Cefpiramide와 Aminoglycoside의 혼합시 배합 변화

Abstract

Cefpiramide is usually used for the treatment of a documented or suspected infection due to susceptible organisms such as G(-), G(+), P. aeruginosa. Aminoglycoside is used for infection due to G(-) organism. Aminoglycoside is usually used with cefpiramide to widen antibacterial spectrum. So in clinically, this combination used frequently. But, in vitro, when aminoglycosides antibiotics is added to Cephalosporin antibiotics, it is known to be incompatible. In Seoul National University Hospital in Korea, there is a report of incompatibility that when aminoglycoside antibiotic is added to cefpiramide, it will precipitate. So. We study, in vitro, compatibility of cefpiramide with aminoglycoside. The test sample was diluted in D5W, NS. cefpiramide was prepared five different concentrations; 1g/10ml(10%), 1g/20ml(5%), 1g/50ml(2%), 1g/100ml(1%), and 1g/200ml(0.5%). Three aminoglycoside antibiotics were prepared two different concentrations; amikacin(0.5%, 0.125%), gentamicin(0.16%, 0.04%), tobramycin(0.16%, 0.04%) of which prepared sample was mixed 1:1 in different concentration. We took 2 ml that the mixed sample, and observed for precipitation visually and determine the pH with pH meter. Immediately after preparing a injection, we observed signs for incompatibility such as formation of particle, occurrence of haze and gas, increase of turbidity and change of color. In result, compatible concentration range of cefpiramide + aminoglycoside group was 1% + 0.5%, cefpiramide + gentamicin group was incompatible within the range of study concentration, cefpiramide + tobramycin group was 0.5% + 0.16%. And the higher concentration of cefpiramide result in the higher pH of mixed sample to be incompatible.