亚胺培南/西司他丁钠致老年患者癫痫样发作1例

1例老年男性患者因脑梗死合并肺部感染接受"头孢唑肟"抗感染治疗10 d后未治愈,换用亚胺培南/西司他丁钠(泰能,0.5 g,q8h)治疗d 3出现癫痫样发作,考虑系该药物的不良反应。本例患者出现癫痫样发作可能与患者年龄大且合并有肾功能不全有关,更换美罗培南后避免了患者癫痫样发作等严重不良反应的发生。     

对头孢唑肟钠致3例溶血的分析

目的：对临床发生的3例头孢唑肟钠致溶血进行分析,为临床合理、安全使用该药提供参考。方法：收集本院2015年1月至2017年12月上报的3例头孢唑肟钠致溶血性贫血不良反应（ADR）报告,探讨发生原因。结果：溶血性贫血是头孢唑肟钠少见的不良反应,但老年患者仍需加强重视,防止漏诊、误诊。结论：使用头孢唑肟钠时需避免超剂量、超适应症用药,使用过程中对患者用药情况监护,防止溶血性贫血造成严重危害。     

39例头孢唑肟钠注射剂的不良反应分析

目的 通过对39例头孢唑肟钠注射剂引起的不良反应报告进行分析,探讨头孢唑肟钠注射剂不良反应发生的规律和临床表现,提示临床注意监测其不良反应,避免严重后果.方法 对39例头孢唑肟钠注射剂引起的不良反应进行统计和分析.结果 女22例,男17例,女性多于男性;患者年龄在0～50岁之间,其中10岁以下儿童发生率最高,为46.15%;静脉滴注给药38例（97.44%）,肌内注射给药1例（2.56%）;头孢唑肟钠注射剂的主要不良反应是过敏反应（66.67%）,此外还可引起过敏性休克、呼吸系统损害等较少见的、严重的不良反应.结论 要合理使用头孢唑肟钠注射剂,避免和减少不良反应的发生.     

基于中国医院药物警戒系统评价儿童应用头孢唑肟的安全性

目的:借助中国医院药物警戒系统(CHPS)的真实世界数据,评价某院儿童使用头孢唑肟的安全性,并分析头孢唑肟相关药物不良反应(ADR)发生情况及影响因素。方法:基于CHPS平台,对我院2018年2月至2020年4月使用头孢唑肟的住院患儿进行单中心回顾性主动监测,药师对系统监测病例进行评定,获得头孢唑肟ADR发生率,并对ADR影响因素进行分析。结果:系统共回顾性监测了2 948例使用头孢唑肟的患儿,31例出现ADR,ADR发生率为1.09%。多因素logistic回归分析显示,头孢唑肟联合氟氯西林、单次用药剂量是儿童使用头孢唑肟发生ADR的独立影响因素。结论:头孢唑肟在儿童用药中发生ADR并不少见。减少与氟氯西林联合用药、根据说明书推荐剂量用药有助于降低临床用药风险,CHPS系统的应用对今后进行大样本量真实世界用药评价具有重要意义。     

乳酸左氧氟沙星与头孢唑肟对急性水肿型胆源性胰腺炎患者抗感染治疗的临床疗效比较

目的:比较乳酸左氧氟沙星与头孢唑肟分别对急性水肿型胆源性胰腺炎(AEBP)抗感染治疗的临床疗效以及对炎性因子水平改善的影响.方法:选取医院2018年7月-2020年7月间收治的AEBP患者84例,按治疗用药的不同将其分为头孢唑肟组42例和左氧氟沙星组42例;头孢唑肟组患者予以注射用头孢唑肟治疗,左氧氟沙星组患者给予注射用乳酸左氧氟沙星治疗;比较两组患者治疗后的临床疗效、临床相关指标复常时间的差异,以及治疗前后各炎性因子水平测得值的变化情况和用药期间不良反应发生情况.结果:两组患者治疗后的总有效率经组间比较其差异无统计学意义(P＞0.05);左氧氟沙星组患者用药后的临床症状、血液淀粉酶、血常规复常时间均早于头孢唑肟组(P＜0.05),白细胞(WBC)计数和C反应蛋白(CRP)水平测得值低于头孢唑肟组(P＜0.05);两组患者用药期均未发生严重不良反应.结论:乳酸左氧氟沙星与头孢唑肟分别用于AEBP患者治疗中均可取得理想治疗效果,但乳酸左氧氟沙星对炎症因子水平的改善时间更早,临床症状缓解更快,且安全可靠.     

