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目的 :通过测定奈替米星 (NTM)两种给药方案的体内抗菌活性 (SBA)及血药浓度 ,观察不同给药方案的疗效与不良反应。方法 :血药浓度用 TDx(荧光偏振免疫法 )测定。体内杀菌活性用微量稀释法测定。结果 :日剂量相同时 ,NTM qd给药 ,谷浓度均低于 2 μg/ m l,且较 bid给药有显著性降低 (P<0 .0 5 ) ,而其峰浓度较 bid给药有显著性增高 (P<0 .0 1)。除绿脓假单胞菌外 ,NTM对其他 3种菌峰时 SBA均≥ 1∶ 8,经 Wilconxon秩和检验 ,较 bid给药有显著性增强。 qd给药组病人给药前后Cr、BU N没有变化 ,而 bid给药组病人用药后较用药前 Cr有显著性增高 (P<0 .0 5 )。结论 :NTM qd比 bid给药能够获得较高的峰浓度与 SBA,较低的谷浓度。 NTM qd给药能够获得较强的疗效 ,较少的不良反应。
OBJECTIVE: To observe the efficacy and side effects of different administration regimens by measuring the in vivo antibacterial activity (SBA) and plasma concentration of two regimens of netilmicin (NTM). Methods: Blood concentration was measured by TDx (fluorescence polarization immunoassay). In vivo bactericidal activity was measured by micro-dilution method. Results: At the same dosage, NTM qd administration and trough concentrations were both lower than 2 μg / ml, which was significantly lower than that of bid administration (P <0.05), while the peak concentration was significantly higher than that of bid administration Sex increased (P <0.01). Except Pseudomonas aeruginosa, NTM had SBA ≥1: 8 for the other three kinds of bacteria peak, which was significantly enhanced by Wilcoxon rank-sum test compared with bid administration. The levels of Cr and BU N did not change before and after administration in patients in qd administration group, while patients in bid administration group were significantly higher than those before treatment (P <0.05). CONCLUSIONS: NTM qd achieved higher peak concentrations and SBA, lower trough concentrations than bid. NTM qd administration can get a stronger effect, fewer adverse reactions.