奈替米星血药浓度、血清杀菌活性与给药方案的相关性研究  

Study of the Relationships of Serum Concentration and Bactericidal Activity of Netilmicin with Different Administrations

作　　者：孙淑娟[1] 苏乐群[1] 李宏建[1] 孟彦[1] 李妍[1] 于振海[1] 张曙光[1] 阮长乐[1] 

机构地区：[1]山东省千佛山医院,山东济南250014

出　　处：《中华医院感染学杂志》2001年第2期87-89,共3页Chinese Journal of Nosocomiology

基　　金：山东省科研课题基金资助

摘　　要：目的　通过测定奈替米星 (乙基西梭霉素 ,NTM)不同给药方案的血药浓度及血清杀菌活性 (SBA) ,观察与其不同给药方案的疗效与副作用 ,探讨其血药浓度和血清杀菌活性与给药方案的相关性 ,优选其最佳给药方案。方法　血药浓度用 TDX(荧光偏振免疫法 )测定 ;SBA以微量稀释法测定 ;患者分成 OD组 (once daily)和 TD(twice daily)组以观察临床疗效和不良反应。结果　 OD给予 NTM,其谷浓度均低于 2 μg/ m l,且较 TD给药有显著性降低 (P<0 .0 5 ) ,而其峰浓度较 TD给药则有显著性增高 (P<0 .0 1) ;除铜绿假单胞菌外 ,NTM对其他 3种菌峰时 SBA均≥ 1∶ 8,经 Wilcoxon秩和检验 ,较 TD给药有显著性增强 ;OD给药组患者给药前后 Cr、BU N没有变化 ,而 TD给药组患者用药后较用药前 Cr有显著性增高 (P<0 .0 5 )。结论　 NTM OD比 TD给药能够获得较高的峰浓度与杀菌活性 。OBJECTIVE To select the optimal regimen of administration by studying the relationships of serum concentration and bactericidal activity of netilmicin with different administrations. METHODS Serum concentrations were determined by TDx (fluorescence polarization immunoassy technology). SBAs were determined by microdilution method. Patients were classified into once daily (OD) and twice daily (TD) groups to observe the efficacy of infection prevention and adverse drug reactions. RESULTS The parameters of pharmcokinetics we got are coincident with those reported. All trough concentrations were <2 μg/ml when NTM was given OD, the peak ones were greater and the trough ones were lower than those of TD. The medians of peak SBA against S.aureus, E.coli, K.pneumoniae were≥1∶8 when NTM was used OD, and there was marked difference compared with those of TD(P<0.05). Cr And BUN had no changes in OD, but obvious changes had risen in TD administration. CONCLUSIONS The results showed that the peak concentration, and SBA of OD were greater, the trough concentration, was lower than those of TD. So it is suggested that OD administration be more at least equal effective than TD, but the possibility of occurred adverse drug reactions can be reduced remarkably.

关 键 词：奈替米星 血药浓度 血清杀菌活性 给药方案 

分 类 号：R978.1[医药卫生—药品]