高剂量头孢噻肟治疗的脑膜炎患儿脑脊液对耐头孢菌素肺炎链球菌的杀菌活性
Cerebrospinal fluid bactericidal activity against cephalosporin-resistant Streptococcus pneumoniae in children with meningitis treated with high-dosage cefotaxime.
作者信息
Friedland I R, Klugman K P
机构信息
Department of Pediatrics, Baragwanath Hospital, and The University of Witwatersrand, Johannesburg, South Africa.
出版信息
Antimicrob Agents Chemother. 1997 Sep;41(9):1888-91. doi: 10.1128/AAC.41.9.1888.
Abstract
We determined cefotaxime and desacetyl-cefotaxime concentrations in children with bacterial meningitis receiving high-dose cefotaxime (300 mg/kg of body weight/day) and concomitant dexamethasone therapy. The median peak cerebrospinal fluid cefotaxime and desacetyl-cefotaxime concentrations were 4.7 and 8.1 microg/ml, respectively. In vitro bactericidal activity (>99.9% killing in 6 h) was found in 17 (94%), 13 (72%), and 8 (44%) of 18 cerebrospinal fluid specimens against cefotaxime-susceptible, -intermediate (MIC, 1 microg/ml), and -resistant (MIC, 4 microg/ml) strains, respectively. High-dose cefotaxime, while safe, is not reliably sufficient therapy for cephalosporin-nonsusceptible pneumococcal meningitis, and combination therapy is recommended.
摘要
我们测定了接受大剂量头孢噻肟（300mg/kg体重/天）并同时接受地塞米松治疗的细菌性脑膜炎患儿脑脊液中头孢噻肟和去乙酰头孢噻肟的浓度。脑脊液中头孢噻肟和去乙酰头孢噻肟的峰值浓度中位数分别为4.7和8.1μg/ml。18份脑脊液标本中，分别有17份（94%）、13份（72%）和8份（44%）对头孢噻肟敏感、中介（MIC，1μg/ml）和耐药（MIC，4μg/ml）菌株在体外具有杀菌活性（6小时内杀菌率>99.9%）。大剂量头孢噻肟虽然安全，但对于对头孢菌素不敏感的肺炎球菌性脑膜炎并非可靠的充分治疗方法，建议采用联合治疗。
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