头孢他啶对奈替米星体内药动学的影响

Effect of Ceftazidime on Pharmacokinetics of Netilmicin on Subjects

目的考察头孢他啶对奈替米星在受试者体内药动学的影响,为临床合理用药提供依据。方法12例受试者在单剂量静脉滴注奈替米星(单用组)或奈替米星加头孢他啶(联用组)后,采用高效液相色谱-间接光度法测定不同时间点血清及尿液中奈替米星浓度,计算其药动学参数及尿药回收率。结果单用、合用头孢他啶后奈替米星的体内过程均符合二房室开放模型,其药动学参数单用组AUC0-t,t1/2β,CL与0～24h尿药回收率分别为(52.93±5.58)mg·L-1·h、(3.68±0.33)h、(4.49±0.53)L·h-1与72.22%,联用组分别为(71.81±8.03)mg·L-1·h、(5.06±0.57)h、(2.95±0.37)L·h-1与59.20%。两组比较差异有显著性。结论奈替米星与头孢他啶联用后,其消除过程减慢,连续应用可能导致药物体内蓄积,二者合用时应适当减少奈替米星的剂量。

Objective To study effects of ceftazidime on pharmacokinetics of netilmicin on subjects and provide information for its rational use in clinical practice. Methods The serum and urine netilmicin at different time point were determined by a high performance liquid chromatography-indirect photometry method in 12 subjects given with netilmicin by drop infusion or netilmicin combined with ceftazidime. The pharmacokinetic data of netilmicin and urine recoveries were calculated with DAS software. Results The pharmacokinetics of netilmicin both in single use or combined with ceftazidime fitted with an open two-compartment model. AUCo-t ,t1/2β, CL of netilmicin and the urine recovery within 0-24 h from a single administration group were （52.93±5.58） mg · L^-1 · h, （3.68±0.33） h, （4.49±0.53） L · h^-1 and 72.22% ,while the data from coadministration group were （71.81 ± 8.03） mg · L^-1 · h, （5.06±0.57）h, （2.95±0.37） L · h^-1 and 59.20%, respectively. It was indicated that there was a significant difference in the parameters between two groups. Conclusion The elimination of netilmicin from human bodies descended markedly when combined with ceftazidime, which resulted in drug accumulation after continuous administration. A proper reduction in dosage of netilmicin was necessary when combined with ceftazidime.