甲磺酸吉米沙星对泌尿道常见致病菌的PK-PD研究

目的：开展吉米沙星对泌尿道常见致病菌的药动学／药效学研究。方法：测定吉米沙星对临床分离的泌尿道常见致病茵的最小抑菌浓度及最低杀菌浓度；测定健康受试者口服甲磺酸吉米沙星片320mg后尿药浓度并计算Cmax／MIC90和AUC24h／MIC90。结果：吉米沙星对临床分离的泌尿道常见致病茵的敏感率较低。健康受试者口服甲磺酸吉米沙星片320mg后尿药峰浓度C。。。为（144±124）ug／mL，尿药浓度时间曲线下面积AUC24h为（1368±671）肚g·mL-1·h。尿液中吉米沙星对大肠埃希茵、铜绿假单胞菌、粪肠球菌的Cmax／MIC90为2．9～5．8、AUC：4h／MIC90〉30；对肺炎克雷伯菌、屎肠球菌AUC24h／MIC90为19．25。结论：吉米沙星可有效清除泌尿道感染的大肠埃希菌、铜绿假单胞茵、粪肠球菌，并避免耐药茵产生；对肺炎克雷伯茵、屎肠球菌生长有抑制作用。

PK-PD study on gemifloxacin mesylate against common pathogenic bacteria in urinary tract

To carry out PK/PD study of gemifloxacin mesylate against common patho genic bacteria in urinary tract. METHODS： MIC （minimum inhibitory concentration） and MBC （minimum bactericidal concentration） of gemi floxacin against common pathogenic bacteria in urinary tract were determined. Urine concentra tion of healthy subjects after oral administration of gemifloxaein mesylate tablets （320 rag） was determined and then Cmax/MICg0 and AUC24h/ MICg0 were calculated. RESULTS： Gemifloxacin had lower sensitivity to common pathogenic bac- teria in urinary tract. Urinary peak concentra tion （Cm.x） Of gemifloxacin was （ 144 __＋ 124） /2g/mL and the area under urine concentration time curve （AUC24h） was （1368 ＋_ 671） /lg＂ mL-1＂ h after orally administered gemi-floxacin mesylate tablets （320 mg） to healthy subjects. Cmax/MICg0 of gemifloxacin in urine a gainst Escherichia coli, Pseudomonas aeruginosa and Enterococcus faecalis was 2.9- 5. 8 and AUC24h/MICg0 was more than 30, whereas AUC24 h/MICg0 of gemifloxacin against Klebsiella pneumoniae and Enrerococcus feces was 19.25. CONCLUSION. Gemifloxacin could effectively remove Escherichia coli, Pseudomonas aerugino sa and Enterococcus faecalis infected in urinary tract, and avoid resistance. Gemifloxacin could inhibit growth of Klebsiella pneumoniae and En terococcus feces.