静脉滴注羧苄青霉素抗绿脓杆菌感染方案的讨论

羧苄青霉素 (以下简称羧苄 )为青霉素类抗绿脓杆菌有效的抗生素 ,主要用以治疗全身性绿脓杆菌感染。在我院住院患者中 ,绿脓杆菌感染者药敏试验常常对羧苄高敏 ,临床上主要应用于敏感细菌所引起的呼吸道感染、泌尿系感染、绿脓杆菌败血症等 ,多由静脉滴注方法给药 ,常采用每日 1次 ,每次 6.0～ 1 0 .0 g的给药方案 ,其疗效不明显。本文就羧苄对绿脓杆菌感染者的静滴给药方案讨论如下 :羧苄抗绿脓杆菌的最低抑菌浓度 ( MIC)半数细菌为 40～ 2 0 0 μg/ml,1 /4菌株的 MIC超过 2 0 0 mg/ml[1] ,生物半衰期 T12 =1 h,表现分布容积 Vd=1 2 .6…     

呋苄青霉素对绿脓杆菌K799/WT青霉素结合蛋白亲和力研究

本文对呋苄青霉素等五种B—内酰胺类抗生素与绿脓杆菌K799/WT靶位蛋白—青霉素结合蛋白(PBPs)的亲和力进行了研究。结果表明呋苄青霉素对绿脓杆菌K799/WT的致死性PBPs具有强大的亲和力。对PBP-1a、PBP-1b、PBP-2、PBP-3的IC_(50)值分别为0.13、1.03、2.89、0.014 mg/L。羧节青霉素对PBP-1a、PBP-2、PBP-3的亲和力仅分别为呋苄青霉素的34％,<9.6％,与2.9％。呋苄青霉素对绿脓杆菌PBPS亲和力与苯咪唑青霉素相似,优于氧哌嗪青霉素与头孢哌酮。     

国产半合成青霉素—呋氨西林(BL-P1597)体内外抗菌作用研究

据国外资料报导,半合成青霉素呋喃酰脲氨苄青霉素简称呋氨西林(BL-P1597)具有广谱抗菌活性,对绿脓杆菌体外抗菌作用超过羧苄青霉素。1970年Price等及Robert等研究证明BL-P1597同类物BL-P1654体内外抗绿脓杆菌实验结果均优于羧苄青霉素。本文报告国产呋氨西林(BL-P1597)体内外抗菌作用研究结果。     

应做皮肤过敏性试验的药物

在临床上,有一些药物易致过敏性休克,严重时可引起死亡。为了避免这一严重反应,在用药前应做“皮试”,阳性者禁用,阴性者方可用药。下面介绍一些在临床上用药前应做皮试的药物。 1.青霉素类药 青霉素G钾(钠)、苯唑青霉素、氨苄青霉素、羟氨苄青霉素、磺苄青霉素、氧哌嗪青霉素、邻氯青霉素、羧苄青霉素、呋苄青霉素、苄星青霉素(长效西林)、羧噻     

抗生素在结核病番茄疫苗研究中的应用

目的探索卡那霉素（Km）、羧苄青霉素（Carb）和头孢霉素（Cef）在结核病番茄疫苗研究中的应用。方法取未转化番茄子叶进行卡那霉素和羧苄青霉素敏感性实验，未转化不定芽进行羧苄青霉素和头孢霉素敏感性实验。转化后的子叶经10．0mg／L卡那霉素筛选后再生的抗性芽，经过第二次筛选再生根。结果卡那霉素抑制番茄子叶再生，随着培养基中卡那霉素浓度升高，子叶再生愈伤组织和芽的时间延长，数量减少。当卡那霉素达到10．0mg／L完全抑制子叶再生。以10．0mg／L卡那霉素筛选转化后的子叶，30％形成愈伤组织，13％分化出不定芽。不定芽在10．0mg／L卡那霉素培养基中进行生根筛选，只有少数不定芽萌发出根，生根时间延长，根数减少。两次筛选需要大约2月时间。0～500．0mtg／L羧苄青霉素对子叶再生没有影响，可素促进生根，但根粗、短。500．0mtg／L头孢霉素促进根生长，根长、细。结论卡那霉素选择压以10．0mg／L为宜。不定芽分化阶段宜用500．0mg／L羧苄青霉素，生根阶段宜用500．0mg／L头孢霉素。针对子叶再生愈伤组织和不对芽再生根两次筛选，敏感、快速，节约筛选时间。     

