抗菌药物临床应用指导原则

头孢菌素类根据其抗菌谱、抗菌活性、对β内酰胺酶的稳定性以及肾毒性的不同，目前分为四代。第一代头孢菌素主要作用于需氧革兰阳性球菌，仅对少数革兰阴性杆菌有一定抗菌活性；常用的注射剂有头孢唑林、头孢噻吩、头孢拉定等，口服制剂有头孢拉定、头孢氨苄和头孢羟氨苄等。第二代头孢菌素对革兰阳性球菌的活性与第一代相仿或略差，对部分革兰阴性杆菌亦具有抗菌活性；注射剂有头孢呋辛、头孢替安等，口服制剂有头孢克洛、头孢呋辛酯和头孢丙烯等。     

国内头孢地尼临床应用文献综述

头孢地尼(cefdinir)为第3代口服头孢菌素,由日本藤泽药品工业公司研发,1991年首次在日本上市,1997年被美国食品药品管理局(FDA)批准临床使用,2001年国产头孢地尼获准在我国上市。本品侧链上的羟氨基、氨噻基,不仅增强了对革兰阴性菌的抗菌活性和对β-内酰胺酶的稳定性,而且增强了对革兰阳性菌的抗菌活性,特别是对葡萄球菌、肺炎链球菌、肠杆菌属等有较强的抗菌活性。头孢地     

头孢呋辛/他唑巴坦对β内酰胺酶稳定性及抑酶增效作用

目的观察在头孢呋辛(第2代头孢类抗生素)中加入不同配比他唑巴坦后,对β内酰胺酶的稳定性及抑酶保护作用。方法以超声破碎细菌,得粗制β内酰胺酶,紫外分光光度法测定抗菌药物浓度,计算酶对底物水解率,并以头孢呋辛水解率为100%,计算不同配比头孢呋辛/他唑巴坦的相对水解率和抑酶保护率。结果头孢呋辛中加入他唑巴坦后,β内酰胺酶对其水解率较单用头孢呋辛下降;对大多数菌株,相对水解率<30%,抑酶保护率>70%,3种配比与单用头孢呋辛比较有非常显著性差异(P<0.01)。结论他唑巴坦有很好的抑酶作用,提高了头孢呋辛对革兰阴性杆菌所产β内酰胺酶的稳定性。     

拉氧头孢钠治疗重症颅脑损伤术后感染安全及疗效分析

<正>重型颅脑损伤术后颅内感染、肺部感染、泌尿系感染发病率高,是颅脑损伤术后患者最主要的死亡原因,近2年研究现发现革兰阴性细菌感染率逐步升高,革兰阳性感染率逐步下降[1]。拉氧头孢属氧头孢烯类新型的β-内酰胺类广谱抗生素,对多种革兰阴性菌有良好的抗菌作用,易通过血脑屏障,对厌氧菌有良好的抗菌作用,耐β-内酰胺酶的性能强,微生物对本品很少发生耐药性,是颅脑术后感染首选药物[2]。但近2年临床使用发现拉氧头孢     

氟莫头孢的药理和临床

本文介绍氟莫头孢的抗菌作用,体内保护效果,对β-内酰胺酶的稳定性,对动物毒性,药理作用,药物动力学,临床适应证,应用方法及疗效和副作用。本品抗菌谱广,对MRSA有良好抗菌作用,对β-内酰胺酶稳定,临床上对G~+和G~-菌感染有较好疗效,副作用小。     

头孢他美的体内外抗菌活性

测定头孢他美对临床分离菌株 (包括革兰氏阳性菌、革兰氏阴性菌 )的体内、体外抗菌活性 ,同时测定了头孢他美对产 β-内酰胺酶菌株的最低抑菌浓度及它对 β-内酰胺酶的稳定性。并与头孢噻肟、头孢哌酮、头孢呋辛、头孢曲松等 4个头孢菌素做了比较。结果表明头孢他美具有和它们相似的抗菌活性 ,而且具有很强的β-内酰胺酶稳定性。     

两例头孢呋辛钠的神经系统不良反应

<正>头孢呋辛钠为半合成的第2代头孢类抗生素,兼具抗革兰阳性菌和革兰阴性菌作用,对葡萄球菌和革兰阴性杆菌产生的β-内酰胺酶相当稳定。使用头孢吠辛钠偶有发生不适反应,但症状均轻微且短暂。头孢呋辛钠的药品说明书载明的不良反应有皮疹及ALT、假膜性结肠炎、短暂性血红蛋白浓度降     

