羧苄西林对终末期肾衰竭患者体内阿米卡星和庆大霉素的灭活作用
Inactivation of amikacin and gentamicin by carbenicillin in patients with end-stage renal failure.
作者信息
Blair D C, Duggan D O, Schroeder E T
出版信息
Antimicrob Agents Chemother. 1982 Sep;22(3):376-9. doi: 10.1128/AAC.22.3.376.
Aminoglycosides are inactivated by carbenicillin in vitro and in patients with end-stage renal failure. In vitro, amikacin is inactivated to a lesser extent than is gentamicin. In five patients on chronic hemodialysis, serum levels of amikacin alone and after repeated intravenous carbenicillin infusions were determined. Analogous gentamicin studies were conducted with five different patients. Neither amikacin serum levels nor serum clearances were affected by carbenicillin. The mean gentamicin serum half-life was significantly lower in the presence of carbenicillin: 18.4 +/- 8.2 compared with 61.6 +/- 30.7 h. Serum clearance increased significantly. The inactivation of gentamicin by carbenicillin was both time related (greater than 12 h of exposure) and concentration dependent (molar carbenicillin/gentamicin ratios greater than or equal to 39:1). Amikacin would be preferable to gentamicin in patients with end-stage renal failure.
在体外以及终末期肾衰竭患者体内，氨基糖苷类药物会被羧苄西林灭活。在体外，阿米卡星的灭活程度低于庆大霉素。对5例接受慢性血液透析的患者测定了单独使用阿米卡星时以及反复静脉输注羧苄西林后的血清水平。对另外5例不同患者进行了类似的庆大霉素研究。羧苄西林对阿米卡星的血清水平和血清清除率均无影响。在存在羧苄西林的情况下，庆大霉素的平均血清半衰期显著缩短：分别为18.4±8.2小时和61.6±30.7小时。血清清除率显著增加。羧苄西林对庆大霉素的灭活与时间相关（暴露超过12小时）且与浓度有关（羧苄西林/庆大霉素摩尔比大于或等于39:1）。在终末期肾衰竭患者中，阿米卡星比庆大霉素更可取。
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