CZXの前立腺および膀胱壁内移行に関する検討

Abstract

前立腺肥大症患者21例につき手術中CZX 1 g静注後の前立腺, 膀胱壁内濃度を経時的に測定した.1)通常施行される前立腺摘除術では, 薬剤の血清濃度は30%高値を示し, 排泄が遅れる傾向が見られた.2)血清, 前立腺, 膀胱壁内濃度は静注30分で最高値に達し, 以後漸減した.3)前立腺腺腫内濃度と血清濃度比は静注2時間で0.91と他剤に比し移行性がすぐれていた.4)腺腫内円形細胞浸潤の程度の強いものに組織内濃度が高い傾向が認められた.5)前立腺腺腫の組織型では腺性優位型が混合型に比し高い組織内濃度を示した.6) CZXの発育阻止濃度から考え, 一般の前立腺炎の起炎菌に対し有効性が期待できるが, Enterobacter, S. epidermidisなどに対しては投与後120分しか有効濃度を維持しえず, 他剤併用など考える必要がある

Prostatic and vesical tissue levels of Ceftizoxime (CZX) were determined in 21 patients with prostatic hyperplasia after the intravenous administration of 1 g of CZX. Serum concentration on prostatic surgery continued to be 1.3 fold higher than that of healthy adults. Prostatic tissue levels attained a peak of 40.7 +/- 1.6 micrograms/g (mean +/- SE) at 30 minutes after administration and vesical tissue levels attained a peak of 72.4 +/- 24.8 micrograms/g at 30 minutes. The mean value was 21.0 +/- 6.4 micrograms/g in prostatic tissue after administration for 120 minutes with the tissue/serum ratio of 0.91. Prostatic tissue level in glandular dominant were slightly higher than those of myoglandular hyperplasia (P less than 0.1). Judging from its favorable transfer into the prostatic tissue and MIC against clinically isolated E. coli, Proteus sp. and Klebsiella, CZX seemed to be clinically useful in the treatment of prostatic infection.