牙周递药系统的研究进展

目的:了解牙周递药系统的研究进展。方法:根据文献,对牙周炎疾病的治疗药物的载药方式进行综述。结果与结论:牙周递药系统的载药方式包括脂质体、纤维剂、棒剂、膜剂、微球、缓释凝胶、黏固剂。牙周递药系统已由传统给药方式逐渐转为以高分子材料为载体的缓释制剂,具有局部给药剂量小、可持续稳定释放药物、使药物浓集于牙周袋内、提高药物疗效等特点,是很有发展潜力的药物传递系统。     

80例牙周缓释药膜对牙周探诊深度和龈沟出血指数的研究

目的:探讨牙周缓释药膜对牙周炎的临床治疗效果。方法:选取80例典型牙周炎患者,随机分为实验组和对照组,实验组基础治疗后,局部牙周袋应用牙周缓释药膜,对照组基础治疗后,局部牙周袋应用碘甘油,治疗前后分别检查患者患牙的牙周探诊深度及探诊出血情况并记录观察比较,进行统计学分析。结果:实验组疗效优于对照组,统计学有显著性差异。结论:牙周缓释药膜对治疗牙周炎有显著的临床治疗效果,其治疗效果要优于单纯涂抹碘甘油的治疗方法,是一种比较理想的治疗方法。     

慢性牙周炎治疗体会

牙周炎是口腔科常见的细菌感染性疾病,也是人类失牙的主要病因。牙周病基础治疗是用机械的方法去除菌斑和结石,抗菌药物的使用是牙周病基础治疗的重要辅助手段。米诺环素软膏（商品名：派丽奥软膏）是一种牙周局部缓释药物,其主要成分是盐酸米诺环素,本研究采用采诺环素软膏辅助治疗慢性牙周炎,以碘甘油为对照,并作临床疗效分析。     

甲硝唑在牙周病治疗中的应用

牙周疾病是由牙周袋内致病微生物引起的局部细菌感染性疾病。牙周组织的破坏是复杂的龈下菌群与特异性的宿主防御机制之间相互作用的结果。牙周可疑致病菌对多种抗菌药物敏感,近年来许多临床研究表明甲硝唑对牙周病治疗起着重要作用。本文主要谈谈甲硝唑的全身用药和局部应用缓释药在牙周病治疗中的应用。1 全身用药1978年该药被 WHO 确定为治疗厌氧菌的首先药物。1981年 Loescho 报道甲硝唑治疗5例牙周炎取得明显疗效。     

盐酸米诺环素软膏治疗牙周炎的疗效观察

牙周炎是口腔常见的细菌感染性疾病，有部位特异性，抗菌物质能通过牙周袋口进入，达到治疗目的。近年来研究表明：四环素族药物除对多种原因可疑致病菌有较强抑菌作用外，还有抑制胶原酶，促进牙周组织再生的作用。本研究局部应用盐酸米诺环素软膏治疗成人牙周炎，结果报告如下。     

甲硝唑牙周炎控缓药膜对慢性牙周病龈沟液基质金属蛋白酶-8表达的影响

<正>慢性牙周炎是牙周支持组织发生的不可逆的慢性、进行性、破坏性的疾病[1,2]。牙周袋内的非附着性龈下菌斑在发病和发展机制中起了重要的作用,尤以厌氧菌为主,而甲硝唑是针对厌氧菌的特效药。近年来牙周局部控缓释药物是用于牙周治疗最常规的诊疗程序,因生物可吸收性甲硝唑牙周炎控缓释膜安全有效、不良反应小、使用方便,被临床医师推荐为安全有效的牙周缓控释药物。基质金属蛋白酶-8(MMP-8)是龈沟液中一种胶原降解酶,通过裂解胶原纤维,达到破坏牙     

局部缓释药派力奥治疗牙周炎的近期疗效观察

20世纪80年代以来,治疗牙周炎的药物给药方式已发生重大变化,药物剂型亦不断改进,局部缓释药即为近年来国内外全新的药物治疗手段.一般认为口腔内给药最大的问题是在牙周部位如何保持有效浓度,而派力奥软膏即是一种牙周袋内直接给药、可抑制多种牙周病原菌生长且疗效肯定的新型缓释制剂,其主要成分为盐酸二甲胺四环素.此药膏遇水后变硬呈高黏度凝胶状,可在牙周袋内缓慢释放其药物成分,并保持局部有效浓度达7 d.作者通过对240个牙位点的临床治疗,取得满意效果.     

