2种注射用头孢唑肟治疗急性呼吸系统细菌感染的多中心临床评价

目的评价国产注射用头孢唑肟治疗中、重度呼吸系统细菌性感染的有效性和安全性。方法采用区组随机化、多中心、平行对照、单盲试验,共入选138例呼吸道感染病人。试验组予国产注射用头孢唑肟治疗,对照组予进口注射用头孢唑肟治疗,均为头孢唑肟2g加入氯化钠注射液250 mL,30～60 min内静脉滴注,q12 h,疗程均为7～14 d。评价2组临床疗效和不良反应。结果可进行安全性评价130例,可列入临床疗效评价共计125例,试验组和对照组分别为61例和64例。试验组和对照组临床有效率分别为92%(56/61)和89%(57/64),细菌清除率分别为94%(48/51)和93%(50/54),药物不良反应发生率分别为5%(3/65)和6%(4/65)。均无显著差异(P>0.05)。结论国产注射用头孢唑肟治疗中、重度呼吸系统细菌性感染疗效确切、药物不良反应少,疗效和安全性与进口注射用头孢唑肟相当。     

HPLC与微生物法测定注射用头孢唑肟钠含量的比较

目的建立HPLC测定注射用头孢唑肟钠含量，并与微生物法测定含量的结果进行比较。方法HPLC测定条件：采用Waters Symmetry C18柱，pH3．6缓冲液-乙腈（80：20）为流动相，流速1．0ml／min,检测波长254nm。结果头孢唑肟钠在12．5-50．0μg／ml。进样量范围内线性关系良好（r=0．9999），精密度为0．37％。结论两种含量测定方法的结果相近。     

头孢唑肟钠与三种常用输液配伍的稳定性考察

考察３５ ℃时头孢唑肟钠（ Ｃ Ｚ Ｘ） 在５０ｇ／ Ｌ葡萄糖注射液（ Ｇ Ｓ） 、５０ｇ／ Ｌ葡萄糖氯化钠注射液（ Ｇ Ｎ） 以及１００ｇ／ Ｌ葡萄糖注射液（ Ｇ Ｓ） 中的稳定性。利用 Ｃ Ｚ Ｘ 在紫外区波长在２３４ｎｍ 处有最大吸收峰,采用紫外３５ ℃分光光度法进行 Ｃ Ｚ Ｘ 含量分析。结果： Ｃ Ｚ Ｘ 在３５ ℃时,在５０ｇ／ Ｌ Ｇ Ｓ、５０ｇ／ Ｌ Ｇ Ｎ,１００ｇ／ Ｌ Ｇ Ｓ３ 种输液中的 Ｔ０ ．９ 分别为１７ ．２１ ,２１ ．３８ ,１４ ．７０ｈ 。结论： Ｃ Ｚ Ｘ 与三种输液配伍后, Ｔ０ ．９ 均在１４ｈ 以上,故可以为配伍较稳定。     

头孢唑肟钠治疗急性细菌性感染多中心随机对照临床研究

目的评价国产注射用头孢唑肟钠（第3代头孢类抗生素）治疗急性细菌性感染的安全性和有效性。方法用区组随机化、平行对照、多中心单盲试验设计，试验药为国产头孢唑肟钠，对照药为头孢唑肟钠（进口原料）；2组各61例，用法、用量、疗程均相同，每日4g，分2次给药，静脉滴注，疗程7～14天。结果试验药与对照药治疗呼吸和泌尿系统感染的痊愈率分别为75．41％和80．33％，总有效率均为96．72％（P〉0．05）；细菌清除率分别为98．25％和100％，阴转率分别为96．49％和100％（P〉0．05）；药物不良反应发生率分别为6．25％和9．38％（P〉0．05）。结论国产注射用头孢唑肟钠治疗急性细菌性感染有效、安全。     

头孢唑肟在输液中与6种注射剂配伍的稳定性研究

目的：研究头孢唑肟在５％葡萄糖输液与维生素Ｂ６等６种注射剂配伍的稳定性,为临床合理用药提供科学依据。方法：选择在３５℃下６ｈ内观察配伍液的外观,ＰＨ及ＣＺＸ紫外光谱的变化。用紫外分光光度法测定ＣＺＸ的含量。结果：Ａ春稳定性与和ＰＨ有关。结论Ｌ：在３５℃下６ｈ内与维生素Ｂ６、地塞米松、酚磺乙胺、氯化钾注射剂配伍、则稳定可用,与维生素Ｃ、氨茶碱注射剂配伍,则最好在４ｈ内使用。     

Cost-effective choice of antimicrobial therapy for serious infections

The authors evaluated the financial and health implications of treatment choices for three serious classes of infection: hospital-acquired pneumonia, intra-abdominal infection, and sepsis of unknown origin. Data were obtained from a systematic review of clinical literature and published data bases, by written questionnaire from a panel of infectious disease authorities, and from actual costs at a tertiary-care hospital. For pneumonia and sepsis, the third-generation cephalosporin evaluated (ceftizoxime) was found to be less expensive than other regimens, when costs of dose preparation and administration, monitoring, and toxicity were added to drug acquisition costs. The lowestcost regimen for intra-abdominal infection was metronidazole plus gentamicin. Modest differences in efficacy would easily outweigh differences in toxicity, however, and could justify the use of more expensive regimens (e.g., mezlocillin plus gentamicin for hospital-acquired pneumonia, and cefoxitin plus gentamicin for intra-abdominal infection). If all regimens are assumed to be equally efficacious, then the third-generation cephalosporin was both lowest in cost and, owing to its low toxicity, greatest in net health benefit. Supported by a grant from Smith Kline and French Laboratories and by the Harvard Community Health Plan Foundation through the Institute for Health Research, a joint program of the Harvard Community Health Plan and Harvard University.     

