The in vitro elution characteristics of vancomycin and tobramycin from calcium sulfate beads

The purpose of this study was to determine the elution characteristics of vancomycin and tobramycin when mixed with calcium sulfate to form antibiotic beads. Calcium sulfate was combined with vancomycin and tobramycin separately to form 2 types of antibiotic beads, which were packaged and labeled separately. The packaged calcium sulfate beads with vancomycin and tobramycin were then gas sterilized. The beads were placed in phosphate-buffered saline and kept at 36 degrees C for 6 weeks. Two separate series of assays were run simultaneously for both types of beads. In one assay, a bead containing vancomycin was placed in a fresh vial of phosphate buffered saline after each assay. The same was done with beads containing tobramycin. In the second series of assays, 9 vials of phosphate buffered saline each containing 1 vancomycin bead and 9 vials of phosphate buffered saline each containing 1 tobramycin bead was arranged. The phosphate-buffered saline was then assayed at predetermined times for both the vancomycin bead series and the tobramycin bead series. The amount of vancomycin and tobramycin assayed nearly equaled the calculated amount of antibiotic per bead measured before bead construction. Also, the elution of antibiotic from the calcium sulfate was complete within 72 hours. In conclusion, the construction and gas sterilization of calcium sulfate beads containing vancomycin and tobramycin does not destroy vancomycin and tobramycin. Also, the complete elution of available vancomycin and tobramycin in calcium sulfate beads occurs within 72 hours.     

Atracurium and vecuronium interaction with gentamicin and tobramycin

Drug interactions between the aminoglycosides (tobramycin and gentamicin) and atracurium and vecuronium were studied prospectively in 44 patients. Twenty-two patients had therapeutic serum levels of tobramycin or gentamicin and 22 served as controls. Onset time, clinical duration, and time to spontaneous recovery of T4/T1 ratio of 0.70 after atracurium or vecuronium injection were measured. No statistically significant differences were found in onset time, but clinical duration and time to recovery were significantly longer in patients receiving tobramycin or gentamicin and paralyzed with vecuronium than for controls (P less than 0.01 for clinical duration and P less than 0.0005 for recovery). The neuromuscular block produced by atracurium was not significantly influenced by the presence of therapeutic serum levels of tobramycin or gentamicin. We conclude that for patients treated with these antibiotics, atracurium may present some advantages over vecuronium when a prolonged block is not desired.     

高效液相色谱—间接光度检测法同时测定血清和尿中5种氨基苷类抗生素

目的：建立一种直接分离测定体液中庆大霉素、丁胺卡那霉素、妥布霉素、西梭霉素和乙基西梭霉素等５种氨基苷类抗生素的高效液相色谱－间接光度检测（ＨＰＬＣ－ＩＰＤ）法。方法：在流动相中加入具有紫外检测响应的检测剂烟酰胺,用紫外检测器直接测定紫外吸收很差的上述５种药物。Ｃ１８固定相,流动相为含烟酰胺０５ｍｍｏｌ·Ｌ－１、庚烷磺酸钠５ｍｍｏｌ·Ｌ－１和磷酸００５ｍｏｌ·Ｌ－１的甲醇－乙腈－水（２７∶１８∶５５）混合溶液。结果：血清和尿样平均回收率均大于９６％,日内和日间ＲＳＤ均小于６％。并测定了肌注此类药物病人的血清和尿样品。结论：该法适于体液中氨基苷类药物检测。     

妥布霉素有关物质薄层色谱测定法的改进

对美国药典24版中妥布霉素的色谱纯度检查方法进行改进，使用自制薄层硅胶板达到该药典的分离检测要求。     

动态浊度法定量测定妥布霉素中细菌内毒素含量的可行性研究

目的:应用动态浊度法鲎试验定量测定妥布霉素原料药中细菌内毒素.方法:通过对样品添加定量的标准内毒素进行干扰预试验,当回收率为50%～200%时从中筛选出最佳的检测浓度,然后进行3批样品的正式干扰试验.结果:将妥布霉素制备成浓度为0.125 mg·mL-1可排除干扰;3批样品在浓度为0.125 mg·mL-1时的回收率分别为118.5%,131.2%,146.3%.结论:动态浊度法鲎试验可有效地测定妥布霉素原料药中细菌内毒素含量,且方法简便,结果可靠,可用于有效的日常检查.     

