ペニシリン系およびセフェム系抗生物質の扁桃内移行に関する研究

A Study of Penicillin and Cephem Antibiotic Concentration in the Tonsil

I．はじめに

　我々が抗生物質療法を行う場合に，使用する抗生物質がもつ抗菌スペクトラム，抗菌力，作用機作などと同時に体内動態，とくに対象臓器への移行度を知っておくことはその薬剤の投与方法や投与量を決める際に重要な参考資料となる。

　筆者らは現在までに各種抗生物質の扁桃組織への移行の実態を測定し，その値を基準として扁桃炎に対する投与方法や投与量の基準を作るという検討を重ね，その成果を報告してきた^1〜3）。今回は，ペニシリン系のAmpicillin（ABPC），セフェム系のCephacetrile（CEC）およびCefmenoxime（CMX）の3薬剤について扁桃への移行度および扁桃炎に対する使用方法について検討を加えたので報告する。

　In chemotherapy for tonsillitis, it is important to determine the pertinent doses of antibiotics. As a basic investigation on this problem, the concentration changes of antibiotics in serum and in the tonsil were studied after intravenous administration. During tonsillectomy performed under general anesthesia, 30mg/kg of ABPC, CEC and CMX were administered intravenously to the patients and the blood and a part of the tonsil were sampled at scheduled intervals. The number of patients were 5 for ABPC, 5 for CEC and 3 for CMX.

　In general, tonsillar concentrations were approximately 10-15% of serum concentrations, but CMX showed the highest uptake and the next was CEC. Fitting curve functions were computed from the data obtained, then concentration curves in the tonsil were simulated for intravenous drip injection by a microcomputer. This simulation suggested that two hours drip administration could maintain a concentration of 1.56pg/g in the tonsil for much longer than one hour drip injection or one shot administration.