抗生剤の髄腔内投与に関する臨床的研究
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概要
- 論文の詳細を見る
On administration of antibiotics by the intrathecal or intraventricular route for purposes of meningitis therapy,it is necessary to decide the dosage by considering the concentration in the regions where the dispersion of antibiotic is worst. For the purpose of investigating the antibiotic concentration in CSF at the region of administration and at remote regions gentamycin (GM) or sulbenicillin (SBPC) were administered in the CSF cavity to 16 cases who did not have CSF circulation disorders and the concentration was measured in CSF in several regions.The lowest antibiotic level in cases of intraventricular administration was in the lumbar CSF the highest concentration.Among them being 0.18±0.09% of dose concentration which was calculated theoretically as the concentration of antibiotic in 1 ml solution. The highest concentration in the CSF collected at the same time from ths chiasmatic cistern was 0.22-0.83%.With intrathecal administration, the concentration was lowest in the ventricle, the highest concentration among them being 0.05±O.O2%. The highest concentrations in the upper cervical CSF were 1.14±0.39%.Severe side effects observed when administering antibiotics in the CSF cavity are disturbances of consciousness,respiratory and circulatory disorders and other brain stem symptoms. During the 5 years from 1971 to 1976 at the Department of Neurosurgery, the number of cases who were treated by administration of antibiotics in the CSF cavity either during meningitis or clinical research was approx. 70, and in two cases among these transient brain stem symptoms were observed. Also observed were cases who developed light degree intraventricular bleeding, or vomiting, and diffuse flashing of skin, but there were no fatalities or cases of aftereffects. Based on the literature or on the experiences in this department, the safe dosage when administering antibiotics in the CSF cavity should be 50 mg or less for CET, CER and SBPC, and 12 mg or less for GM.
- 日本脳神経外科学会の論文
- 1978-11-15