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目的 :通过测定奈替米星 (NTM )的体内、外杀菌活性及血药浓度 ,观察不同给药方案的疗效与不良反应 ,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。体内、外杀菌活性用微量稀释法测定。结果 :NTM对常见致病菌有较强的体外抗菌活性。给予NTM ,OD给药 (qd) ,其谷浓度均低于 2 μg/ml,较TD给药(bid)有显著性降低 (P <0 .0 5 ) ,而其峰浓度较TD给药有显著性增高 (P <0 .0 1)。除绿脓假单胞菌外 ,NTMqd给药对其他 3种菌峰时体内杀菌活性 (SBA)均≥ 1∶8,且较TD给药有显著性增强。qd给药组患者给药前后Cr,BUN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 :奈替米星对常见致病菌具有较强的抗菌活性。NTMOD比TD给药能够获得较强的疗效 ,较少的不良反应
OBJECTIVE: To determine the efficacy and adverse reactions of different administration regimens by determining the in vitro and in vivo bactericidal activity and plasma concentration of netilmycin (NTM), and to optimize its administration regimen. Methods: Blood concentration was measured by TDx (fluorescence polarization immunoassay). In vitro and in vivo bactericidal activity was measured by micro-dilution method. Results: NTM has strong antibacterial activity against common pathogens in vitro. Administration of NTM, OD administration (qd), the trough concentrations were lower than 2 μg / ml, compared with TD dosing (bid) was significantly reduced (P <0.05), while the peak concentration than TD Significantly increased (P <0.01). Except Pseudomonas aeruginosa, the in vivo bactericidal activity (SBA) of NTMqd administered to the other three kinds of bacteria peak was both 1: 8 and significantly higher than that of TD. The levels of Cr and BUN did not change before and after administration in patients in qd administration group, while those in TD administration group were significantly higher than those in patients before medication (P <0.05). Conclusion: Netilmicin has strong antibacterial activity against common pathogenic bacteria. NTMOD than TD can get a more effective treatment, fewer adverse reactions