THE BIOAVAILABILITY OF ORAL PENICILLIN V. A COMPARATIVE STUDY OF THE ABSORPTION OF DIFFERENT SALTS OF PENICILLIN V IN CHILDREN

ABSTRACT. Different salts of penicillin V (pc-V): potassium pc-V (Calciopen® and Kåvepenin®), calcium pc-V (Penicals®) and benzathine pc-V (Meropenin®) were given to 37 children (age 2 months to 4 years) with upper respiratory infections. The gastrointestinal absorption of the drug given in a mixture was followed for three hours after administration by determination of the serum levels from capillary samples. Administration of the mixtures containing the potassium pc-V resulted in a more rapid absorption and in significantly higher plasma concentrations at 30 min than did administration of the preparations containing the calcium and benzathine salts. In four children with coeliac disease, verified by intestinal biopsy, the absorption of potassium pc-V (Calciopen®) was compared with that of calcium pc-V (Penicals®). A decreased absorption was found and this was most pronounced when the calcium salt was given.     

青霉素过敏患者白细胞介素13血清浓度及其基因多态性

目的探讨青霉素类抗生素过敏反应与白细胞介素13(IL-13)及其基因多态性的关系。方法采用ELISA检测51例青霉素过敏患者和20例健康人血清IL-13浓度,放射过敏原吸附试验检测血清中8种青霉素特异性IgE抗体水平,聚合酶链反应-限制性片段多态性分析法检测IL-13+2044G/A多态性位点的基因型。结果青霉素过敏患者血清IL-13浓度的中位数为19.80(0.10,50.00)ng·L-1,显著高于健康对照组1.68(0.20,22.90)ng·L-1,而且血清IL-13浓度随着青霉素特异性IgE抗体阳性种类的增加而增加。IL-13+2044G/A多态性位点等位基因频率与健康对照组无明显差异,GG基因型患者血清氨苄西林主要抗原决定簇IgE抗体水平显著高于GA和AA基因型患者。结论青霉素过敏反应可能与血清IL-13浓度升高有关;IL-13+2044G/A基因多态性可能与某些青霉素特异性IgE抗体浓度升高有关。     

Adult bacterial meningitis: aetiology, penicillin susceptibility, risk factors, prognostic factors and guidelines for empirical antibiotic treatment

Episodes of adult bacterial meningitis (ABM) at a Danish hospital in 1991-2000 were identified from the databases of the Department of Clinical Microbiology, and compared with data from the Danish National Patient Register and the Danish National Notification System. Reduced penicillin susceptibility occurred in 21 (23%) of 92 cases of known aetiology, compared to an estimated 6% in nationally notified cases (p < 0.001). Ceftriaxone plus penicillin as empirical treatment was appropriate in 97% of ABM cases in the study population, and in 99.6% of nationally notified cases. The notification rate was 75% for penicillin-susceptible episodes, and 24% for penicillin-non-susceptible episodes (p < 0.001). Cases involving staphylococci, Pseudomonas spp. and Enterobacteriaceae were under-reported. Among 51 ABM cases with no identified risk factors, nine of 11 cases with penicillin-non-susceptible bacteria were community-acquired. Severe sequelae correlated independently with age, penicillin non-susceptibility, mechanical ventilation and non-transferral to a tertiary hospital (p < 0.05; logistic regression). Other factors that correlated with severe sequelae by univariate analysis only were inappropriate clinical handling, abnormal consciousness, convulsions and nosocomial infection. Overall, the data indicated that neither age alone, community-acquired infection nor absence of identified risk factors can predict susceptibility to penicillin accurately. Recommendations for empirical antibiotic treatment for ABM should not be based exclusively on clinical notification systems with possible unbalanced under-reporting.     

青岛地区部分医院2005-2008年肺炎链球菌的耐药性分析

目的 监测青岛地区肺炎链球菌的耐药性,为临床合理应用抗菌药物提供依据.方法 采集青岛地区部分医院2005年1月到2008年12月门诊与住院感染患者呼吸道、血液、脑脊液等标本,培养、分离和鉴定肺炎链球菌.根据NCCLS的推荐,采用琼脂微茸稀释法测定分离出的231株肺炎链球菌对11种常用抗菌药物的耐药性,分析耐药趋势及年龄差异.结果 231株肺炎链球菌对青霉素不敏感率为23.38%[耐青霉素肺炎链球菌(PRSP):9.52%;低耐青霉素肺炎链球菌(PISP):13.85%].对头孢噻肟耐药率最低为9.96%(23/231),其次阿莫西林为12.55%(29/231).对红霉素耐药率最高为90.48%(209/231).14岁以下患者PRSP检出率为27.91%(12/43),明显高于成人的PRSP检出率5.38%(10/186).结论 本地区PRSP检出率较2004年前明显增加,并有逐年增加的趋势,肺炎链球菌的耐药性也有逐年上升的趋势.本地区对感染低耐青霉素肺炎链球菌的患者头孢噻肟、阿莫西林可为首选药物.     