呋苄青霉素抗菌作用研究

呋苄青霉素,是一个国产新的半合成广谱青霉素。1971年Bodey等报告本品(代号BL-P 1597)与其同类物BL-P 1654具有广谱抗菌活性,体外对绿脓杆菌抗菌作用超过羧苄青霉素,同年Price等报导BL-P1654体内外抗绿脓杆菌作用都比羧苄青霉素强,对阴性杆菌感染小鼠保护作用超过氨苄青霉素。以后,对BL-P 1654的抗菌作用、药物动力学、毒副作用陆续有所报导,但71年以来,一直未再见有关BL-P1597的报告。     

常用抗绿脓杆菌感染药物的评价

<正> 抗绿脓杆菌的药物不断涌现,种类很多,为临床治疗此类感染提供了很大的选择余地,但是在众多的药物中如何选择使用或联合使用是很重要的,常使用的抗绿脓杆菌的药物有羧苄青霉素,磺苄青霉素、呋苄青霉素及氧哌嗪青霉素,头孢哌酮头孢噻甲羧肟,头孢三嗪噻肟,庆大霉素,丁胺卡那霉素,磷霉素,吡哌酸,氟派酸等十多种,仅以上药品做一评价。 一、羧苄青霉素:(羧苄西林)Carbenicillin:抗绿脓杆菌的作用较弱,最低抑菌浓度为50～100mg/ml,所以成人患者一日用量要高达20mg左右,而且副作     

呋苄青霉素致畸性和致突变的研究

呋苄青霉素(Furbenicillin简称BL-P1597)系半合成广谱抗生素之一,其特点抗绿脓杆菌作用比羧苄青霉素强8～16倍。经临床应用本品治疗绿脓杆菌、大肠杆菌感染,有效率达90％以上,对肝、肾及造血系统均无明显毒性作用,主要由尿路和胆道排出。呋苄青霉素是一个新产品,国内外尚未见有该药致畸性     

呋苄青霉素、庆大霉素及卡那霉素在人体胆汁中浓度的动态观察

本文报告了14例人体胆汁中的呋苄青霉素、庆大霉素和卡那霉素的浓度测定及其在胆道内排泄过程的观察。实验表明:在人体胆汁中,庆大霉素和卡那霉素的浓度较低;而呋苄青霉素的浓度明显高于血中即刻浓度,且远远超过该药对大肠杆菌的最低有效抑菌浓度,维持有效抑菌浓度的时间也较长。故在治疗重症胆道感染时,如有条件,应当首选此药。     

耳针防治氨基苄青霉素药疹112例观察

临床上常见到氨苄PC引起的药疹.在临床护理工作中,我们对112例使用氨基苄青霉素患者,采取针刺耳穴法进行防治,收到较为满意的临床效果.1 临床资料对入院后使用氨基苄青霉素的病人,随机分为耳针治疗、服药治疗、耳针预防和空白对照四组.耳针防治112例,其中耳针治疗42,耳针预防70例,服药治疗22例,对照24例.治疗是适用于出现氨基苄青霉素药疹者,预防则是防止出现氨基苄青霉素药     