头孢甲肟治疗肺部感染60例

注射用盐酸头孢甲肟为第三代半合成的头孢菌素类广普抗生素,通过抑制细菌细胞壁的生物合成而达到杀菌作用。体外实验表明,本品对革兰阳性菌和革兰阴性菌均有作用。本品对革兰阴性菌具有强抗菌作用是由于其对细胞外膜的通透性良好和对β-内酰胺酶稳定,且对青霉素结合蛋白（PBPs）1A、1B和3的亲和力强,从而对细胞壁黏肽交联形成具有较强的阻碍作用。2007年1月至2008年12月本院应用头孢甲肟治疗肺部感染60例,取得满意的疗效。     

头孢地尔对产金属β-内酰胺酶革兰阴性菌的作用现状研究

产金属β-内酰胺酶(MBLs)革兰阴性菌是临床常见的感染病原菌,该类菌可引起多种严重感染,其中产金属β-内酰胺酶肺炎克雷伯菌(KP)是世界范围内的重要医院获得性感染菌,对当前抗感染治疗构成严重威胁。头孢地尔作为新型头孢菌素,具有抗菌活性强、作用范围广、组织穿透力强等特点,对产碳青霉烯酶的肠杆菌、鲍曼不动杆菌、铜绿假单胞菌、嗜麦芽窄单胞菌有强大的抗菌活性,其中它对金属β-内酰胺酶也有相当好的活性。本研究针对头孢地尔对产金属β-内酰胺酶革兰阴性菌的作用进行了全面的现况分析研究。     

用头孢呋辛后出现高热伴三叉神经痛1例

用头孢呋辛后出现高热伴三叉神经痛１例莫美娟，杨澜帆（浙江省绍兴市人民医院，绍兴３１２０００）关键词头孢呋辛；支气管扩张；三叉神经痛；发热头孢呋辛（ｃｅｆｕｒｏｘｉｍｅ）属第２代头孢菌素类抗生素，可抵抗大多数的β－内酰胺酶，对大部分革兰阳性菌、革兰阴性...     

A clinical observation of cefuroxime in pediatric field (author's transl)]

Cefuroxime, a new synthetic cephalosporin, was administered to 10 pediatric patients (6 with respiratory tract infection, 2 with urinary tract infection, 1 with sepsis of E. coli and 1 with enterocolitis). The clinical result was good and excellent in all the 10 cases. No side effect was observed in any of them.     

4种头孢菌素对社区呼吸道感染分离菌的体外抗菌活性

目的研究头孢菌素的体外抗菌活性。方法从未接受抗菌药物治疗或48h接受有效抗菌药物治疗的呼吸道感染病人中分离致病菌,采用纸片法测定细菌敏感试验结果及采用琼脂平板二倍稀释法测定最低抑菌浓度(MIC)。结果本项研究共分离出致病菌160株,常见病原菌为:克雷伯菌(42)、嗜血杆菌(30)、葡萄球菌(30)、肺炎链球菌(9)、阴沟肠杆菌(7)和大肠埃希菌 (14)。对于流感嗜血杆菌和肺炎链球菌头孢呋辛和头孢他啶的敏感性为100％;对于甲氧西林敏感的金黄色葡萄球菌(MSSA)头孢唑林钠的敏感性最高,为100％,其次为头孢呋辛94％、头孢他啶61％,其MIC值的结果显示同样的结果;对于革兰阴性杆菌,第三代头孢菌素最强,依次为第二代、一代头孢菌素,在本次实验中一代头孢菌素对于克雷伯菌、大肠埃希菌有较好的抗菌活性。结论针对不同来源的病人,合理选择不同的头孢菌素。     

深圳市光明地区社区尿路感染患者抗菌药物应用分析

目的:了解深圳市光明地区社区尿路感染患者的抗菌药物使用现状与发展趋势,为临床合理用药提供参考.方法:对光明地区2008-2010年医院和社区尿路感染患者使用抗菌药物的种类、金额和用药频度(DDDs)等进行回顾性调查、统计分析.结果:DDDs排序前3位分别是头孢呋辛钠、阿米卡星和头孢唑肟.结论:需进一步加强社区抗菌药物应...     

Clinical experience with cefuroxime in pediatric field (author's transl)

Cefuroxime (CXM) was administered to 11 patients with pediatric bacterial infections, and clinical effective results were obtained in all these cases. Causative organisms detected in 5 cases with respiratory tract infection, and with urinary tract infections were all eliminated, and the bacterial count decreased in patients with colitis. As for side effect, 1 case developed eosinophilia, and another case with impaired liver function as underlying disease showed transitory exacerbated examination values. Time-course determinations of blood levels and urinary excretions were performed in 1 case. Fecal levels were determined in 2 cases but could not be detected; inactivation action of CXM was observed from the same fecal filtrate.     

