Canis F, Trivier D, Vic P, Ategbo S, Turck D, Husson M O
Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CHRU, Lille, France.
Pathol Biol (Paris). 1998 Jun;46(6):449-51.
An aminoglycoside in association with beta-lactam antibiotic are usually the most efficient treatment for Pseudomonas aeruginosa infections in cystic fibrosis patients. Tobramycin has the lower MICs than the other aminoglycosides to Pseudomonas aeruginosa. The aim of the work was to compare pharmacokinetics of tobramycin after once daily (15 mg/kg/day; 11 patients) or thrice daily dose (5 mg/kg/day; 9 patients) in combination ceftazidime (CAZ 200 mg/day in 3 inj. IVD) in sputum and sera for two weeks. No statistical difference in the serum concentration obtained in each group of patients was observed between the first and the 14th day. Serum concentrations were three fold higher when tobramycin was administered in once daily dose. Low through concentrations were quickly obtained, but they were slightly higher after thrice daily doses. Bronchial concentrations were 2 to 2.5 superior and near the critical concentration of tobramycin. The clinical efficacy were comparable in the two regimens.
氨基糖苷类药物与β-内酰胺类抗生素联合使用通常是囊性纤维化患者铜绿假单胞菌感染最有效的治疗方法。妥布霉素对铜绿假单胞菌的最低抑菌浓度低于其他氨基糖苷类药物。这项研究的目的是比较妥布霉素每日一次(15mg/kg/天;11例患者)或每日三次给药(5mg/kg/天;9例患者)联合头孢他啶(200mg/天,分3次静脉注射)两周后在痰液和血清中的药代动力学。在每组患者中,第1天和第14天的血清浓度未观察到统计学差异。当妥布霉素每日一次给药时,血清浓度高出三倍。很快就获得了较低的血药浓度,但每日三次给药后的血药浓度略高。支气管浓度比妥布霉素的临界浓度高2至2.5倍且接近该浓度。两种给药方案的临床疗效相当。