Empirical antibiotic treatment with piperacillin-tazobactam in Patients with microbiologically-documented biliary tract infections

AIM: To report our experience with empiric antimicrobial monotherapy (piperacillin/tazobactam, of which no data are available in such specific circumstances) in microbiologically-documented infections in patients with benign and malignant conditions of the biliary tract.METHODS: Twenty-three patients, 10 with benign and 13 with malignant conditions affecting the biliary tree and microbiologically-documented infections were recruited and the efficacy of empirical antibiotic therapy was assessed.RESULTS: The two groups featured similar demographic and clinical data. Overall, the infective episodes were most due to Gram negative agents, more than 60% of such episodes (mostly in malignant conditions) were preceded by invasive instrumental maneuvers. Empirical antibiotic therapy with a single agent (piperacillin/tazobactam) was effective in more than 80% of cases. No deaths were reported following infections. CONCLUSION: An empiric therapeutic approach with piperacillin/tazobactam is highly effective in biliary tract infections due to benign or malignant conditions.

哌拉西林在胆道手术患者药代动力学的研究

本文研究了哌拉西林（ｐｉｐｅｒａｃｉｌｌｉｎ，ＰＩＰ）在８例施各类胆道手术附Ｔ型管引流患者的药代动力学，采用ＡＶＡＮＴＡＧＥ全能自动化微生物分析仪测定血清及胆汁哌拉西林浓度。结果表明，静滴哌拉西林３ｇ或２ｇ后即刻血药浓度分别可达到３２２．７±２８．４和２０４．５±１６．２μｇ／ｍｌ，８ｈ后仍保持７．４±３．０和１．８±０．７μｇ／ｍｌ；Ｔ型管胆汁药物峰浓度可达到２０７．９±８３．６和１４４．７±６．６μｇ／ｍｌ，达峰时间约２ｈ左右。该药体内在观分布容积大于血容量，提示体内分布广泛，因静滴哌拉西林后血药及胆药浓度均较高，故适用于防治胆道感染。

左旋氧氟沙星在胆道手术患者的药代动力学研究

目的 研究左旋氧氟沙星 (Levofloxacin ,LVFX)在胆道手术患者的药代动力学。方法 13名施行胆道手术并行T 管引流的患者口服LVFX 2 0 0mg ,q8h ,连服 5d ,用高效液相色谱法测定LVFX在血浆、胆汁、尿中的药物浓度。结果 胆道手术患者术前单次口服LVFX后 ,达峰时间为 (1 95± 1 10 )h ,峰浓度为 (1 5 8± 0 94)mg/L ,消除半衰期为 (3 91± 1 2 8)h ,曲线下面积为 (10 76±5 97)h·mg/L ,其体内药代动力学行为与健康人相比有明显不同 ;无论是单次给药还是多次给药 ,LVFX在胆汁中的浓度均大于血浆浓度 ,胆汁药物浓度均超过胆道常见病原菌的MIC。结论 外科手术影响LVFX的吸收 ,降低体内药物浓度 ;

胆道手术患者洛美沙星的胆汁药动学

目的:研究洛美沙星(lomefloxacine)在胆道手术患者的药动学。方法:施行胆道手术并行T管引流的患者静脉滴注洛美沙星200 mg,用高效液相色谱法(HPLC)测定洛美沙星在胆汁中的浓度,3P97 软件拟合药动学参数。结果:胆汁中达峰时间为(71±41)min,峰浓度为(40±59)mg·L-1,消除半衰期为(189.2±111)min。结论:胆汁洛美沙星浓度超过胆道常见病原菌的最低抑菌浓度(MIC),个体差异较大,提示该药在治疗和预防胆道感染时具有良好应用价值。

注射用头孢他啶联合注射用哌拉西林钠舒巴坦钠治疗儿童下呼吸道铜绿假单胞菌感染的疗效观察

目的:探讨注射用头孢他啶联合注射用哌拉西林钠舒巴坦钠治疗儿童下呼吸道铜绿假单胞菌感染的疗效。方法:选取邵武市立医院2015—2016年收治的下呼吸道铜绿假单胞菌感染患儿60例作为研究对象,按随机数字表法分为观察组和对照组,每组30例。观察组患儿给予注射用头孢他啶联合注射用哌拉西林钠舒巴坦钠,对照组患儿给予注射头孢他啶,观察两组患儿的临床疗效、细菌清除及不良反应发生情况。结果:观察组患儿总有效率为96.7%(29/30),明显高于对照组的70.0%(21/30),差异有统计学意义(P<0.05);观察组患儿的细菌清除率为90.0%(27/30),明显优于对照组66.7%(20/30),差异有统计学意义(P<0.05);两组患儿不良反应发生率的差异无统计学意义(P>0.05)。结论:注射用头孢他啶联合注射用哌拉西林钠舒巴坦钠治疗下呼吸道铜绿假单胞菌感染的疗效较好,且安全性较高。