Bégué P, Safran C, Quiniou F, Fifils A, Bodard M, Cotin G
Ann Otolaryngol Chir Cervicofac. 1983;100(4):239-41.
Tonsillar diffusion of two antibiotics was compared in 61 children, 26 receiving 100 mg/kg/d of ampicillin, and the other 35 being treated with 50 mg/kg/d of triacetyloleandomycin during the 24 hours preceding tonsillectomy. Drug levels were measured by a microbiological method. The mean ampicillin level in the tonsil was 0,84 mcg/ml for a serum level of 4,1 mcg/ml 90 minutes before sampling, concentrations being absent in the tonsil in 12 cases (45 p. cent). Mean triacetyloleandomycin levels in the tonsil were 12,16 mcg/ml for a serum level of 2,27 mcg/ml 90 minutes before sampling, concentrations being absent in the tonsil in only 4 cases (11 p. cent). Very high concentrations of triacetyloleandomycin as against low or no levels of ampicillin were therefore detected in the tonsil. This suggest that macrolides should be employed in preference to ampicillin for the treatment of recurrent sore throats, and tonsillixis, and for preventive treatment of acute rheumatic fever.
对61名儿童扁桃体中两种抗生素的扩散情况进行了比较。在扁桃体切除术前24小时内,26名儿童接受100mg/kg/d的氨苄西林治疗,另外35名儿童接受50mg/kg/d的醋竹桃霉素治疗。采用微生物学方法测量药物水平。采样前90分钟血清水平为4.1mcg/ml时,扁桃体中氨苄西林的平均水平为0.84mcg/ml,12例(45%)扁桃体中未检测到药物浓度。采样前90分钟血清水平为2.27mcg/ml时,扁桃体中醋竹桃霉素的平均水平为12.16mcg/ml,仅4例(11%)扁桃体中未检测到药物浓度。因此,在扁桃体中检测到醋竹桃霉素浓度非常高,而氨苄西林浓度低或未检测到。这表明,在治疗复发性咽痛、扁桃体炎以及预防急性风湿热时,应优先使用大环内酯类药物而非氨苄西林。