Pharmacokinetics of ceftizoxime

Summary The kinetics of ceftizoxime, a newly developed cephalosporin, were evaluated in 6 healthy subjects, with respect to its excretory pathways especially by the biliary route. Total, renal and biliary clearance were determined at two different steady states. Steady state was achieved by constant intravenous infusion (604.1 mg/h) over 6 h after an initial loading dose (750 mg); 1.5 h after discontinuation of that infusion, a further infusion was commenced at a lower rate (284 mg/h) over 3 h, the second steady state being reached 0.5 to 1.0 h later.The drug was mainly excreted by the kidneys (56.7 to 92.9% of the dose). Biliary excretion, measured by the duodenal perfusion and marker dilution technique, was low (0.2 to 7.8% of the dose). Urinary and biliary excretion as well as total clearance were not dose-dependent. However, there was pronounced interindividual variation in total (35.2 to 236 ml/min) and renal clearance (10.6 to 208 ml/min), which could both be explained by varying interindividual urinary flow rates (mean flow rate: 0.99 ml/min to 3.14 ml/min).Intraindividual variation in renal clearance was less pronounced, but in the same subject changes in renal clearance were correlated with changes in urinary flow rate. From the varying renal clearance, which exceeded the glomerular filtration rate at high urinary flow rates and was below it at low urinary flow rates, it can be concluded that, in addition to glomerular filtration, tubular secretion and tubular reabsorption are involved in the renal excretion of ceftizoxime.The half-life calculated from two point estimates after discontinuation of the infusion at the higher rate tended to be longer in subjects with high total clearance (e. g. 1.4 h, clearance 223 ml/min) and shorter in subjects with low total clearance (e.g. 0.85 h, clearance 35.2 ml/min). From this it is concluded that the true half-life was not observed after discontinuation of the infusion.     

头孢唑肟致Stevens-Johnson综合征一例

摘要：Stevens-Johnson综合征是一种累及皮肤和黏膜的急性水疱病变，通常可由感染或口服某些药物后发生，其 病死率可高达10%。本文报道了1例头孢唑肟引起的Stevens-Johnson综合征，回顾了该患者的诊治经过并进行相关 文献分析，以提高对本病的认识。     

Postoperative infection prophylaxis for upper gastrointestinal tract surgery—A prospective and comparative randomized study of cefoxitin and ceftizozime

A prospective and randomized clinical study was conducted in order to compare cefoxitin (CFX) and ceftizoxime (CZX) as prophylactic antibiotics. Two hundred and three consecutive cases of elective upper gastrointestinal tract surgery, performed at our institute between January, 1983, and March, 1986, were entered in the trial. The patients were assigned randomly, before surgery, to the CFX or to the CZX group. Two grams of the assigned antibiotic was first administered during surgery and then continued at a dose of 1 gram, every 8 hrs for a total of 4 days. One patient was withdrawn from the study due to an allergic reaction. Both groups were comparable in sex, age, underlying disease, diagnosis, operation, and preoperative laboratory data. There were 18 infections related to the operation in the CFX group, while there were only 3 in the CZX group (p<0.001). The number of unrelated infections in each group was 6 and 6 respectively (NS). No special differences were found between the two groups regarding the kinds of microorganisms isolated, and no significant differences were seen in the adverse effects of either antibiotic. Our study demonstrated that ceftizoxime was more efficient than cefoxitin in preventing postoperative infection, following upper gastrointestinal tract surgery.     

A Comparison of Choline Magnesium Trisalicylate and Acetylsalicylic Acid in Patients with Rheumatoid Arthritis

Summary

Five newer beta-lactam antibiotics and two aminoglycosides were tested on 400 freshly isolated clinically significant organisms from specimens at a district general hospital. All the antibiotics had very broad-spectrum activities but none could cover against all probable pathogens. Latamoxef was the best of all against Bacteroides spp. Aminoglycosides, followed by cefotaxime and ceftizoxime, were best against staphylococci. Tobramycin, followed by ceftazidine and netilmicin, had the best activity against Pseudomonas aeruginosa. Of all 7 antibiotics tested only piperacillin demonstrated activity against Streptococcus faecalis. Cefotaxime and ceftizoxime were the best against Escherichia coli, Klebsiella spp. and most of streptococci. The study demonstrated that safer alternatives to aminoglycosides are now available.