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目的:测定头孢唑肟等7种抗生素对肺、肝、肾和胰腺组织的穿透能力,为临床选择用药提供参考。方法:小鼠灌服或静脉注射抗生素后在不同时间点采集血清、肺、肝、肾和胰腺组织标本,按微生物琼脂扩散法测定抗生素浓度。测定抗生素对6种常见病原菌的最小抑菌浓度(MIC_(90))。计算出抗生素对组织的穿透率(组织浓度/血清浓度)及在组织中的杀菌指数(组织浓度/MIC_(90))。结果:抗生素对肺、肝、肾和胰腺组织的穿透率分别是:头孢唑肟为60%、99%、202.7%和44.6%,头孢曲松为121.9%、92.4%、199.3%和22%,头孢哌酮为77.8%、408.8%、229.2%和33.3%,头孢布烯为29.0%、17.2%、132.3%和0,氨曲南为94.3%、472.9%、161.7%和82.7%,奈替米星为38.6%、5.8%、72.4%和8.7%,万古霉素为95.4%、11.6%、148.5%和9%。结论:氨曲南、头孢唑肟、头孢曲松和头孢哌酮适用于肺、肝、肾和胰腺组织细菌感染。头孢布烯、奈替米星和万古霉素在肺、泌尿系感染中有较好抗菌效果,但在肝、胰组织中浓度低,难望有好的疗效。
OBJECTIVE: To determine the penetrating ability of seven antibiotics such as ceftizoxime on lung, liver, kidney and pancreas, and to provide a reference for clinical choice of medication. Methods: Serum, lung, liver, kidney and pancreas were collected at different time points after oral administration or intravenous injection of antibiotics in mice. The concentration of antibiotics was determined by microbial agar diffusion method. The minimum inhibitory concentration (MIC_ (90)) of antibiotics on six common pathogens was determined. The penetration rate (tissue concentration / serum concentration) of the antibiotic to the tissue and the bactericidal index (tissue concentration / MIC_ (90)) in the tissue were calculated. Results: The penetration rates of antibiotics in lung, liver, kidney and pancreas were 60%, 99%, 202.7% and 44.6% for ceftizoxime and 121.9%, 92.4%, 199.3% and 22% for ceftriaxone, respectively Cefoperazone was 77.8%, 408.8%, 229.2% and 33.3%, ceftibuten was 29.0%, 17.2%, 132.3% and 0, aztreonam was 94.3%, 472.9%, 161.7% and 82.7% Mice were 38.6%, 5.8%, 72.4% and 8.7%, while vancomycin was 95.4%, 11.6%, 148.5% and 9%, respectively. CONCLUSION: Aztreonam, ceftizoxime, ceftriaxone and cefoperazone are suitable for bacterial infections in lung, liver, kidney and pancreas. Ceftibuten, netilmicin and vancomycin in lung and urinary tract infections have good antibacterial effect, but in the liver, pancreatic tissue concentration is low, it is difficult to expect a good effect.