探讨甲硝唑缓释药膜治疗牙周炎的临床疗效

牙周炎是一种比较常见的口腔疾病,在临床上表现为形成牙周袋、牙周溢脓、牙齿松动以及局部跳痛等症状,该病好发于中老年人,诱发该病的因素有很多,其中感染细菌是重要原因,通常可能感染的细菌类型有很多,比如葡萄球菌、链球菌、黑色素类杆菌以及牙龈卟啉菌等[1]。近年来,随着人口老龄化的进一步加剧,我国牙周炎患者的人数呈现逐年上升的趋势,由于该病具有起病慢、病程长以及复发率高等特点,不仅威胁患者的身体健康,还严重影响其生活质量。临床上在治疗牙周炎时,有多种多样的药物,治疗效果各有千秋。本文重点探讨了甲硝唑缓释药膜治疗牙周炎的临床效果,现报道如下。     

米诺环素软膏治疗成人牙周炎临床研究

目的 探讨米诺环素软膏治疗成人牙周炎的临床效果。方法 随机选取临床确诊为成人牙周炎的患牙80颗分为盐酸米诺环素软膏治疗组和对照组（不用药），观察治疗前后的菌斑指数（PLI），龈沟出血指数（SBI），牙周袋深度（PD），牙周附着水平（AL）．牙齿松动度（MD）的变化。结果 治疗组在用药1周和1个月后，各项指标改善程度均明显优于对照组。结论 盐酸米诺环素软膏是一种有效的牙周局部缓释药物。     

缓释型药物辅助治疗牙周疾病

牙周炎的始动因子是龈下菌斑中的细菌,临床上传统采用龈上洁治和龈下刮治等机械方法去除菌斑来治疗牙周病,有一定的疗效.以牙周洁刮治和根面平整可去除附着在牙面上的大部分菌斑和牙石.但对于深牙周袋底部和根分叉附近的菌斑和牙石单靠机械方法很难完全彻底去除,加之造成牙周深部组织炎症破坏的菌斑更多的是附着于牙周袋软组织壁上或游离袋内的龈下非附着性菌斑.因此常规机械治疗配合在深牙周袋内局部应用抗菌药物,可有效杀灭抑制残留于牙周袋内的致病微生物,提高治疗效果[1].近年来,缓释型药物的应用给牙周病的治疗提供了新的途径.     

Functional biomaterials for comprehensive periodontitis therapy

Periodontitis is an inflammatory disease caused by bacterial infection directly, and the dysregulation of host immune-inflammatory response finally destroys periodontal tissues. Current treatment strategies for periodontitis mainly involve mechanical scaling/root planing (SRP), surgical procedures, and systemic or localized delivery of antimicrobial agents. However, SRP or surgical treatment alone has unsatisfactory long-term effects and is easy to relapse. In addition, the existing drugs for local periodontal therapy do not stay in the periodontal pocket long enough and have difficulties in maintaining a steady, effective concentration to obtain a therapeutic effect, and continuous administration always causes drug resistance. Many recent studies have shown that adding bio-functional materials and drug delivery systems upregulates the therapeutic effectiveness of periodontitis. This review focuses on the role of biomaterials in periodontitis treatment and presents an overview of antibacterial therapy, host modulatory therapy, periodontal regeneration, and multifunctional regulation of periodontitis therapy. Biomaterials provide advanced approaches for periodontal therapy, and it is foreseeable that further understanding and applications of biomaterials will promote the development of periodontal therapy.     

Antimicrobial drug delivery to the eye

A major obstacle in the treatment of ocular infections is the difficulty in obtaining adequate antimicrobial drug concentration at the site of infection. This article reviews the pharmacokinetic principles of ophthalmic drug delivery as it pertains to antimicrobial therapy. The administration of antimicrobials by topical application, subconjunctival injection, intravitreal injection, vitreous replacement fluid, and systemic administration are addressed. Representative data on the intraocular penetration of antimicrobials as well as recommended doses of drugs for ocular infections are presented.     

