Couldry R, Sanborn M, Klutman N E, Strayer A H
Department of Pharmacy, University of Kansas Medical Center, Kansas City 66160-7231, USA.
Am J Health Syst Pharm. 1998 Jan 15;55(2):145-9. doi: 10.1093/ajhp/55.2.145.
The serum disposition, antimicrobial activity, and stability of ceftazidime continuously infused with an elastomeric infusion device (Homepump, Block Medical) were studied. Twelve healthy adult volunteers were given a 500-mg bolus dose of ceftazidime infused i.v. over two minutes, followed by a continuous i.v. infusion of 3 g over 24 hours. Blood samples were drawn five minutes before and at intervals up to 24 hours after the start of the bolus infusion. Samples were collected from the infusers immediately before and at the end of the 24-hour infusion. Infusers were insulated with ice packs. Ceftazidime concentrations were determined by high-performance liquid chromatography. Minimum inhibitory concentrations (MICs), serum inhibitory titers (SITs), and serum bactericidal titers (SBTs) were determined by the microdilution technique. Mean +/- S.D. serum ceftazidime concentrations ranged from 39.50 +/- 6.92 micrograms/ml at peak (30 minutes after the start of the bolus infusion) to 15.30 +/- 2.83 micrograms/mL at trough (24 hours after the start). The ceftazidime MIC for Pseudomonas aeruginosa was 1 microgram/mL; this MIC was exceeded 100% of the time. Serum ceftazidime concentrations achieved a median SIT and SBT of 1:32 and 1:16, respectively, at 30 minutes and 1:8 and 1:8, respectively, at 24 hours. Six infusers met or exceeded the 24-hour infusion time; ceftazidime was stable in these infusers. A 500-mg i.v. bolus of ceftazidime followed by a continuous infusion (3 g over 24 hours) delivered by an elastomeric infusion device produced serum drug concentrations that were constantly above the MIC for P. aeruginosa and maintained serum bactericidal activity against that organism. Adequate stability of ceftazidime was ensured by placing an ice pack next to the infuser.
研究了使用弹性输液装置（Homepump，Block Medical公司）持续输注头孢他啶时的血清处置、抗菌活性及稳定性。12名健康成年志愿者静脉注射500mg头孢他啶大剂量负荷，2分钟内输注完毕，随后在24小时内持续静脉输注3g。在负荷输注开始前5分钟以及开始后直至24小时的不同时间点采集血样。在24小时输注开始前及结束时从输液器中采集样本。输液器用冰袋保温。采用高效液相色谱法测定头孢他啶浓度。采用微量稀释技术测定最低抑菌浓度（MIC）、血清抑菌滴度（SIT）和血清杀菌滴度（SBT）。平均±标准差血清头孢他啶浓度在峰值（负荷输注开始后30分钟）时为39.50±6.92μg/ml，在谷值（开始后24小时）时为15.30±2.83μg/ml。铜绿假单胞菌的头孢他啶MIC为1μg/ml；该MIC在所有时间均被超过。血清头孢他啶浓度在30分钟时的SIT和SBT中位数分别为1:32和1:16，在24小时时分别为1:8和1:8。6个输液器达到或超过24小时输注时间；头孢他啶在这些输液器中稳定。静脉注射500mg头孢他啶大剂量负荷后，通过弹性输液装置持续输注（24小时内3g）产生的血清药物浓度持续高于铜绿假单胞菌的MIC，并维持对该菌的血清杀菌活性。通过在输液器旁放置冰袋确保了头孢他啶的充分稳定性。
