红霉素胸膜固定术对自发性气胸的治疗价值

目的　评价红霉素作为胸膜硬化剂治疗自发性气胸的价值。方法　复发性自发性气胸患者 4 7例 ,红霉素 1g溶于 5 0ml生理盐水中注入患侧胸膜腔内治疗胸膜腔粘连。结果　红霉素治疗总有效率为 85 1% ,一次注药有效率为 5 7 4 % ,仅 4例多发性肺大疱患者复发。胸液分析显示为炎性改变。不良反应主要为胸痛 ,发生率为 4 2 5 % ,其中 16 1%的患者疼痛较剧烈 ,给予止痛剂可缓解。复发率为 10 3%。结论　红霉素可作为一种有效的胸膜硬化剂治疗自发性气胸。     

Erythromycin ototoxicity in liver transplant patients

We reprot on three liver transplant patients who developed erythromycin-related ototoxicity. This complication has been described in renal transplant patients and in patients with liver dysfunction, but to our knowledge it has not yet been reported in liver transplant patients. The influence of hepatic dysfunction, common renal failure, and the interaction between cyclosporin and erythromycin in the development of erythromycin ototoxicity are discussed.     

The frequency of resistance to erythromycin in group A streptococci in Ankara

Abstract The frequency of resistance to erythromycin of group A beta-haemolytic streptococci in the last 7 years was determined in three medical centres in Ankara. While all group A beta-haemolytic streptococci strains were susceptible to penicillin, a gradual increase in resistance to erythromycin until 1992 was observed. However, a substantial increase in erythromycin resistance occurred in 1993 when newer macrolides became available and were widely used in the latter part of 1992.Conclusion The data show that frequent testing for resistance to erythromycin of group A betahaemolytic streptococci is required for the use of this antibiotic in our country.     

Effect of multiple-dose erythromycin on everolimus pharmacokinetics

Objective We sought to quantify the influence of the CYP3A inhibitor erythromycin on the pharmacokinetics of everolimus, a CYP3A substrate.Methods This was a two-period, single-sequence, crossover study in 16 healthy subjects. In period 1, subjects received the reference treatment of a single 2-mg dose of everolimus. In period 2, they received the test treatment of erythromycin 500 mg three times daily for a total of 9 days and a single 2-mg dose of everolimus coadministered on the fifth day of erythromycin therapy. The test/reference ratio and 90% confidence interval (CI) were derived for everolimus C _max and AUC.Results During erythromycin coadministration, everolimus C _max increased 2.0-fold (90% CI, 1.8–2.3) from 20±5 ng/ml to 40±10 ng/ml. Everolimus AUC increased 4.4-fold (90% CI, 3.5–5.4) from 116±37 ng h/ml to 524±225 ng h/ml. Everolimus half-life was prolonged by 39% from 32±6 h to 44±6 h. Erythromycin predose concentrations were not changed after single-dose administration of everolimus. Conclusion Multiple-dose erythromycin increased single-dose everolimus blood levels by an average 4.4-fold (range, 2.0–12.6). During erythromycin treatment, a compensatory everolimus dose reduction should be made guided by everolimus therapeutic drug monitoring.This study was financed by Novartis Pharmaceuticals.     

金黄色葡萄球菌对大环内酯、林可酰胺和链阳霉素B类耐药性检测

目的调查医院金黄色葡萄球菌临床分离株对大环内酯类（红霉素）、林可酰胺类（克林霉素）和链阳霉素B类（MLSB）抗菌药物的耐药性，检测克林霉素诱导耐药的发生情况及耐药菌株的耐药相关基因。方法单一纸片扩散法检测金黄色葡萄球菌对红霉素和克林霉素的耐药性，再以D-试验检测红霉素诱导克林霉素耐药表型；PCR反应检测各耐药菌株的红霉素耐药相关基因。结果临床分离的金黄色葡萄球菌对红霉素和克林霉素的耐药率分别为80．3％和70．2％，对两者同时耐药（结构型MLS。耐药）的菌株占70．2％；克林霉素诱导耐药（D-试验阳性）菌株占所检测菌株的9．6％，占红霉素耐药、克林霉素敏感菌株的95．5％；在所有的红霉素耐药菌株中检出ermA、ermC和msrA基因。结论医院感染金黄色葡萄球菌对MLSB类抗菌药物的耐药性比较严重；在红霉素耐药、克林霉素敏感菌株中克林霉素诱导耐药率很高，临床实验室对该类菌株必须进行D-试验，以指导临床正确使用MLSB类抗菌药物。     

