全身投与された抗生剤の経時的髄液移行に関する実験的および臨床的研究
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概要
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The authors have surveyed the causative bacteria for postoperative meningitis past four years (1972-1975),and obtained the result that 78% of those was gram-negative bacteria.Ten dogs were given single shot injection of either Cephalothin (CET), Chloramphenicol (CP) or Sulbenicillin (SB-PC), and the blood and the cerebrospinal fluid concentration of these drugs were measured. The results revealed that Chloramphenicol was higher than Cephalothin or Sulbenicillin in cerebrospinal fluid concentration.The antibiotics were administered subcutaneously or intravenously to patients with aneurysm of cerebral artery,head injury, tumor near pituitary gland or hydrocephalus who had continuous ventricullar drainage and were comparatively stable in condition. The transit of antibiotics to the cerebrospinal fluid were measured for six hours.As the result, Cefazolin (CEZ) moved in the most and Cephaloridine (CER) did in more than Cephalothin.The transit of Sulbenicillin and Gentamicin (GIVE) were not sufficient. The maximum values of each antibioticsfound in the cerebrospinal fluid were as follows; 2.6 mcg/ml after subcutaneous injection of 1g CEZ, 0.58 mcg/ml after intravenous single shot injection of 2g CER and 0-3.6 mcg/ml after intravenous drip injection of 2g CET.The transit of Gentamicin and Sulbenicillin to cerebrospinal fluid was not recognized. These values are not enough to maintain MIC (minimum inhibitory concentration for growth of bacteria) for gram-negative bacteria.From those data, it is advisable to administer a large dosis of antibiotics systemically for certain length of time.Considering the side-effects caused by the large dosis administration of antibiotics systemically, it is necessary to treat the intracranial infection with both systemic administration and the intrathecal administration of anti-biotics.
- 日本脳神経外科学会の論文
- 1978-11-15