门冬氨酸阿奇霉素治疗儿童下呼吸道感染的疗效分析

目的 探讨门冬氨酸阿奇霉素治疗儿童细菌性下呼吸道感染的可行性及安全性。方法我院注射用门冬氨酸阿奇霉素治疗下呼吸道感染儿童166例。门冬氨酸阿奇霉素剂量按每天10mg／kg,加入葡萄糖液中1～3h静脉慢滴,疗程3～7d。观察治疗前后症状、体征变化,以及外周血、肝功能、肾功能及X线胸片变化,并取痰液作培养及门冬氨酸阿奇霉素药敏试验,或取痰液及血清进行非典型病原菌抗原抗体检测。结果治愈55例,显效67例,好转11例,无效33例,总有效率为73．5％,18例（10．8％）发生不良反应,其中纳差16例,恶心2例,不良反应1d后消失。2例治疗前血清转氨酶为48U／L、56U／L（正常值〈40U／L）,治疗后患儿下呼吸道感染痊愈,肝功恢复正常。结论门冬氨酸阿奇霉素对儿童细菌性下呼吸道感染疗效较好,安全性高。     

阿奇霉素肠溶片人体生物等效性研究

目的旨在研究由石家庄欧意药业有限公司生产的阿奇霉素肠溶片的人体生物等效性。方法采用3×3交叉设计,将24例健康男性受试者随机分为三组,口服受试制剂（阿奇霉素肠溶片）、参比制剂（阿奇霉素片）或静脉注射参比制剂（注射用阿奇霉素）500mg,采用HPLC—MS法测定血药浓度,用DAS软件测定血药浓度参数,进行生物等效性评价。结果受试药物阿奇霉素肠溶片、对照药物阿奇霉素片和注射用阿奇霉素主要药动学参数AUC072分别为6030 1126ng·h／ml、6142 1295ng·h／ml和12359 2295ng·h／ml;AUC0分别为6575 1274ng·h／ml、6656 1519ng·h／ml和14967 2870ng·h／ml。Cmax分别为610 167ng／ml、608 163ng／ml和3451 450ng／ml;Tmax分别为2．420．70h、2．270．68h和0．930．12h;结论阿奇霉素肠溶片与参比制剂阿奇霉素片比较,相对生物利用度为99．4％±14．3％,两者具有生物等效性。     

阿奇霉素联合沐舒坦雾化吸入治疗小儿支原体肺炎的临床疗效观察

目的观察阿奇霉素联合沐舒坦雾化吸入治疗小儿支原体肺炎的临床疗效。方法将明确诊断为支原体肺炎的84例患儿随机分为2组：治疗组给予阿奇霉素静脉滴注和沐舒坦雾化吸入联合治疗,对照组给予阿奇霉素静脉滴注治疗,比较2纽治疗的疗效。结果治疗组治疗总有效率为95．35％,对照组总有效率为80．49％,2组比较有统计学意义（P〈0．05）;话疗组较对照组临床表现有明显改善（P〈0．05）。结论阿奇霉素联合沐舒坦雾化吸入治疗小儿支原体肺炎有良好的疗效。     

中西医结合治疗小儿反复呼吸道感染108例

目的:观察中西医结合治疗小儿反复呼吸道感染临床疗效。方法:108例患者采用阿奇霉素加服中药(黄芪、白术、防风、薏苡仁、苏子、枇杷叶、前胡、薄荷)加减,7d为1疗程,1疗程后评定疗效。结果:108例中治愈88例,有效14例,无效6例。结论:中西医结合治疗小儿反复呼吸道感染,可显著提高患儿免疫力,减少复发率。     

Biomarkers to monitor drug-induced phospholipidosis

Di-docosahexaenoyl (C22:6)-bis(monoacylglycerol) phosphate (BMP) was identified as a promising phospholipidosis (PL) biomarker in rats treated with either amiodarone, gentamicin, or azithromycin. Sprague-Dawley rats received either amiodarone (150 mg/kg), gentamicin (100 mg/kg) or azithromycin (30 mg/kg) once daily for ten consecutive days. Histopathological examination of tissues by transmission electron microscopy (TEM) indicated different degrees of accumulation of phospholipidosis in liver, lung, mesenteric lymph node, and kidney of drug-treated rats but not controls. Liquid chromatography coupled to mass spectrometry (LC/MS) was used to identify levels of endogenous biochemical profiles in rat urine. Urinary levels of di-docosahexaenoyl (C22:6)-bis(monoacylglycerol) phosphate (BMP) correlated with induction of phospholipidosis for amiodarone, gentamicin and azithromycin. Rats treated with gentamicin also had increased urinary levels of several phosphatidylinositol (PI), phosphatidylcholine (PC), and phosphatidylethanolamine (PE) species.     

