Nakamura T, Hashimoto I, Sawada Y, Mikami J, Saitoh M, Hattanda K, Bekki E, Nishidai H, Nakanishi M, Kasai Y
Jpn J Antibiot. 1982 Apr;35(4):897-908.
An antibiotic drug of aminoglycoside group, amikacin (AMK) for parenteral use was used to 8 hospitalized patients: 4 with acute or subacute cholecystitis and cholangitis, 4 with acute peritonitis (3 cases were due to acute appendicitis and a case was torsion of right ovarian cyst). AMK in a dose of 200 mg were administered by intravenous drip infusion for 1 to 2 hours, twice a day for 4 to 9 days. To the cases with biliary tract infection, AMK was treated to preoperatively and to the cases with acute peritonitis, AMK was treated to the postoperatively. Clinical response was excellent in 2 cases, good in 6 cases, fair and poor in none. No adverse effect was observed. The organisms were isolated in 4 cases, 4 were Escherichia coli, 1 was Klebsiella pneumoniae and 1 was Bacteroides fragilis. The MIC for AMK were 3.13-1.56 micrograms/ml in 10(8) and 10(6) cells/ml, except Bacteroides fragilis. Before the operation of above cases, AMK in a dose of 200 mg were administered by intravenous drip infusion in 2 cases (acute and subacute cholecystitis and cholangitis with cholelithiasis), 5 cases by intramuscularly and 1 case by intravenously (acute appendicitis with localized peritonitis). The materials of A-bile, B-bile, wall of gallbladder, the appendix, ascites and serum samples were taken during the operation. AMK concentration was measured by bioassay method with Bacillus subtilis ATCC 6633 as test organism. AMK concentration in B-bile were higher than those in the A-bile. AMK concentrations in wall of gallbladder were much higher than those in A and B-bile. The concentrations after intravenous drip infusion were higher than those after intramuscularly administration. AMK changes of inflammation. In a case of gastric ulcer, AMK 200 mg by intravenous drip infusion was administrated, the AMK concentrations of the tissues at 25 minutes after end of infusion, they were 15.00 micrograms/g in gastric ulcer, 7.20 micrograms/g in normal gastric wall, 9.14 micrograms/g in duodenal wall and 8.12 micrograms/g in the omentum, respectively. Serum concentration of AMK on this case at 58 minutes was 15.7 micrograms/ml. Therefore, it was supposed that AMK could be used safety and effective by intravenous drip infusion.
一种氨基糖苷类抗生素药物阿米卡星（AMK）用于8例住院患者的肠外给药：4例患有急性或亚急性胆囊炎和胆管炎，4例患有急性腹膜炎（3例因急性阑尾炎，1例为右卵巢囊肿扭转）。以200mg的剂量通过静脉滴注给药1至2小时，每天两次，持续4至9天。对于胆道感染病例，术前使用AMK治疗；对于急性腹膜炎病例，术后使用AMK治疗。临床反应2例优秀，6例良好，无一般和差的情况。未观察到不良反应。4例分离出病原体，4例为大肠杆菌，1例为肺炎克雷伯菌，1例为脆弱拟杆菌。除脆弱拟杆菌外，AMK对10⁸和10⁶个细胞/ml的MIC为3.13 - 1.56微克/毫升。上述病例术前，2例（急性和亚急性胆囊炎和胆管炎伴胆结石）通过静脉滴注给予200mg AMK，5例通过肌肉注射，1例通过静脉注射（急性阑尾炎伴局限性腹膜炎）。术中采集A胆汁、B胆汁、胆囊壁、阑尾、腹水和血清样本。以枯草芽孢杆菌ATCC 6633作为测试生物，通过生物测定法测量AMK浓度。B胆汁中的AMK浓度高于A胆汁中的浓度。胆囊壁中的AMK浓度远高于A胆汁和B胆汁中的浓度。静脉滴注后的浓度高于肌肉注射后的浓度。AMK在炎症中的变化。在1例胃溃疡患者中，通过静脉滴注给予200mg AMK，输注结束后25分钟时组织中的AMK浓度，胃溃疡中为15.00微克/克，正常胃壁中为7.20微克/克，十二指肠壁中为9.14微克/克，大网膜中为8.12微克/克。该病例58分钟时血清AMK浓度为15.7微克/毫升。因此，推测静脉滴注使用AMK安全有效。
