抗生素对肝脏和胰腺组织穿透能力及杀菌效力的实验研究  

The penetration of antibiotics into the liver and pancreas and their tissue bactericidal indexes

作　　者：黎沾良[1] 邓群[1] 陆连荣[1] 祝小枫[1] 吕国平[1] 马楠[1] 熊德鑫[1] 

机构地区：[1]解放军第三○四医院

出　　处：《中华外科杂志》1998年第A00期44-46,共3页Chinese Journal of Surgery

摘　　要：目的测定７种抗生素对肝脏和胰腺组织的穿透能力，为临床选择用药提供参考。方法小鼠静脉注射或灌服抗生素后不同时间点采集血清及肝、胰组织标本，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（ＭＩＣ９０）。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／ＭＩＣ９０）。结果抗生素对肝、胰组织的穿透率分别是：氨曲南４７２９％和８２７％，头孢唑肟９９０％和４４６％，头孢三嗪９２４％和２２０％，头孢哌酮４０８８％和３３３％，头孢布烯１７２％和０，乙基西梭霉素５８％和８７％，万古霉素１１６％和９０％。氨曲南、头孢唑肟、头孢三嗪和头孢哌酮对肠道杆菌的杀菌指数都＞１００。结论上述４种抗生素适用于肝、胰细菌感染。头孢布烯、乙基西梭霉素和万古霉素在肝、胰组织中浓度低，难望有好的疗效。Objective To examine the penetration rates of 7 antibiotics into the liver and pancreatic tissues. Method Kunming mice received intravenous or oral bolus of antibiotics. Drug concentrations in serum and hepatic and pancreatic tissues were measured dynamically by microbiological agar diffusion method. The MIC 90 of tested drugs for common causative pathogens was determined. The penetration rates(tissue concentration/serum concentration) and bactericidal indexes(tissue concentration/MIC, BI) were calculated. Result The drug penetration rates of azotreonam into hepatic and pancreatic tissues were: 472 9% and 82 7%, respectively, ceftizoxime 99 0% and 44 6%,ceftitriaxone 92 4% and 22 0%, cefoperazone 408 8% and 33 3%, ceftibuten 17 2% and 0,netilmicin 5 8% and 8 7%, and vancomycin 11 6% and 9 0%. Azotreonam, ceftizoxime, ceftitriaxone and cefoperazone showed high bactericidal indexes(>100) to enterobacteraceae both in the liver and pancreas, while netilmycin and vancomycin′s BI was <2. Conclusion Azotreonam, ceftizoxime, ceftitriaxone and cefoperazone are effective in the treatment of bacterial infections in the liver and pancreas.

关 键 词：抗生素 药代动力学 杀菌指数 肝脏 胰腺 

分 类 号：R978.1[医药卫生—药品]