Antimicrobial therapy in critically ill patients: a review of pathophysiological conditions responsible for altered disposition and pharmacokinetic variability

Antimicrobials are among the most important and commonly prescribed drugs in the management of critically ill patients. Selecting the appropriate antimicrobial at the commencement of therapy, both in terms of spectrum of activity and dose and frequency of administration according to concentration or time dependency, is mandatory in this setting. Despite appropriate standard dosage regimens, failure of the antimicrobial treatment may occur because of the inability of the antimicrobial to achieve adequate concentrations at the infection site through alterations in its pharmacokinetics due to underlying pathophysiological conditions. According to the intrinsic chemicophysical properties of antimicrobials, hydrophilic antimicrobials (beta-lactams, aminoglycosides, glycopeptides) have to be considered at much higher risk of inter- and intraindividual pharmacokinetic variations than lipophilic antimicrobials (macrolides, fluoroquinolones, tetracyclines, chloramphenicol, rifampicin [rifampin]) in critically ill patients, with significant frequent fluctuations of plasma concentrations that may require significant dosage adjustments. For example, underexposure may occur because of increased volume of distribution (as a result of oedema in sepsis and trauma, pleural effusion, ascites, mediastinitis, fluid therapy or indwelling post-surgical drainage) and/or enhanced renal clearance (as a result of burns, drug abuse, hyperdynamic conditions during sepsis, acute leukaemia or use of haemodynamically active drugs). On the other hand, overexposure may occur because of a drop in renal clearance caused by renal impairment. Care with all these factors whenever choosing an antimicrobial may substantially improve the outcome of antimicrobial therapy in critically ill patients. However, since these situations may often coexist in the same patient and pharmacokinetic variability may be unpredictable, the antimicrobial policy may further benefit from real-time application of therapeutic drug monitoring, since this practice, by tailoring exposure to the individual patient, may consequently be helpful both in improving the outcome of antimicrobial therapy and in containing the spread of resistance in the hospital setting.     

门诊应用抗菌药物的调查分析制定相应用药对策

目的 了解门诊抗菌药物使用情况,指导临床合理用药.方法 采用随机抽查某医院门诊处方,对抗菌药物治疗进行调查分析制定合理用药对策.结果 抗菌药物的使用率为50.27%,其中单用占75.56%,二联使用率占22.89%、三联抗菌药物联合使用占抗菌药物使用病人的1.56%.门诊抗菌药物使用以β内酰胺类比例最高达73.22%.应用抗菌药物率50.27%稍超卫生部要求.结论 制定相应合理用药的对策加强抗菌药物的使用管理,增强实验室的微生物培养意识,以提高抗菌药物的合理使用.     

Local delivery of antimicrobial agents for the treatment of periodontal diseases.

Periodontitis is an inflammatory disease of the supporting tissues of the teeth caused by groups of specific microorganisms. Aggressive forms of periodontitis can be localized or generalized. The concept that localized problem sites may be treated by local drug delivery appears attractive as the antimicrobial agent is delivered within periodontal pockets and the therapy is targeted on specific pathogenic microorganisms. Local delivery of antimicrobial agents using controlled release systems should be considered as adjunctive to mechanical debridement for the treatment of localized forms of periodontal destruction. This article reviews various types of delivery systems evaluated in practical periodontal therapy. Despite the large number of studies showing an enhanced effectiveness of local antibiotherapy, there are insufficient comparative data to support any of the local delivery system.     

我院抗菌药物应用情况调查与分析

目的找出不合理应用抗菌药物症结,为临床合理用药提供科学依据.方法调查我院2001年3月出院患者病历1 175份,并分析抗菌药物应用的合理性.结果共应用抗菌药物2 013例次,抗菌药物应用率为73.45%.其中,预防用药49.18%,治疗用药49.18%,盲目用药1.64%;合理用药67.76%,基本合理用药23.40%,不合理用药8.84%;共用药13类、58种,居前5位者依次为喹诺酮类、头孢菌素类、青霉素类、硝咪唑及大环内酯类.结论我院抗菌药物应用率仍高于卫生部要求,应用合理率偏低.     

