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合用青霉素和氨基糖甙类药物已作为处理胆道感染的首选疗法,但年老的、脓毒性和黄疸病人常有肾功能问题,应采用肾脏毒性较低的新型抗生素以取代氨基糖甙类药物.作者在20个月期间的53例急性胆囊炎和53例胆管炎病例中,前瞻性随机观察氨苄青霉素加用妥布霉素、头孢哌酮和哔哌青霉素的效果.凡属体温≥38℃、低温≤36.5℃、白细胞计数≥10,000或伴脓毒性休克的病例才列入试验对象,而孕妇、已知对该药过敏或耐药者、已用有效抗生素冶疗以及估计在48小时内死亡者均不包括在内.所用抗生素
Combination of penicillin and aminoglycoside drugs have been the treatment of choice for biliary tract infection, but elderly, septic and jaundice patients often have kidney problems, should be used to lower the toxicity of new antibiotics to replace aminoglycosides. In a cohort of 53 acute cholecystitis and 53 cholangitis cases over a 20-month period, we prospectively observed the effects of ampicillin plus tobramycin, cefoperazone, and penicillin, Patients with hypothermia ≤36.5 ° C, leukocyte count ≥10,000 or with septic shock were included in the study, whereas pregnant women, who are known to be allergic or resistant to the drug, have been treated with potent antibiotics and are estimated to die within 48 hours Not included. Antibiotics used