McDuffie R S, Eskens J L, Gibbs R S
Department of Obstetrics and Gynecology, Kaiser Permanente, Denver, Colorado 80205, USA.
Obstet Gynecol. 1998 Jul;92(1):28-30.
To evaluate the efficacy of oral levofloxacin in the treatment of experimental polymicrobial puerperal infection in the rabbit.
Timed pregnant rabbits were anesthetized on day 29 or 30 of a 31-day gestation and 106 colony-forming units each of Escherichia coli, group B streptococcus, and Staphylococcus saccharolyticus were inoculated endoscopically in the cervices. Labor was induced with intramuscular oxytocin 16 hours later if it had not occurred spontaneously. The animals then were observed every 3 hours for fever; when a temperature of 104F was reached, treatment was begun. Animals were assigned randomly in a blinded, placebo-controlled manner to received oral levofloxacin (10 mg/kg/day) or placebo and were treated twice daily for 4-5 days. The animals were killed and necropsy was performed 4-6 hours after the last dose. Specimens for culture were taken from uterine horns, peritoneum, and blood. Levofloxacin concentrations were determined from blood samples at necropsy. Clinical cure of fever, eradication of microbes, and presence of uterine abscesses at necropsy were assessed.
Compared with placebo-treated rabbits, levofloxacin-treated animals had a significantly greater number of clinical cures (nine of 11 versus four of 12, P=.027) and significantly more eradication of E coli (ten of 11 versus five of 12, P=.022). Four uterine abscesses were seen in 12 placebo-tested animals, compared with none of 11 levofloxacin-tested animals (P=.093). There was no difference in eradication of group B streptococcus between the two groups. No blood cultures were positive for organisms in any animal. Levofloxacin was detected in all treated animals, but at low levels (less than 1 microg/mL).
Treatment of experimental puerperal infection with oral levofloxacin in rabbits resulted in significantly more clinical cures and eradication of E coli compared with treatment with placebo.
评估口服左氧氟沙星治疗兔实验性多微生物产后感染的疗效。
在31天妊娠期的第29天或第30天，对定时妊娠的兔子进行麻醉，通过内镜在宫颈接种10⁶个菌落形成单位的大肠杆菌、B组链球菌和解糖葡萄球菌。如果16小时后未自然分娩，则肌肉注射催产素诱导分娩。然后每3小时观察动物是否发热；当体温达到104°F时开始治疗。动物以盲法、安慰剂对照的方式随机分配，接受口服左氧氟沙星（10mg/kg/天）或安慰剂，每天治疗两次，持续4 - 5天。在最后一剂后4 - 6小时处死动物并进行尸检。从子宫角、腹膜和血液中采集培养标本。在尸检时从血样中测定左氧氟沙星浓度。评估发热的临床治愈情况、微生物的根除情况以及尸检时子宫脓肿的存在情况。
与接受安慰剂治疗的兔子相比，接受左氧氟沙星治疗的动物临床治愈的数量显著更多（11只中的9只对12只中的4只，P = 0.027），大肠杆菌的根除率也显著更高（11只中的10只对12只中的5只，P = 0.022）。在12只接受安慰剂测试的动物中发现了4个子宫脓肿，而11只接受左氧氟沙星测试的动物中均未发现（P = 0.093）。两组之间B组链球菌的根除情况没有差异。所有动物的血培养均未发现微生物阳性。在所有接受治疗的动物中均检测到左氧氟沙星，但水平较低（低于1μg/mL）。
与安慰剂治疗相比，用口服左氧氟沙星治疗兔实验性产后感染可显著提高临床治愈率并根除大肠杆菌。