红霉素治疗70例小儿功能性消化不良临床疗效观察

目的 探讨小剂量红霉素治疗小儿功能性消化不良的临床效果。方法 将138例功能性消化不良患儿随机分成治疗组70例和对照组68例，对照组给予胃蛋白霉、思密达等口服；治疗组在给上述药物的同时给予红霉素口服，剂量为1Omg.kg^-1,d^-1,3次/d，两组疗程均为5天，对两组疗效进行评价。结果 治疗组总有效率为97.1％；对照组总有效率为73.5％，两组疗效差异有统计学意义，P〈0.05。结论 小剂量红霉素治疗小儿功能性消化不良具有良好的治疗效果。     

红霉素与阿奇霉素治疗小儿支原体肺炎的临床疗效

目的探讨治疗小儿支原体肺炎更有效、更经济的方法。方法将98例患儿分为三组：红霉素组、阿奇霉素组和联合用药组,分析其临床疗效。结果红霉素组发热缓解时间最短,阿奇霉素组和联合用药组肺部啰音消失时间较短,而联合用药组住院时间最短,所需费用最少（P〈0.01）。结论红霉素和阿奇霉素联合治疗小儿支原体肺炎更有效、更经济和更安全。     

不同青霉素红霉素敏感性组合模式肺炎链球菌的抗生素敏感性特征

目的分析不同青霉素和红霉素敏感性组合模式的肺炎链球菌对其他常用抗生素敏感性分布的特征,探讨监测青霉素和红霉素敏感性是否具有代表性意义。方法对2000—2002年每年2～5月北京、上海、广州三家儿童医院门诊就诊(年龄1个月至5岁)的急性上呼吸道感染儿童鼻咽部分离肺炎链球菌,采用纸片扩散法和E-test最小抑菌浓度(MIC)法检测其对8种常用抗生素的敏感性。结果将青霉素敏感性分为R(耐药)、I(中介)和S(敏感),红霉素敏感性分为NS(不敏感)和S(敏感),按青霉素敏感性/红霉素敏感性组合模式可分为6组(没有分离到R/S模式菌株)。R/NS组29·8%(17/57)对头孢曲松不敏感;对头孢呋辛和头孢克洛均不敏感;阿莫西林/克拉维酸不敏感株只出现于R/NS组。I/NS组仅0·03%(8/288)对头孢曲松不敏感;头孢呋辛和头孢克洛不敏感率分别为38·2%(110/288)和52·4%(151/288)。头孢克洛不敏感菌株还出现于I/S组。复方新诺明敏感性主要与红霉素是否敏感有关。氯霉素耐药株在各组分布的差异没有统计学意义。R/NS和I/NS几乎都是联合耐药株,S/S组无联合耐药株。结论不同青霉素和红霉素敏感性组合模式的肺炎链球菌对其他常用抗生素敏感性分布具有各自不同的特点,青霉素和红霉素是肺炎链球菌耐药性监测的代表性药物。     

红霉素溶析结晶过程中原溶剂对其晶习及纯度的影响研究

针对目前我国红霉素产品杂质含量高、外观较差等问题,研究了溶析结晶过程中异丙醇、正丙醇、丙酮、乙醇等原溶剂对红霉素结晶晶习及纯度的影响,实验结果发现丙酮和乙醇的混合溶剂（体积比３∶１）作为原溶剂可较好地改善红霉素晶习并提高其纯度。