Studley J G, Schentag J J, Schenk W G
Ann Surg. 1981 May;193(5):649-54. doi: 10.1097/00000658-198105000-00016.
The objective of this study has been to lay the groundwork for a re-evaluation of the place of antibiotics in acute pancreatitis. This section has been devoted to determining if antibiotics excreted by the normal pancreas are excreted similarly in acute pancreatitis. Ten mongrel dogs were studied, each acting as its own control. Day 1: Operation--construction of pancreatic fistula. Day 2: Study of antibiotic excretion. Day 14: Operation--induction of acute focal pancreatitis. Day 15: Study of antibiotic excretion. Antibiotic concentrations in pancreatic fluid were studied by injecting tobramycin intravenously (5 mg/kg). Serum levels and excretion of the drug in the pancreatic secretion were then monitored over the next six hours. Results showed excretion of tobramycin reached bactericidal concentrations in pancreatic fluid from the normal and inflamed pancreas, with no significant differences (p = 0.2) between the excretion rates. The place of antibiotics in acute pancreatitis is discussed. Based on usual pathogens isolated in pancreatic abscesses, and their usual sensitivity patterns, tobramycin with Cephamandole are the antibiotics of choice in acute pancreatitis, and a clinical trial is indicated to evaluate their place in reducing complications and deaths in the disease.
本研究的目的是为重新评估抗生素在急性胰腺炎中的地位奠定基础。本节致力于确定正常胰腺分泌的抗生素在急性胰腺炎中是否以类似方式分泌。对10只杂种狗进行了研究，每只狗都作为自身对照。第1天：手术——构建胰瘘。第2天：研究抗生素排泄。第14天：手术——诱发急性局灶性胰腺炎。第15天：研究抗生素排泄。通过静脉注射妥布霉素（5毫克/千克）来研究胰液中的抗生素浓度。然后在接下来的6小时内监测血清水平以及药物在胰腺分泌物中的排泄情况。结果显示，妥布霉素在正常胰腺和发炎胰腺的胰液中的排泄均达到杀菌浓度，排泄率之间无显著差异（p = 0.2）。文中讨论了抗生素在急性胰腺炎中的地位。基于胰腺脓肿中分离出的常见病原体及其通常的敏感性模式，妥布霉素与头孢孟多是急性胰腺炎的首选抗生素，因此建议进行一项临床试验以评估它们在降低该疾病并发症和死亡率方面的地位。
