氨基糖甙类抗生素不同给药法与血药浓度的关系

 对４５例使用庆大霉素（ＧＴＭ）和丁胺卡那霉素（ＡＭＫ）的住院病人，对其不同给药法进行了血药浓度的测定（ＴＤＸ仪），同时监测肾功能。结果，ＧＴＭ组１６例（１６０ｍｇ／ｄ，ｂｉｄ，ｉｍ，连用５ｄ）血药浓度Ｃ＿（ｍａｘ）（μｇ／ｍｌ）４．０±０．９，峰值偏低。ＡＭＫ组２９例（４００ｍｇ／ｄ，分为ｑｄ与ｂｉｄ，ｉｍ和ｉｖ），血药浓度ｑｄ与ｂｉｄ分别为（μｇ／ｍｌ）：ｉｍ组１８．６±２．７与８．０２±２．０；ｉｖ组１７．２±４．０与７．２±２．９，有显著性差异（Ｐ＜０。０１）。用药前、后肾功能监测均在正常值范围。本结果初步表明：ｑｄ给药法可提高抗菌效果，降低肾毒性。

The relationship between different administration and blood concentra-tion for aminoglycosidic antibiotics

Gentamicin(GTM ) and amikacin(AMK) were given to 45 inpatients,and followedby therapeutic drug monitoring(use TDX)。The renal function was also monitered; In GTM group(16 cases)(160 mg/d,divided 2 times im for 5 days),blood concentration(μg/ml)was 4. 0±0.9,and peak value was on the low side,In AMK group(29 cases)(400 mg/d,divided 1/d and2/dim and intravenous drip for 5 days),blood concentration(μg/ml)was 1/d and2/d. In groupthe vale was 18. 6±2. 7 and 8.0±2.0. And in intravenous drip group 17. 2±4. 0 and 7. 2±2.9(P<0. 01).Rennal function was normal, before and after administration。 The result indicated that1/d administration method may raise the antibiotic effect and reduce the nephrotoxic actions。