STUDY OF IN VITRO ANTIBACTERIAL ACTIVITY OF 19 ANTIMICROBIAL AGENTS AGAINST PSEUDOMONAS AERUGINOSA

The in vitro antibacterial activity of 19 antimicrobial agents against 40 strains of P aeruginosa was studied. The 19 antimicrobial agents included 7 semisynthetic penicillins, 6 third generation cephalosporins, 5 aminoglycosides and l quinolone agent. The minimal inhibition concentrations (MIGs) were measured by the serial dilution on solid agar. Ceftazidime was the most active in 19 antimicrobial agents again P aeruginosa (MIC50: I pg / ml, MIC90: 2 /ig / ml) Amikacin and ofloxaxin followed it in activity. Acylureido-penicillins, such as azlocillin, fur- benicillin and piperacillin were highly active against P aeruginosa, which could inhibit, 92.5%, 90% and 85% of these strains at a concentration of 8 µg/ml. Cefsulodine and cefoperazone were also active against the same strains, inhibiting 92.5% and 99% of the strains at a concentration of 8 µg / ml. The potency of the agents mentioned above against P.aeruginosa was similar to that of aminoglycosides. The drug susceptibility of 10 strains isolated in our hospital was compared with that of 29 strains of other hospitals in Beijing. The MICS of 5 penicillins and 3 cephalosporins against the isolates of our hospi- tal was higher than that of other hospitals, suggesting that the susceptibility of β-lactam antibiotics against isolates of our hospital was lower. The effects of combined use of azlocillin with oxacillin and piperacillin with ofloxacin against 4 strains of carbenicillin-resistant P aeruginosa was studied using check-board testing. The synergy and partial synergy were observed in both combinations.     

FURBENICILLIN AND ITS ANTIBACTERIAL ACTIVYITY

Furbenicillin (BL-P 1597), a new seinisyn- t.hetic broad spectrum penicillin, was evaluatecl in vitro irt Z-fold tube dilution testing against 307 different clinical isolates in parallel with carbcnicillin and ampicillin. Furbenicillin was shown to be more erfcctivc than carbenicillin aganist penicillin-sensitive grtun-positive and gram-negative cocci as well as many gram- negative bacilli includirig Pseudomonas ae'rug- in.osa. About 82% of Ps. aerugin.osa strains corild be inhibited by furhenicilliri at 12.5 rig:,iml wliic:k is 16 times stronger than the antioacterial action of carbenicilhn. The ac- tivity of furbenicillin against penicillin-sensi- tive organisms is similar to that of ampicillin. Furbenicillin demonstrated greater iji vivo ac- tivity against species of! cxperimental.pathoge:nic bacterial infections than carbenicillin. The !atter is 2-3 times less active than the former against mouse pseudomonas infcctior:t in tests.     

A surveillance study on penicillin-resistant streptococcus pneumoniae in China

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INITIAL RESULTS OF IN VITRO STUDIES OF CLAVULANIC ACID SYNERGISM

Clavulanic acid is a potent beta-lacta- mase inhibitor. Its synergistic effect on the minimum inhibitory concentration and mini- mum bactericidal concentration of furbenicillin, ampicillin, or carbenicillin against clinical iso- lates resistant to beta-lactam antibiotics is ini- tially estimated.     

哌拉西林/他唑巴坦治疗下呼吸道感染

目的观察哌拉西林/他唑巴坦治疗下呼吸道感染的临床疗效。方法88例诊断为下呼吸道感染的患者分为观察组和治疗组各44例。观察组给予哌拉西林/他唑巴坦4.5 g静脉滴注,每日3次,疗程7~15 d;对照组给予头孢曲松钠2.0 g静脉滴注,每日3次,疗程7~15 d。疗程结束后比较2组总有效率和细菌清除率。结果观察组总有效率93.2%,细菌总清除率86.4%;对照组总有效率75.0%,细菌总清除率68.9%,2组总有效率和细菌清除率比较差别均有统计学意义(P<0.05)。结论哌拉西林/他唑巴坦治疗下呼吸道感染安全、有效,值得临床推广。     

^99mTc—DTPA气熔胶显像测定呼吸道粘液纤毛清除功能

为进一步研究呼吸道疾病时的粘液纤毛清除功能,采用＾９９ｍＴｃ－ＤＴＰＡ所溶胶吸入显像,通过电影显示定性和定量指标分析。对１８例健康受试者和患者进行了显像研究,得到气道清除率和粘液纤毛清除率的正常值,并观察了３２例慢性阻塞性肺病（ＣＯＰＤ）患者气管－支气管纤毛清除功能的改变。结果显示,健康受试者与ＣＯＰＤ患者不同时间气清除率和粘液纤毛清除率均明显低于健康受试者（ｐ〈０．０１）。本研究方法简便客观,具     