Cefuroxime: antimicrobial activity, Pharmacology, and clinical efficacy

The antimicrobial activity, pharmacology, toxicity, and clinical efficacy of cefuroxime are reviewed. Cefuroxime has a second-generation cephalosporin spectrum of activity similar to cefamandole. Addition of a methoxyimino side chain has enhanced its beta-lactamase stability. Cefuroxime is active against certain cephalothin-, cefamandole-, and gentamicin-resistant bacteria. Cefuroxime has an extended half-life which allows dosing every 8 h. If penetrates into bodily tissues and fluids, including the cerebrospinal fluid, in therapeutic concentrations. Cefuroxime has been used successfully in the treatment of meningitis; sepsis; urinary tract, bone and joint, pulmonary, skin, and soft tissue infections; and gonorrhea. Competitive pricing of cefuroxime should provide a cost-effective substitute for cefamandole and, in certain situations, third-generation cephalosporins.     

头孢呋辛钠疗效和安全性再评价

目的进一步评价头孢呋辛钠治疗细菌性感染的安全性、有效性及药物不良反应。方法开放试验,每次1.5 g,每日2次,静脉注射,重度患者每次3.0 g,每日2次。手术后预防细菌感染,每日1次,每次1.5 g,静脉注射。结果头孢呋辛钠治疗呼吸道感染痊愈率65.06%、有效率88.86%。其细菌总清除率为88.87%,药物不良反应发生率为4.5%。结论头孢呋辛钠治疗呼吸道感染、泌尿道感染、其他感染及手术后预防细菌感染疗效确切,药物不良反应少而轻。     

Clinical results of cefuroxime (CXM) therapy in pediatric infections (author's transl)]

Cefuroxime, a new cephalosporin C antibiotic, was administered to 15 children with respiratory tract infection, urinary tract infection, or subcutaneous tumour. The following results were obtained. 1) CXM 30 approximately 100 mg/kg/day were used in treatment of respiratory tract infection. Eight of the eleven patients treated responded to the therapy. 2) CXM 45 approximately 75 mg/kg/day were given to 3 patients with urinary tract infection. Excellent results were obtained in all these cases. 3) One patient with subcutaneous tumour responded to CXM therapy. 4) Clinical isolates from the foci involved, i.e., Staphylococcus aureus (4 strains), Group A Streptococcus hemolyticus (1 strain), Streptococcus pneumoniae (1 strain), Haemophilus influenzae (1 strain), and Escherichia coli (3 strains) were all eliminated by CXM therapy except 2 unassessable strains. 5) No noteworthy side effect was noted.     

Cefuroxime axetil

Cefuroxime axetil is a orally active prodrug formulation of cefuroxime, which upon absorption undergoes immediate deesterification to free cefuroxime. Cefuroxime axetil offers an in vitro antibacterial spectrum against many gram-positive and some gram-negative organisms. Its beta-lactamase stability makes it useful in treating a variety of infections caused by beta-lactamase-producing strains of Haemophilus influenzae, Branhamella catarrhalis, and Staphylococcus aureus. Cefuroxime axetil has good activity against the Enterobacteriaceae and moderate activity against non-Bacteroides fragilis anaerobes. Clinical studies suggest it is at least as effective as ampicillin, amoxicillin, amoxicillin/clavulanic acid, penicillin V, or cefaclor in the treatment of uncomplicated urinary tract infections, acute otitis media, upper respiratory infections, skin and soft tissue infections, and uncomplicated gonorrhea.     

嗜麦芽窄食单胞菌在下呼吸道感染中的耐药分析

目的 探讨临床分离到的嗜麦芽窄食单胞菌耐药特点,为临床合理选用抗生素提供依据.方法 2006年1月～2007年10月临床送检痰标本,分离56株嗜麦芽窄食单胞菌,对其进行药敏分析.结果 嗜麦芽窄食单胞菌对复方新诺明耐药率为3.6%,对环丙沙星耐药率为39.3%,对头孢呋辛、头孢噻吩、头孢噻肟、头孢西丁、替卡西林、阿莫西林、亚胺培南耐药率在100%,对哌拉西林、阿米卡星、庆大霉素、奈替米星、阿莫西林,棒酸、妥布霉素耐药率在90%以上.结论 嗜麦芽窄食单胞菌主要引起呼吸系统感染,该菌耐药情况十分严重,而且各地区耐药情况差异很大,应建立本地区菌株药敏谱.     

Pharmacokinetics and tissue concentrations of cefuroxime

Cefuroxime is well-absorbed and distributed over the human body. This review gives a general summary of published information on tissue concentrations of cefuroxime after an intravenous or intramuscular dose of 750 or 1,500 mg of cefuroxime. Tissue concentrations are given for blister fluid, meninges, eyes, respiratory tract, sputum and bronchi, abdominal and urogenital tract, uterine, ovarian and fallopian tube tissue, myometrium, membranes, placenta, puruloid and healthy human milk, bile, prostate, hip and knee bone. Pharmacokinetics are reviewed in patients with impaired kidney function and in pregnancy.