Thoroddsen E, Marr C, Efthymiopoulos C, Thorarinsson H
Medical Clinic, Reykjavik, Iceland.
Pediatr Infect Dis J. 1997 Oct;16(10):959-62. doi: 10.1097/00006454-199710000-00011.
Antibiotic concentrations in serum and middle ear effusion are important in determining therapeutic success in acute otitis media. For beta-lactams the most relevant pharmacokinetic index for clinical efficacy is the time for which serum concentrations exceed the minimum inhibitory concentration (MIC) of the pathogen, which should be at least 40 to 50% of the dosing interval.
In this open, single center study, the concentration of cefuroxime achieved in the serum and middle ear effusion of pediatric acute otitis media patients with purulent effusion was assessed between 2 and 5 h after a single oral dose of 15 mg/kg cefuroxime axetil suspension.
Serum concentrations of cefuroxime ranged from 2.8 to 7.3 microg/ml and were consistent with the results of previous pharmacokinetic study. These results show that serum concentrations of cefuroxime remain above the MIC90 (2.0 microg/ml) for Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis for at least 5 h (42%) of the 12-h dosing interval. Cefuroxime was detected in 14 of 17 (82%) middle ear effusion samples and ranged from 0.2 to 3.6 microg/ml, indicating that cefuroxime penetrates well into the middle ear.
Cefuroxime is well-absorbed and penetrates well into the middle ear after oral administration of cefuroxime axetil suspension.
血清和中耳积液中的抗生素浓度对于确定急性中耳炎的治疗效果很重要。对于β-内酰胺类药物，临床疗效最相关的药代动力学指标是血清浓度超过病原体最低抑菌浓度（MIC）的时间，该时间应至少占给药间隔的40%至50%。
在这项开放性单中心研究中，评估了单次口服15mg/kg头孢呋辛酯混悬液后2至5小时内，小儿急性化脓性中耳炎患者血清和中耳积液中头孢呋辛的浓度。
头孢呋辛的血清浓度范围为2.8至7.3μg/ml，与先前药代动力学研究结果一致。这些结果表明，在12小时给药间隔中，头孢呋辛的血清浓度至少在5小时（42%）内保持高于肺炎链球菌、流感嗜血杆菌和卡他莫拉菌的MIC90（2.0μg/ml）。在17份中耳积液样本中的14份（82%）中检测到了头孢呋辛，浓度范围为0.2至3.6μg/ml，表明头孢呋辛能很好地渗透到中耳。
口服头孢呋辛酯混悬液后，头孢呋辛吸收良好且能很好地渗透到中耳。
