三种头孢菌素在颅脑手术患者脑脊液杀菌效价的比较

Comparison of Bactericidal Activity in cerebrospinal Fluid of Three Cephalosporins in Patients undergoing Surgery of Skull and Brain

本文应用微量稀释法研究了24名施硬膜内手术患者应用头孢曲松(CTRX)、头孢噻肟(CTX)和头孢呋肟(CFR)后血清和脑脊液杀菌效价(SBA与CBA)。结果表明,其中CTRX对肠杆菌科细菌的体内外抗菌活性最强,在脑脊液中的杀菌效价也较高,维持时间长,从而提示一日2次,每次1g静脉给药,可望有效防治严重的肠杆菌科细菌的杀菌效价均较高,可用于防治颅脑手术后感染。CFR在脑脊液中杀菌作用较弱,但抗菌谱广,价格偏低,可用于预防一般颅脑手术感染,本文发现CBA是一项能反映抗菌药物对细菌的作用和对血脑屏障通透性的重要指标,故建议将CBA作为选择抗菌药物防治颅脑手术感染的重要参考依据。

The bactericidal activity of serum and cere brospinal fluid (SBA and CBA)of ceftroiaxone (CTRX), cefotaxime(CTX) cefuroxime(CFR) in the patients undergoing surgery of skull and brain were studied by means of microdi luted method. The results showed antibacterial activity of CTRX against, enterobactericeae in vitro or in serum and cerebrospinal fluid (CSF) was the highest, it is suggested that the schadule of CTRX per 12hr may be used in prevention and treatment of serious infections after surgery of skull and brain.The bacteria The SBA and CBA of CFR were less ,but its antibacterial spectrum was wide and bactezi cidal activity of CTX against gram positive strains and enterobactericeae in sencm and CSF were higher, CTX may be used in treatment of infections of nervous system caused by mixed bacteria, the cost was lower, so CFR may be selected in the moderate infections. The CBA was a synthesized guide reflexing the antibactieral activity and penetration into barrier, so it is impostand reference to select antibiotics of infection after surgery of skull and brain.