呼吸
词汇介绍
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解析
Amikacin /'æmikəsin/
释 义 n. 阿米卡星
例 句 The pharmaceutics of Amikacin (AMK) in old patients with respiratory system infections was studied to provide a basis for clinical use. 研究阿米卡星(AMK)在老年呼吸系统感染患者体内的药动学,为临床合理用药提供依据。
概述
药物概述
阿米卡星对多种革兰阴性杆菌、革兰阳性球菌、铜绿假单胞菌及若干分枝杆菌属具有较强的抗菌活性。对多数细菌的作用与卡那霉素相似或略优,较庆大霉素为差,对厌氧菌无效。本品最突出的优点是对许多肠道革兰阴性杆菌和铜绿假单胞菌所产生的乙酰转移酶、磷酸转移酶和核苷转移酶等稳定,因此在临床分离的肠杆菌科细菌中,约70%以上对庆大霉素、妥布霉素和奈替米星等耐药的菌株对本品仍敏感。主要用于对庆大霉素等耐药的细菌感染,或在庆大霉素耐药性普遍存在的医院中作为首选药物。粒细胞减少或其他免疫缺陷患者合并严重革兰阴性杆菌时,与β-内酰胺类抗生素联用(如哌拉西林或头孢菌素类)比单药疗效更为可靠。肌注或静滴:成人 0.4g/d,分1~2 次肌注。静脉给药适用于严重染患者,剂量与肌注相同,每次滴注时不少于 1h。分类化学:氨基糖苷类。治疗学:抗菌药物
作用对象及机制
氨基糖苷类对各种需氧革兰阴性杆菌包括大肠埃希菌、铜绿假单胞菌、变形杆菌属、克雷伯菌属、肠杆菌属、志贺菌属和枸橼酸杆菌属具有强大的抗菌活性;对沙雷菌属、沙门菌属、产碱杆菌属、不动杆菌属和嗜血杆菌属也有一定抗菌作用;对淋病奈瑟菌、脑膜炎奈瑟菌等革兰阴性球菌作用较差;对各组链球菌作用微弱,对肠球菌和厌氧菌不敏感。氨基糖苷类的抗菌机制主要是抑制细菌蛋白质合成,还能破坏细菌胞质膜的完整性。
相互作用
本品与半合成青霉素类或头孢菌素类联合常可获协同作用,如与哌拉西林联合对铜绿假单胞菌有协同作用,与头孢菌素类联合对肺炎杆菌有协同作用。
药动学
本品在体内各脏器的分布浓度由高到低依次为肾、血清、肺、脑,因此适用于尿路感染和呼吸道感染。不易透过血脑屏障,即使在脑膜有炎症时,脑脊液中也达不到有效浓度。
注意事项
(1)用药期间应定期检测肾功能和尿常规。(2)肾功能不全患者应减少剂量或延长给药间隔时间。(3)不宜与其他伤肾药物联用。
PCR检测16S rRNA基因快速诊断新生儿败血症,而大肠杆菌为主的EOS病例血培养和PCR结果相似
发表时间:2019-10-02
影响指数:3.0
作者: Mostafa I EL-Amir
期刊:Infect Drug Resist
Gram-negative bacteria isolated from blood culture showed antibiotic susceptibility to ofloxacin, ciprofloxacin, imipenem, and amikacin, and marked resistance to ampicillin, amoxicillin clavulanic acid, ceftriaxone, piperacillin, cefoxitin, and azithromycin. According to Gram-positive bacteria, they showed marked susceptibility to vancomycin followed by imipenem, then oxacillin, and amikacin. On the other hand, Gram-positive bacteria showed marked resistance against ampicillin, amoxicillin clavulanic acid, ofloxacin, ceftriaxone, and ciprofloxacin. E.coli which was the commonest organism isolated from EOS cases showed susceptibility to ofloxacin, ciprofloxacin, imipenem followed by amikacin, while S. aureus which was the commonest cause for LOS showed susceptibility to vancomycin followed by oxacillin and imipenem. Our results are similar to those of another study from Egypt, which found that imipenem and quinolones are the best antibiotics against Gram-negative bacteria, while 100% of the Gram-positive bacteria were susceptible to vancomycin.
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