Implications on Emergence of Antimicrobial Resistance as a Critical Aspect in the Design of Oral Sustained Release Delivery Systems of Antimicrobials

Purpose To assess the effects of the unabsorbed fraction of an orally administered antimicrobial drug which enters the colon on the emergence of resistance among the natural microflora, a phenomenon largely overlooked so far despite its clinical importance, especially when sustained release formulations are used. Methods Effects of an orally administered model β-lactam antibiotic (amoxicillin) on emergence of resistant bacteria were assessed using a microbiological assay for qualitative and quantitative determination of resistant bacteria in fecal samples of rats following gastric administration of the drug to rats for 4 consecutive days. Time- and site-controlled administration of a β-lactamase to the rat colon was assessed as a potential strategy for prevention the emergence of resistant bacteria following oral administration of incompletely absorbed antimicrobials. Results Emergence of resistant bacteria was demonstrated following oral administration of amoxicillin to rats, whereas de-activation of the β-lactam prior to entering the colon, by infusion of a β-lactamase into the lower ileum, was shown to prevent the emergence of resistant colonic bacteria. Conclusions This study illustrates the need to consider the emergence of antimicrobial resistance as a goal equally important to microbiological and clinical cure, when designing oral sustained-release delivery systems of antimicrobial drugs.     

盐酸米诺环素缓释药条用于成人牙周炎辅助治疗的疗效观察

目的 评价盐酸米诺环素缓释药条用于成人牙周炎辅助治疗的临床效果。方法 采用单盲随机法，选择成人牙周炎患16例，126个BOP( )位点，探诊深度＞5mm。基础治疗后，随机分为两组，试验组为盐酸米诺环素缓释药条组，对照组则为龈下刮治组。试验组每周于牙周袋内上药1次，共6周。第0、4、6、12周观察PD、AL、BOP临床指标。结果 试验组各临床指标改善均优于对照组。结论 盐酸米诺环素缓释药条用于成人牙周炎辅助治疗是有效的。     

腹腔镜胆囊切除术围手术期抗菌药物的使用分析

目的：调查我院普外科腹腔镜胆囊切除术围手术期抗菌药物的使用情况,评价其用药的合理性。方法：随机抽取2011-2013年出院病例639例,对抗菌药物的种类、用药时间、用药比例及药物联用等进行调查与分析。结果：639例中使用抗菌药物的病例有432例。其中,2011年266例,使用率94.5%;2012年173例,使用率75.72%;2013年200例,使用率21.50%。使用抗菌药物的品种有13种,头霉素类最多,头孢菌素类、抗厌氧菌类及酶抑制剂类次之。围手术期用药存在用药疗程过长,个别联合用药欠妥的现象。结论：抗菌药物专项整治后腹腔镜胆囊切除术围手术期抗菌药物使用率降低明显。抗菌药物的选用逐步合理化,但24小时内停药率偏低,医院要继续加强围手术期抗菌药物的应用管理,提高合理用药水平,有效控制细菌耐药,并持续改进。     

我院儿科下呼吸道感染抗菌药物应用评价

目的：了解我院儿科下呼吸道感染抗菌药物的应用情况,为临床合理用药提供参考。方法：收集2013年6-11月我院儿科下呼吸道感染患儿出院病历共708份,统计分析抗菌药物使用情况。结果：我院儿科下呼吸道感染住院患儿抗菌药物使用率99.9%（707/708）,均为静脉滴注给药,联合用药率为52.5%（372/708）,换药率为16.2%（115/708）,2.1%（15/708）患儿无指征换药。红霉素、头孢硫脒、头孢呋辛钠用药频次居前三位,使用率分别为52.7%（373/708）、26.3%（186/708）、23.6%（167/708）。联合用药以红霉素＋β-内酰胺类抗菌药物为主。结论：我院儿科下呼吸道感染抗菌药物应用在用药指征、联合用药、给药途径、给药频次、药物更换等方面存在不合理情况,应加强抗菌药物合理应用的监管,促进临床合理用药。