Cazzola M, Gabriella Matera M, Polverino M, Santangelo G, De Franchis I, Rossi F
Institute of Pharmacology and Toxicology, Medical School, Second Neapolitan University, Naples, Italy.
J Chemother. 1995 Feb;7(1):50-4. doi: 10.1179/joc.1995.7.1.50.
For an antibiotic to be effective in lower respiratory tract infections, it should be available in adequate concentrations in respiratory tissues and fluids. Cephalosporins usually achieve modest concentrations in the respiratory tract. In this study we have determined the pulmonary penetration of intramuscularly administered ceftazidime (a single dose of 1 g). Levels of ceftazidime in bronchial secretions (BS), bronchial mucosa (BM), epithelial lining fluid (ELF), and serum (S) were measured by microbiological assay in 25 patients suffering from acute exacerbation of chronic bronchitis who were divided into 5 groups of 5 subjects according to sampling time (1, 2, 4, 8 and 12 hours after the administration of the antibiotic). The peak S level was high (39.89 +/- 10.42 micrograms/ml at 1 hour) and mean S concentrations decreased slowly and were still detectable at 12 hours (1.07 +/- 0.45 microgram/ml). In all other samples, mean concentrations were in excess of the ceftazidime minimum inhibitory concentrations (MICs) for many relevant respiratory pathogens (Haemophilus influenzae 0.15 microgram/ml; Moraxella catarrhalis 0.06 micrograms/ml; Streptococcus pneumoniae 0.15 micrograms/ml; Klebsiella pneumoniae 0.4 microgram/ml). Concentrations in BM (7.05 +/- 2.38, 8.14 +/- 2.23, 6.40 +/- 1.63, 4.06 +/- 0.99 and 0.45 +/- 0.27 microgram/g) were higher than that in BS (6.87 +/- 1.96, 6.54 +/- 1.84, 3.52 +/- 1.23, 1.56 +/- 0.92 and 0.23 +/- 0.19 microgram/ml).(ABSTRACT TRUNCATED AT 250 WORDS)
要使抗生素对下呼吸道感染有效,它应在呼吸道组织和体液中达到足够的浓度。头孢菌素通常在呼吸道中达到适度浓度。在本研究中,我们测定了肌内注射头孢他啶(单剂量1 g)后的肺部渗透情况。通过微生物学测定法,对25例慢性支气管炎急性加重患者的支气管分泌物(BS)、支气管黏膜(BM)、上皮衬液(ELF)和血清(S)中的头孢他啶水平进行了测量,这些患者根据采样时间(抗生素给药后1、2、4、8和12小时)分为5组,每组5名受试者。血清峰值水平较高(给药1小时时为39.89±10.42微克/毫升),血清平均浓度缓慢下降,在12小时时仍可检测到(1.07±0.45微克/毫升)。在所有其他样本中,平均浓度超过了许多相关呼吸道病原体的头孢他啶最低抑菌浓度(MIC)(流感嗜血杆菌0.15微克/毫升;卡他莫拉菌0.06微克/毫升;肺炎链球菌0.15微克/毫升;肺炎克雷伯菌0.4微克/毫升)。BM中的浓度(7.05±2.38、8.14±2.23、6.40±1.63、4.06±0.99和0.45±0.27微克/克)高于BS中的浓度(6.87±1.96、6.54±1.84、3.52±1.23、1.56±0.92和0.23±0.19微克/毫升)。(摘要截取自250字)