妥布霉素地塞米松眼膏联合茶树油清洁湿巾治疗蠕形螨睑缘炎

目的：探讨妥布霉素地塞米松眼膏联合缘螨净茶树油清洁湿巾治疗蠕形螨睑缘炎的治疗效果。

方法：前瞻性临床研究。选取蠕形螨睑缘炎患者72例,随机分为3组,试验组给予妥布霉素地塞米松眼膏联合缘螨净茶树油清洁湿巾治疗,对照1组给予妥布霉素地塞米松眼膏联合茶树油眼膏治疗,对照2组给予茶树油眼膏治疗。治疗30d后,对患者进行症状评分、拔睫毛螨虫计数及裂隙灯下观察临床体征评分。比较三组治疗前后数据。

结果：三组治疗前后蠕形螨计数均有差异(P<0.01),症状总评分差值有差异(F=20.05,P<0.01),体征总评分差值有差异(F=8.10,P<0.01)。

结论：妥布霉素地塞米松眼膏联合缘螨净茶树油清洁湿巾治疗蠕形螨睑缘炎疗效显著,茶树油清洁湿巾具有便携、易保存、不易变质的特点。     

药物联合物理疗法治疗MGD所致干眼的疗效观察

目的：比较左氧氟沙星眼凝胶与妥布霉素地塞米松眼膏治疗睑板腺功能障碍(MGD)所致的蒸发过强型干眼的疗效。

方法：将确诊为MGD所致干眼(蒸发过强型)180例360眼患者随机分组。A组应用左氧氟沙星眼凝胶+玻璃酸钠滴眼液治疗; B组采用妥布霉素地塞米松眼膏+玻璃酸钠滴眼液治疗。A、B两组患者均采用综合治疗：用棉棒挤压排出阻塞在睑板腺管内的分泌物,每周1次,连续4wk为一个疗程; 热毛巾湿热敷眼睑,水温45℃左右,每天3次,每次15min,使残留在睑板腺管内的油脂稀薄软化脂质排出。每次眼睑湿热敷完毕后,A组将左氧氟沙星眼凝胶滴入结膜囊内并涂抹在眼睑睫毛根部,B组将妥布霉素地塞米松眼膏涂抹在眼睑睫毛根部,两组患者均滴玻璃酸钠滴眼液每天4次。观察患者术后的疗效。

结果：两组患者治疗后,临床症状评分、分泌物性状评分、泪膜破裂时间评分和泪液分泌试验评分差异均无统计学意义(Z_症状=-0.64,P_症状=0.524; Z_分泌物=-1.37,P_分泌物=0.171; Z_破裂时间=-1.06,P_破裂时间=0.288; Z_分泌时间=-1.06,P_分泌时间=0.288)。角膜荧光染色评分：A组治愈83.3%,好转11.1%,无效5.6%; B组治愈55.6%,好转27.8%,无效16.7%; A组疗效优于B组(Z=-4.02,P<0.001)。

结论：治疗MGD所致的蒸发过强型干眼,以物理疗法为主,药物治疗为辅,除了患病时间长、病情严重的患者可短期使用妥布霉素地塞米松眼膏外,一般均使用左氧氟沙星眼凝胶完全能达到消炎抗菌、安全稳定、无毒副作用的治疗效果,二者药物之间在治疗效果没有明显的差异。     

复方妥布霉素滴眼液与普南扑灵滴眼液在儿童斜视术后的疗效观察

目的比较复方妥布霉素滴眼液及普南扑灵滴眼液在儿童斜视术后的抗炎效果及安全性。方法征得患儿父母同意,87例（174眼）3～11岁儿童经全身麻醉或局部麻醉下行双眼斜视术矫正后,随机一眼用普南扑灵滴眼液,另一眼用复方妥布霉素滴眼液,自术后第1天开始,每天4次,持续4周,比较两种滴眼液在术后的抗炎作用及对眼内压的影响。结果两种滴眼液对术后炎症反应均有显著的抑制作用,其抗炎效果比较差异无统计学意义（P〉0.05）,复方妥布霉素滴眼液组有明显的升高眼内压作用,普南扑灵组无明显的升高眼内压作用,两者比较差异有统计学意义（P〈0.01）。结论两种滴眼液均对儿童斜视术后有较好的抗炎作用,但普南扑灵无明显的升高眼内压作用。     

泪道探通术联合妥布霉素滴眼液治疗先天性泪囊炎

目的:探讨泪道探通术联合妥布霉素滴眼液治疗先天性泪囊炎的临床疗效。方法:选取2017-01/2019-06来我院就诊的先天性泪囊炎患儿228例250眼作为研究对象,年龄为6月龄~3岁。按年龄分为3组:6月龄~<1岁133例149眼,1~<2岁62例64眼,2~3岁33例37眼。三组均实施表面麻醉下泪道探通术联合术后妥布霉素滴眼液治疗。结果:先天性泪囊炎患儿中6月龄~<1岁治愈率为97.3%(145/149),1~<2岁治愈率为92.2%(59/64),2~3岁治愈率为83.8%(31/37),无不良事件发生。三组患儿治愈率比较,6月龄~<1岁患儿治愈率最高(P=0.009)。结论:泪道探通术治疗先天性泪囊炎疗效显著,术后联合妥布霉素滴眼液安全可靠。以6月龄~1岁为最佳治疗时机,其手术操作简单,并发症少,具有较高的临床价值。