antibiotic. It was proven that, following the intravenous injection of CTT, the concentration of this drug in the feces was sufficient to inhibit the growth of Salmonella, Campylobacter, etc. CTT was administered by intravenous drip infusion as therapy to a total of 37 child patients diagnosed as having acute infections; these infections consisted mainly of upper and lower respiratory tract infections, urinary tract infections, intestinal tract infections and suppurative diseases. The dosage of CTT used in the treatment of these diseases ranged almost from 20 to 40 mg/kg/day, given as 2 doses per day (at intervals of 10-12 hours). The efficacy rate of this therapeutic regimen was 97%.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

在儿科领域开展了一系列关于头孢替坦(CTT)应用的研究。所获结果如下所述。CTT对近期从儿童患者中分离出的大肠杆菌和产酸克雷伯菌菌株的最低抑菌浓度(MICs)大多为0.78微克/毫升或更低。即使是对氨苄青霉素高度耐药的菌株对CTT也敏感。通过静脉滴注或单次静脉注射给儿科患者使用CTT,然后监测血清中的药物浓度。对头孢呋辛(CFX)和头孢孟多(CMZ)采用相同的程序和剂量。与这两种抗生素相比,CTT在血清中显示出更高的峰值浓度,并且在血液中保留的时间更长。在大多数受试者中,CTT血清浓度的半衰期为2小时或更长。当以10毫克/千克的剂量通过静脉滴注给予CTT时,在某些情况下,12小时后血清中仍可检测到该药物。未发现重复静脉滴注给予CTT会导致这种抗生素在血清中蓄积。在静脉注射CTT后的8小时内,发现约50%至80%的给药剂量以活性形式经尿液排出。在脑膜炎急性期,发现静脉注射(单次)的CTT会以足以杀死对该抗生素敏感的细菌的浓度转移至脑脊液中。已证实,静脉注射CTT后,该药物在粪便中的浓度足以抑制沙门氏菌、弯曲杆菌等的生长。对总共37名被诊断患有急性感染的儿童患者通过静脉滴注给予CTT进行治疗;这些感染主要包括上、下呼吸道感染、尿路感染、肠道感染和化脓性疾病。用于治疗这些疾病的CTT剂量几乎为20至40毫克/千克/天,每天分2次给药(间隔10 - 12小时)。该治疗方案的有效率为97%。(摘要截选至400字)

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