Latamoxef(LMOX),Cefoperazone(CPZ),Cefotaxime(CTX)の前立腺移行についての検討

Abstract

Although Cephem antibiotics are transferred to the prostatic fluid in relatively low levels, they are clinically effective for bacterial prostatitis. In the present study, the prostatic tissue concentration of Latamoxef (LMOX), Cefoperazone (CPZ) and Cefotaxime (CTX) were determined, and their penetration rates into the prostatic tissue were analyzed. Before the transurethral resection of the prostate (TUR-P), 2 g of LMOX (21 patients), 1 g of CPZ (15 patients) and 2 g of CTX (14 patients) were intravenously administered in a total of 50 patients with benign prostatic hypertrophy at our two Hospitals. The prostatic tissue was taken by TUR-P at 30 minutes and 60 minutes after the injection. The serum concentration and the prostatic tissue concentration of the three antibiotics were determined by the bioassay method. Additionally their serum concentration and the prostatic tissue concentration in the six cases of CTX-injected patients were also determined by high performance liquid chromatography (HPLC). The penetration rate into the prostatic tissue was obtained by the formula; the penetration rate = the prostatic tissue concentration/the serum concentration. The prostatic tissue concentrations determined by the bioassay method were, 36.9 +/- 10.6 micrograms/g at 30 minutes after the injection of 2 g of LMOX and 28.0 +/- 9.0 micrograms/g at 60 minutes, 31.0 +/- 8.3 micrograms/g at 30 minutes after the injection of 1 g of CPZ and 21.1 +/- 10.0 micrograms/g at 60 minutes, and 8.8 +/- 4.1 micrograms/g at 30 minutes after the injection of 2 g of CTX and 4.5 +/- 2.0 micrograms/g at 60 minutes (mean +/- S.D.). The penetration rates determined by the bioassay method were 36.2 +/- 10.9% at 30 minutes after the injection of LMOX and 34.8 +/- 15.3% at 60 minutes, 43.6 +/- 14.4% at 30 minutes after the injection of CPZ and 39.7 +/- 24.1% at 60 minutes, and 11.1 +/- 4.1% at 30 minutes after the injection of CTX and 9.6 +/- 3.8% at 60 minutes (mean +/- S.D.). The penetration rate of CPZ and LMOX were significantly higher than that of CTX (P less than 0.05, P less than 0.01). In 6 of the 14 CTX-injected patients, the serum and prostatic tissue concentrations of CTX and its metabolite, desacetyl-CTX, were also determined by HPLC. The penetration rate of CTX into the prostatic tissue was obtained by the formula; the penetration rate of CTX = the prostatic tissue concentration (CTX + Desacetyl-CTX)/the serum concentration (CTX + Desacetyl-CTX).(ABSTRACT TRUNCATED AT 400 WORDS)