The effect of erythromycin and clarithromycin versus azithromycin on serum valproate concentration

IntroductionUnlike azithromycin, erythromycin and clarithromycin strongly inhibit CYP450, which metabolizes valproic acid. The aim of this study was to evaluate the impact of macrolide administration on serum valproate trough levels.MethodsThis retrospective cohort study included hospitalized adult patients who concomitantly received valproate with a macrolide. Patients who received a carbapenem, those who do not have a baseline and/or post-levels, and those who received different doses of valproate were excluded. The change in serum valproate trough level from baseline to after the occurrence of co-administration (post-level) was compared in patients who received either erythromycin or clarithromycin versus those who received azithromycin.ResultsA total of thirteen patients were included in the comparison. The mean ± SD for change in serum valproate trough levels was significantly higher in the erythromycin/clarithromycin group than the azithromycin group (209.1 ± 105.9 µmol/L [equivalent to 30.1 ± 15.2 mg/L] vs. 12.7 ± 52.1 µmol/L [equivalent to 1.8 ± 7.5 mg/L]; P = 0.002).ConclusionThis study found a significantly higher increase in serum trough levels of valproate after co-administration of erythromycin/clarithromycin versus azithromycin. Clinicians should consider avoiding co-administration of erythromycin and clarithromycin with valproate if possible or close monitoring of valproate levels with dose reduction.     

口服单剂量阿奇霉素治疗淋球菌性咽炎

用阿奇霉素的治疗２５例淋菌性咽炎患者。给药方法为单剂阿奇霉素１．０ｇ顿服，７天后进行疗效评价，结果病人治愈率及细菌清除率均为９６％，表明口服单剂量阿奇霉素治疗淋球菌性咽炎疗效确切。     

Azithromycin胶囊剂与罗红霉素片剂随机对照治疗急性感染比较

用国产ａｚｉｔｈｒｏｍｙｃｉｎ（ＡＺＭ）和进口罗红霉素作随机对照，ＡＺＭ５００ｍｇ每日１次，疗程３ｄ。非淋球菌性尿道炎１ｇ单剂量；进口罗红霉素１５０ｍｇ每日２次，疗程７ｄ。两组各６１例（呼吸道感染各４１例，非淋球菌性尿道炎各２０例）。试验组和对照组的痊愈率和有效率分别为７７．０５％、９３．４４％；６８．８５％、９０．１６％（Ｐ＞０．０５）。开放试验４２例，呼吸系统感染２５例，皮肤软组织感染１７例，痊愈率和有效率分别为７３．８１％、９２．８６％。细菌的阴转率和消除率分别为９１．２３％、９０．４８％；８６．４４％、８６．１５％（Ｐ＞０．０５）。试验组和对照组细菌有效率分别为９２．９８％、９１．５２％（Ｐ＞０．０５）。试验组和对照组不良反应发生率都为３．２８％，不良反应相同，开放组为２．３８％。提示ＡＺＭ和进口罗红霉素疗效满意，不良反应少，但ＡＺＭ总用药量少、疗程短为其一大优点。     

阿齐霉素三联疗法1周疗程与2周疗程治疗HP感染的疗效观察

目的对比阿齐霉素三联疗法1周疗程与2周疗程方案的疗效差别。方法69例经胃镜检查证实有十二指肠球部溃疡合并有幽门螺杆菌阳性的病人,随机分为A、B两组。A组为2周组,用药为奥美拉唑40mg,每天1次×2周;阿齐霉素每天500mg,仅开始3d口服;阿莫西林500mg,每天4次×2周。B组为1周组,用药为奥美拉唑与阿齐霉素,剂量和疗程同A组,阿莫西林500mg,每天3次×1周。结果H.pylori根除率A、B两组分别为88.0%(31/35)、85.0%(29/34),两组根除率比较无显著性差异(P>0.05);溃疡愈合率、疼痛消失时间、随访1年再检出率和溃疡复发率,两组比较均无显著性差异(P>0.05)。结论阿齐霉素三联疗法1周方案与2周方案疗效无明显差异,值得推广。     

阿奇霉素联合孟鲁司特钠治疗小儿肺炎支原体肺炎的疗效及其对血清C反应蛋白水平的影响

目的观察分析阿奇霉素联合孟鲁司特钠治疗小儿肺炎支原体肺炎的疗效及其对血清C反应蛋白(CRP)水平的影响。方法随机将85例肺炎支原体肺炎患儿随机分为观察组43例和对照组42例。对照组给予阿奇霉素序贯疗法,观察组给予阿奇霉素序贯疗法和孟鲁司特钠联合治疗。疗程结束后分析两组临床治疗效果、临床症状和体征(喘憋、湿啰音、咳嗽)消失时间、平均退热时间、平均住院时间、CRP水平和药物安全性。结果治疗后观察组临床总有效率明显高于对照组(95.3%vs.78.6%),差异具有显著性(P0.05)。观察组临床症状和体征消失时间明显短于对照组,差异具有显著性(P0.05)。且观察组平均退热时间和住院时间也明显短于对照组,差异具有显著性(P0.05)。治疗治疗后两组CRP水平有明显降低,且观察组降低更明显,与对照组治疗后比较,差异具有显著性(P0.05)。两组均未见严重不良反应。结论阿奇霉素和盂鲁司特钠联合使用治疗小儿支原体肺炎临床效果满意,能有效降低CRP,快速缓解患儿临床症状和体征,安全性好,值得临床推广应用。