头孢唑肟致不良反应33例文献分析

目的:总结和探讨头孢唑肟所致各种不良反应的一般规律、特点及其发生机制,以期促进临床合理用药。方法:在中国期刊全文数据库(CNKI)中以"头孢唑肟"及其商品名为关键词,检索1994年1月—2012年12月期间与头孢唑肟相关的不良反应报道,并进行回顾性总结和分析。结果:共检索和筛选33例病例,男女比例约为2∶1,儿童及老年人构成比较高,以过敏反应为主,部分病例出现神经系统反应。结论:应用头孢唑肟时,应严格掌握适应证及用量,加强用药监护和指导,对高敏体质和特殊患者实行重点监护,确保用药安全。     

头孢唑肟致相对严重不良反应19例文献分析

目的:探讨头孢唑肟致不良反应(ADR)的一般规律及特点,避免严重ADR发生,促进临床合理有药。方法:检索中国期刊全文数据库公开发表的1994年1月-2010年9月有关应用头孢唑肟致相对严重ADR的文献,并进行回顾性分析。结果:头孢唑肟致相对严重ADR在60岁以上人群中发生率较高(占52.6%),且多发于连续长时间用药后(10d后占36.8%);临床表现以变态反应为主(占73.7%),其次是神经系统、血液系统。结论:对老年患者应根据病情适当调整剂量,用药前应详细询问患者的过敏史,用药时应对高敏体质患者和特殊患者实行重点监护,严格掌握用药指征,规范用药剂量和时间,切实做好用药期间的全程监护,确保用药安全。     

头孢唑肟钠引起急性血小板减少

1例32岁女性患者,因发热腰痛4 d入院,诊断为急性肾盂肾炎,予静脉点滴头孢唑肟钠(2 g,bid)治疗。用药第2天患者出现血小板急剧下降,无出血,立即停用头孢唑肟钠,患者血小板在1周内逐渐恢复正常。本文分析并总结头孢菌素类药物引起血小板减少的可能发生机制及血小板变化特点,以引起临床关注。     

医院内获得性肺炎抗菌药物的疗效和安全性比较

目的:比较头孢唑肟钠/莫西沙星,头孢哌酮钠/舒巴坦钠和头孢唑肟钠治疗医院内获得性肺炎(HAP)的有效性和安全性.方法:203例HAP患者随机分为Ⅰ、Ⅱ、Ⅲ组.Ⅰ组患者给予盐酸莫西沙星注射液400 mg,qd;注射用头孢唑肟钠2~4 g,bid.Ⅱ组患者给予注射用头孢哌酮钠舒巴坦钠(2:1)1~2 g,bid.Ⅲ组患者给予注射用头孢唑肟钠2~4 g,bid.主要疗效指标是在治疗期结束后患者的临床症状,次要观察指标为不良反应和细菌学反应.结果:头孢唑肟钠/莫西沙星、头孢哌酮钠舒巴坦钠、头孢唑肟钠的临床有效率分别为91.9%、89.7%和78.7%.治疗结束后,头孢唑肟钠/莫西沙星和头孢哌酮钠舒巴坦钠对痰液细菌的清除率显著高于头孢唑肟钠.3组药物的不良反应无明显差异.与头孢唑肟钠单独用药相比,头孢菌素联合喹诺酮类或β-内酰胺酶抑制剂的抗菌疗效更佳.结论:头孢菌素联合喹诺酮类药物或β-内酰胺酶抑制剂可作为临床治疗HAP的优选用药方案.     

