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目的 观察部分喹诺酮及硝基咪唑类衍生物抗生素在人胆汁中的代谢特点 ,为临床抗胆道感染合理用药提供实验依据。方法 通过临床行鼻胆管外引流术 (ENBD)直接获取胆汁 ,分别给予环丙沙星、洛美沙星、甲硝唑和替硝唑 ,利用高效液相色谱法 ,连续动态监测各抗生素在胆汁内浓度变化及代谢特点。结果 静脉给药后 0 2 5～ 1 5h各组抗生素浓度上升 :①环丙沙星较洛美沙星上升更明显 (P <0 0 1) ,峰浓度高、半衰期长 ;②甲硝唑较替硝唑上升更明显(P <0 0 1) ,且峰浓度高、达峰时间短 ,但替硝唑半衰期明显长于甲硝唑。结论 环丙沙星、洛美沙星、甲硝唑和替硝唑均具有在胆汁内达峰时间短、峰浓度高、半衰期长的特点 ,结合临床细菌培养及药敏结果可作为联合抗胆道感染的最佳抗生素选择
Objective To observe the metabolic characteristics of some quinolone and nitroimidazole antibiotics in human bile and provide experimental basis for the rational use of anti-biliary tract infection. Methods The bile was directly obtained by clinical nasobiliary external drainage (ENBD), and were given ciprofloxacin, lomefloxacin, metronidazole and tinidazole respectively. The contents of antibiotics in bile were continuously monitored by high performance liquid chromatography Concentration changes and metabolic characteristics. Results The concentrations of antibiotics in each group increased from 0 2 5 to 1 5 h after intravenous administration. ① Ciprofloxacin increased more significantly than that of lomefloxacin (P <0.01) with high peak concentration and long half-life; The increase of nidazole was more obvious (P <0.01), and the peak concentration was high and the peak time was short, but the half-life of tinidazole was longer than that of metronidazole. Conclusion Ciprofloxacin, lomefloxacin, metronidazole and tinidazole all have the characteristics of short peak time in bile, high peak concentration and long half-life. Combined with clinical bacterial culture and drug susceptibility results can be combined as anti-biliary tract infection The best antibiotic choice