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常用抗生素在动物及人胆汁中的浓度分布和药效学研究 |
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C/MIC). Results The antibiotics with high mean peak concentration in the bile of rabbits were as follows: piperacillin 7 950.16 μg/ml, cefoperazone 5 274.52 μg/ml, ceftriaxone 1 107.01 μg/ml, meropenem 31.97 μg/ml, levofloxacin 66.26 μg/ml an d metronidazole 29.49 μg/ml, respectively. The antibiotics with high concentration in common bile duct and gallbladder were as follows: piperacillin/tazobactam 350.38/16.69 and 139.81/15.92 μg/ml, cefoperazone/sulbactam 563.75/14.76 and 169.90/8.83 μg/ml, ceftriaxone 249.78 and 82.06 μg/ml, ciprofloxacin 13.78 and 6.87 μg/ml, moxifloxacin 18.31 and 7.09 μg/ml. The meropenem and moxifloxacin had strongest antimicrobial activity among these antibiotics. The antimicrobial activity of piperacillin/tazobactam and cefoperazone/sulbactam were much stronger than that of piperacillin and cefoperazone. Piperacillin/tazobactam, cefoperazone/sulbactam and moxifloxacin had the largest bactericidal index. Conclusions The concentrations of all 6 antibiotics exceed their effective bactericidal concentrations in rabbit bile, with high concentrations of piperacillin, cefoperazone and ceftriaxone. And piperacillin/tazobactam, cefoperazone/sulbactam and moxifloxacin have the biggest microbicidal potential in human bile and can be the first choice for treatment of hepatobiliary infections.
【Key words】 Antibiotics; Bile; Concentration; Pharmacodynamics; High performance liquid chromatography
抗菌药物清除感染部位的病原菌，是通过在该部位达到和维持一定的抗菌药物浓度并且要达到或超过最低抑菌浓度(minimal inhibitory concentration,MIC)来实现。胆道感染应选用在胆汁中浓度高且对致病菌敏感的高效抗生素［1-2］。由于抗生素在肝胆组织中的穿透力差异较大，且目前的相关研究不多，以血药浓度为主要依据不足以有效指导胆道感染临床用药。在目前抗生素严重滥用的情况下，药物敏感性不断下降［3］。本研究在动物实验的基础上进一步研究抗生素在胆道手术患者胆汁中的浓度分布，并测定临床分离胆道致病菌的药效学抗菌活性指标—MIC，将药物浓度和药效学结合对杀菌效力进行评估，为临床胆道抗生素用药提供比较系统的依据。
1 材料与方法
1.1 一般资料
1.1.1 受试对象：(1)动物：实验用健康家兔36只，体重(2.5±0.5)kg，分为6组，每组6只，雌雄兼用，由中山大学动物实验中心提供；(2)患者：因胆囊上一页 [1] [2] [3] [4] [5] [6] 下一页
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