癫痫患者CYP2D6~* 10基因多态性分析

目的:通过比较本地区健康人与癫痫患者CYP2D6*10基因多态性的差异,探索CYP2D6*10基因多态性与癫痫易感的关系。方法:应用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)方法检测健康人和癫痫患者CYP2D6*10的基因型分布及等位基因频率,通过χ2检验来比较健康人和癫痫患者的基因型分布差异和等位基因频率差异。结果:健康人和癫痫患者的基因型分布及等位基因频率差异有显著性和高度显著性(P<0.05和P<0.01)。结论:癫痫病的发生与CYP2D6*10的碱基变异具有相关性。     

小柴胡汤加减治疗慢性胆囊炎104例疗效观察

目的探讨观察中医药小柴胡汤与西药抗生素治疗慢性胆囊炎的疗效。方法选取本院2011年4月至2012年4月收治的104例慢性胆囊炎患者,随机分中医药小柴胡汤组58例,西药抗生素头孢唑肟组46例进行治疗观察。结果中医药小柴胡汤组治疗有效率91.31%,头孢唑肟组有效率80.31%。两组在临床治疗结果有显著性差异,经统计学分析处理,P<0.05,具有统计学意义。结论通过中医药小柴胡汤治疗组与西药组的治疗结果对比,说明小柴胡汤治疗慢性胆囊炎优于西药的治疗结果,且不良反应也小于对照组。因此值得临床推广应用。     

Ceftizoxime. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use

Ceftizoxime is a 'third generation' cephalosporin administered intravenously or intramuscularly. Like other third generation cephalosporins it has a wide spectrum of in vitro activity against Gram-positive and Gram-negative bacteria, is particularly active against Enterobacteriaceae (including beta-lactamase-positive strains), and is resistant to hydrolysis by beta-lactamases. However, the third generation cephalosporins are less active than earlier cephalosporins against staphylococci and so could not be considered the drugs of choice. Like many currently available third generation cephalosporins, ceftizoxime has limited activity against Pseudomonas aeruginosa, and thus cannot be recommended as sole treatment of known or suspected non-urinary tract pseudomonal infections. Similarly, although favourable clinical results have been obtained in patients treated with ceftizoxime for infections caused by mixed aerobic/anaerobic organisms (such as intra-abdominal, and obstetric and gynaecological infections), the relatively low in vitro activity of ceftizoxime (in common with most other third generation cephalosporins) against Bacteroides fragilis and enterococci may restrict its usage in situations where these organisms are the suspected or proven pathogens. Ceftizoxime appears to be similar in efficacy to several other cephalosporins in lower respiratory tract infections in elderly and/or debilitated patients, and in chronic and/or complicated urinary tract infections, 2 clinical situations in which third generation cephalosporins may have a major role. Ceftizoxime is also effective clinically and bacteriologically in skin, soft tissue, bone and joint infections, septicaemia/bacteraemia, meningitis and neonatal infections. However, a few large, well designed clinical comparisons of efficacy with aminoglycosides are needed before ceftizoxime can be recommended as an alternative in patients in whom potential aminoglycoside toxicity is a concern. Single intramuscular doses of ceftizoxime appear similar in efficacy to aqueous procaine penicillin G in gonorrhoeae due to nonpenicillinase-producing Neisseria gonorrhoea, and ceftizoxime is also highly effective against penicillinase-producing strains. Although only a few infections have been treated to date, ceftizoxime may be useful in the treatment of gonorrhoea in places where penicillinase-producing strains are common. Thus, ceftizoxime appears to be an effective addition to the growing number of third generation cephalosporins. However, further studies are needed to confirm its relative efficacy compared with other new cephalosporins, in particular cefotaxime.(ABSTRACT TRUNCATED AT 400 WORDS)     

抗生素头孢唑肟丙匹酯的合成研究

目的研究抗生素头孢唑肟丙匹酯的合成方法。方法以头孢唑肟酸为原料经三步反应合成头孢唑肟丙匹酯。结果目标化合物总收率41.5%,结构经1H-NMR和MS确证。结论用本法合成头孢唑肟丙匹酯,原料易得,操作简便,易于工业化生产。     

头孢唑肟治疗重症和难治性感染及淋球菌感染的临床研究

本文报告头孢唑肟治疗72例感染性疾病的临床和实验研究。重症和难治性感染57例,临床治愈率为74％,总有效率为89.5％,细菌总清除率为82.1％。体外敏感度试验和血清杀菌试验均显示对多数致病菌的高度敏感性。头孢唑肟治疗淋球菌感染15例,临床有效率100％。部分经治疗患者的体液药物浓度测定麦明,头孢唑肟的组织渗透性较好,对多种细菌感染疗效满意。毒副作用轻,而主要是由于大剂量或长疗程所致。     

