Antibiotic prophylaxis in cardiac surgery: serum and tissue levels of teicoplanin, flucloxacillin and tobramycin.
Antibiotic prophylaxis in cardiac surgery: serum and tissue levels of teicoplanin, flucloxacillin and tobramycin.
复制标题
心脏手术中的抗生素预防：替考拉宁、氟氯西林和妥布霉素的血清和组织水平。
DOI：
10.1093/jac/21.2.201
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
M. Sturridge
中科院分区：
文献类型：
--
作者：
A. Wilson;B. Taylor;T. Treasure;R. Grüneberg;Patton Kr;D. Felmingham;M. Sturridge
本文研究了替考拉宁两种剂量(400 mg，200 mg)和三种剂量(400 mg，各400 mg)在49例心脏手术中和术后的血清、脂肪和骨骼中的药代动力学。作为对比，另外20名患者接受了氟氯西林(500 mg qds，连用5天)和妥布霉素(最初为1.5 mg/kg，然后80 mg tds，连用3天)方案的类似研究。术中替考拉宁最低血药浓度两剂组为6.9 mg/L，三剂组为9.7 mg/L。手术结束时，氟氯西林平均血药浓度降至7 mg/L，妥布霉素平均血药浓度降至1.4 mg/L。转流结束时，脂肪冲洗液中替考拉宁的平均含量为1.2 mg/L，骨冲洗液中替考拉宁的平均含量为6.3 mg/L，妥布霉素的平均含量分别为0.4和0.9 mg/L，氟氯西林的平均含量均小于1 mg/L。脂肪中低水平的替考拉宁可能解释了伴随的临床试验中过多的革兰氏阳性胸骨感染。
In this study, the pharmacokinetics of teicoplanin have been studied in serum, fat and bone during and after cardiac surgery with two dose (400 and 200 mg) and three dose (400 mg each) regimens in a total of 49 patients. For comparison, 20 other patients, who had received a regimen of flucloxacillin (500 mg qds for five days) and tobramycin (1.5 mg/kg initially then 80 mg tds for three days), were similarly investigated. The lowest mean serum level of teicoplanin during operation was 6.9 mg/l in the two dose regimen and 9.7 mg/l with the three dose regimen. Mean serum levels of flucloxacillin and tobramycin fell to 7 and 1.4 mg/l respectively by the end of operation. At the end of bypass, fat washings contained a mean of 1.2 mg/l of teicoplanin and bone washings a mean of 6.3 mg/l. Mean tobramycin levels were 0.4 and 0.9 mg/l respectively and flucloxacillin less than 1 mg/l in washings from both tissues. The low levels of teicoplanin in fat may explain an excess of Gram-positive sternal infections in the accompanying clinical trial.