Oral antibiotic adverse reactions after penicillin skin testing: multi-year follow-up

BACKGROUND: Long-term follow-up data on adverse drug reactions after oral antibiotic use in penicillin allergy history positive individuals with penicillin skin test done in advance of need are rare. METHODS: Oral antibiotic associated adverse drug reactions in 83 penicillin skin test positive individuals were compared to a sex, age, and length of follow-up matched sample of 166 penicillin skin test negative individuals, all of whom had at least one post penicillin skin test oral antibiotic. The mean post penicillin skin test follow-up interval was 34.5 +/- 16.6 months. There were 1655 total oral antibiotic exposures. RESULTS: In penicillin skin test positive individuals, the adverse drug reaction rate was not significantly different with cephalosporin or non-beta-lactam use (P = 0.12). In penicillin skin test negative individuals the adverse drug reaction rate was significantly lower with cephalosporin vs. non-beta-lactam use (P = 0.005). Penicillin was safely used in penicillin skin test negative individuals. Overall cephalosporins caused fewer adverse drug reactions independent of penicillin skin test status (P = 0.005). CONCLUSIONS: Penicillin skin testing was only able to predict penicillin associated adverse drug reactions in penicillin skin test positive individuals. Excluding accidental penicillin exposure in penicillin skin test positive individuals, non-beta-lactams were associated with adverse drug reactions more often than penicillins or cephalosporins, independent of the penicillin skin test result. Cephalosporins were used as or more safely than non-beta-lactams in both penicillin skin test positive and negative individuals.     

青霉素的应用与细菌耐药性演变的思考

青霉素自1941年用于临床以来，在控制感染性疾病方面起到了重要作用，挽救了无数的生命，但随之出现的严重细菌耐药性，给医学工作者提出了新的挑战。辩证地认识细菌耐药问题，正确合理地使用抗菌药物，已成为人类保护自己生存的一个长期乃至永恒的话题。     

Penicillin-induced lysis in related species of oral streptococci

Treatment of 10 strains representing 5 species of related oral streptococci with penicillin G resulted in measurable levels of cellular lysis. This lysis was dependent on penicillin concentration and cell density. At similar penicillin concentrations and cell densities, the 10 strains demonstrated appreciable differences in their lytic responses. Lysis values for Streptococcus mutans (GS-5 and Ingbritt) and Streptococcus rattus (BHT and FA-1) were greater than those for Streptococcus sobrinus (01 and B13), Streptococcus cricetus (HS6 and AHT), and Streptococcus ferus (8S1 and HD3).     

产黄青霉细胞分化与青霉素生物合成的相关性

目的：通过菌丝细胞在发酵阶段中的分化规律，去了解青霉素生物合成能力的相关性。方法，应用相差显微镜观察产黄青霉在插瓶发酵培养时菌丝形态分化的不同发育阶段。结果：它们分别完成了三个生活循环，每个生活循环中不同分化阶段的菌丝结构东同，功能也不同，结论：根据不同发酵阶段的菌丝细胞分化，可了解和掌握发酵规律。     

低温环境下长效青霉素加温后肌肉注射的效果评价

目的探讨冬季低温环境下长效青霉索加温后肌肉注射的效果。方法采用单盲法，28例（80人次）注射长效青霉素患者采用自身对照，实验组（44人次）把长效青霉素及溶媒放在40℃的电恒温箱加温20-25min后注射，对照组（36人次）室温条件（8～18℃）常规注射。观察两组一次注射成功率、注射过程中疼痛程度、注射后局部疼痛及硬结持续时间。结果两组比较，实验组一次注射成功率高，注射过程中疼痛程度轻，注射后局部疼痛及硬结持续时间短，两组差异有极显著意义（P〈0．01）。结论低温环境下长效青霉素加温后注射可以提高注射质量。