脾动脉结扎对脾清除功能的影响

目的 :探讨脾动脉结扎对脾清除功能的影响。方法 :实验分为 2部分。实验Ⅰ :杂种犬随机分为脾动脉主干结扎组 (A组 )、脾切除组 (B组 )和假手术组 (C组 ) ,每组 7条。于术前和术后 12 0d分别测定脾脏体积、白细胞及中性粒细胞计数 ,检查血中痘痕红细胞 (pittedredcells ,PRC)出现率。实验Ⅱ :SD大鼠 6 0只 ,随机分为脾动脉主干结扎组 (D组 )、脾切除组 (E组 )和假手术组 (F组 ) ,每组各 2 0只。术后 6 0d ,每组各取 12只 ,每只静脉注射 5×10 7个肺炎球菌I型菌液 ,观察动物死亡情况。结果 :A组犬术后 12 0d脾脏体积为 (6 4.0± 11.9)cm3,小于C组的(12 9.5± 14.5 )cm3。A、B组术后白细胞及中性粒细胞计数与术前比较无显著变化。A组痘痕红细胞计数为 1.95‰ ,高于C组的 0 .85‰ ,而低于B组的 19.85‰ (P <0 .0 5 )。注射肺炎球菌后 ,D组大鼠死亡率低于E组 ,而与F组无差异。结论 :脾动脉结扎后 ,虽然脾脏的清除功能有所下降 ,但仍保留有一定的清除功能 ,尤其是对细菌的清除功能     

Effects of Combined Treatment with Sansanmycin and Macrolides on Pseudomonas aeruginosa and Formation of Biofilm

Objective To observe the effects of combined treatment with sansanmycin and macrolides on Pseudomonas aeruginosa and formation of biofilm. Methods Micro-dilution method was used to determine the minimal inhibitory concentrations （MICs） of sansanmycin, gentamycin, carbenicillin, polymyxin B, roxithromycin, piperacillin, and tazobactam. PAl and PA27853 biofilms were observed under optical microscope after staining and under SEM after treatment with sansanmycin at different dosages and combined treatment with sansanmycin and roxithromycin. Viable bacteria in PAl and PA27853 biofilms were counted after treatment with sansanmycin at different dosages or combined treatment with sansanmycin and roxithromycin. Results The MIC of sansanmycin was lower than that of gentamycin and polymyxin B, but was higher than that of carbenicillin. Roxithromycin enhanced the penetration of sansanmycin to PAl and PA27853 strains through biofilms. PAl and PA27853 biofilms were gradually cleared with the increased dosages of sansanmycin or with the combined sansanmycin and roxithromycin. Conclusion Sub-MIC levels of roxithromycin and sansanmycin substantially inhibit the generation of biofilms and proliferation of bacteria. Therefore, combined antibiotics can be used in treatment of intractable bacterial infection.     

A STUDY OF ANTIBACTERIAL ACTIVITY OF FURBENICILLIN AGAINST (3-LACTAMASE PRODUCING GRAM-NEGATlIVE ORGANISMS

The in vitro activity of furbenicillin and ampicillin against 383 strains isolated by clinical laboratories in Beijing was studied. B-lactamases were prepared from 62 resistant gram-negative organisms selected from clinics. The f3-lactamase extracts were identified by the method of iso- electric focusing for studying enzyme stability of furbenicillin, ampicillin, cefazolin, cefaman- dole, and cefotaxime in a biological system. The results showed that the antibaoterial activity of furbenicillin against Escherichia coli, Klebsiella spp, Pseudomonas aeruginosa and Enterobacteria cloacae was better than that of ampiciIlin. Cefotaxime was most stable com- pound to the p-lactamases among all of the anti- biotics examined. The stability of furbenicillin and ampicillin to the B-lactamase extracts in the presence of clavulanic acid was similar to that of cefataxime. The synergism of furbenicillin and clavulanic acid against the resistant gram- negative bacilli was better than that of ampicil- Iin combined with clavulanic acid. The results of the identification of B-lactamases used were similar to those reported in the literature, TEM-l enzyme type being the most common type of the f3-lactamases extracted from enzyme producing resistant gram-negative bacilli.