头孢唑肟钠注射剂治疗呼吸和泌尿系统感染多中心临床研究

目的以头孢噻肟钠注射剂作对照,评价头孢唑肟钠注射剂治疗敏感菌引起的呼吸和泌尿系感染的有效性和安全性。方法用多中心、随机单盲、平行对照的试验方法,头孢唑肟钠注射剂,每次2-3g,每日2次;头孢噻肟钠注射剂,每次2-3g,每日2次,两组的疗程均为7-14天。头孢唑肟钠组临床可评价病例为62例,细菌学疗效评价例数为54例,药物不良反应例数为66例;头孢噻肟钠组分别为61,50,64例。结果试验药组和对照组的临床有效率分别为87.10％和85.25％;细菌清除率分别为85.19％和86.00％,药物不良反应发生率分别为6.06％和7.81％。结论头孢唑肟钠注射剂是治疗中重度感染的安全有效药物。     

头孢唑肟酯的合成研究

头孢唑肟酯是头孢唑肟的前体药,口服后能够表现出更理想的胃肠吸收,本文以头孢唑肟钠为原料,从制备特戊酸碘甲酯开始,经酯化反应后简单处理,直接制得纯度较好的头孢唑肟酯,本制备方法简便,适于工业化生产。     

Fundamental and clinical studies of ceftizoxime in obstetrical and gynecological field

This paper, is concerned with fundamental and clinical studies of ceftizoxime, a newly developed cephalosporin derivative, in the field of obstetrics and gynecology. 1. Concentrations of ceftizoxime after administration 1 g of ceftizoxime by 1 hour drip infusion were determined in genital organs in 17 patients and the exudate of pelvic dead space in 6 patients. Simulated maximal concentrations with the ratios to the simulated peak serum levels were as follows: 27.9 micrograms/g for fundal myometrium with the ratio of 48%, 36.0 micrograms/g for portio vaginalis with 62%, 17.1 micrograms/g for ovary with 29%, 15.0 micrograms/g for oviduct with 26% and 16.2 micrograms/ml for the exudate of pelvic dead space with 30%. 2. Minimal inhibitory concentrations of ceftizoxime were determined against clinically isolated organisms from female genital infectious diseases. Ceftizoxime was found to have a potent in vitro activity against Gram negative bacilli; for example, 0.1 microgram/mg or low against E. coli and K. pneumoniae. Against P. aeruginosa, P. cepacia and b. fragilis, ceftizoxime had an activity which expected to be effective in the clinical use. 3. We gave ceftizoxime to 6 patients comprising 4 patients with puerperal fever, 1 with septic abortion and 1 with tubo-ovarian abscess in daily doses of 2 to 3 g by b.i.d or t.i.d intravenous drip infusion for 4--12 days. The results of the treatment were 'excellent' in 3 patients, 'good' in 2, and 'unevaluatable' in 1. 4. Adverse reactions occurred in 2 patients who showed eruption during the medication with ceftizoxime. These patients had allergic histories due to penicillin derivatives. From the above results it is concluded that ceftizoxime is a useful drug for infections in obstetrical and gynecological field.     

头孢唑肟钠生产工艺及条件的研究

目的:对头孢唑肟钠生产过程进行研究。方法:以粗品7-氨基-3-烷基头孢烷酸和AE活性酯为原料合成头孢唑肟酸,再与无水碳酸钠反应制得头孢唑肟钠;同时研究反应时间、乙醇用量和滴加时间、无水碳酸钠的用量以及pH值对产品质量的影响。结果:反应过程完全可以实现,合成头孢唑肟钠的适宜工艺参数为反应时间1.5h,乙醇滴加速度400mL.h-1,反应温度30℃以下,乙醇与头孢唑肟酸用量比30mL∶1g,无水碳酸钠与头孢唑肟酸的质量比0.15∶1.00,溶液pH值6.9±0.1。结论:该工艺切实可行,为头孢唑肟钠工业化生产提供了可靠的依据。