• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제1권1호
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• pp.100-106
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• 1998

목 적: ceftriaxone은 제 3세대 반합성 cephalosporin제제로 강력한 항균작용이 있어 중증 감염성질환의 치료에 널리 사용되고 있으며, 합병증으로 항생제로서는 유일하게 담낭오니를 형성할 수 있다. 최근의 보고들에 의하면 ceftriaxone의 사용으로 발생된 담낭오니는 약제투여를 중단하면 자연 소실되는 양성경과를 취하는 것으로 알려져 있으나, 드물게 담낭절제술이 시행된 경우도 있었다. 이에 저자들은 ceftriaxone 투여로 발생된 담낭오니의 발생빈도, 유발위험인자, 예후 등을 알아보기 위해 본 연구를 시행하였다. 방 법: 1997년 3월부터 1998년 2월까지 서울대학교병원 소아과에 세균성감염이 의심되어 입원하여 ceftriaxone으로 치료 받으면서 복부 초음파검사가 가능했던 21례 중에서 담낭오니의 발생이 확인된 8명의 환자들을 조사대상으로 하였으며 추적관찰 초음파검사는 6례에서 시행되었다. 선행하는 간질환이나 신기능이 떨어져 있는 경우는 본 조사 대상에서 제외하였다. 결 과: 1) 총 21례의 환자에서 ceftriaxone으로 치료 도중에 복부 초음파검사가 가능했으며, 38%(남아 4례, 여아 4례)에서 담낭오니의 발생이 확인되었다. 2) 담낭오니가 발생된 군의 나이가 $6.3{\pm}2.9$세로 발생하지 않은 군의 나이 $2.2{\pm}3.1$세보다 의미있게 많았으며(p<0.05), 24개월 이후의 연령군에서 이전의 연령군에서보다 더 잘생겼다(p<0.05). 3) 담낭오니는 8례 모두에서 고음영의 에코를 보였으며, 5례에서 후벽음영이 동반되었다. 4) 추적관찰 초음파검사가 가능했던 6례 중 2례는 약제의 투여가 끝난 때로부터 14일째, 2례는 30일째, 나머지 2례는 80일째 시행한 복부초음파검사에서 각각 정상 담낭소견을 보였다. 5) 담낭오니의 발생과 ceftriaxone의 투여용량, 투여기간, 금식, 원인질환 등은 의미있는 상관관계를 보이지 않았다. 결 론: ceftriaxone 투여로 인한 담낭오니의 발생은 나이가 가장 중요한 위험인자로 24개월 이상의 연령군에서 의미있게 발생빈도가 높았다. 그러므로 나이가 24개월 이상의 환자에게 고용량($60{\sim}100\;mg{\cdot}Kg^{-1}{\cdot}day^{-1})$의 ceftriaxone을 투여한 경우와 약제 투여 후에 간담도계 증상이 발생된 모든 경우에는 기본적으로 담낭 초음파검사를 시행하는 것이 바람직하다고 사료된다.

• Pediatric Infection and Vaccine
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• 제4권2호
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• pp.308-313
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• 1997

Ceftriaxone, an effective third generation cephalosporin with a wide range of antimicrobial activity, has become widely used by pediatricians for a variety of bacterial infections including meningitis. It has been associated with the development of sludge or stone in the gallbladder of some patients treated with this drug. Ceftriaxone associated biliary sludge has unusual acoustic characteristics and resembles gallstone. The sludge can cause symptoms such as cramping abdominal pain, and disappears after stopping ceftriaxone administration. Because of these seemingly confusing observations, it is important for the clinicians to recognize these findings that ceftriaxone treatment can cause. We report a case of ceftriaxone associated biliary sludge in Korean children. A 6-year-old girl who was treated for meningitis with ceftriaxone (100mg/kg/day) developed cramping upper abdominal pain from 5th hospital day. Physical examination, liver function tests and X-ray revealed no specific abnormal findings. But abdominal ultrasound revealed high amplitude echogenic sludge with prominent post-acoustic shadow in gallbladder and its diameter was 1.5cm. We stopped ceftriaxone administration and tried conservative care. Abdominal cramping pain subsided after 3 days of ceftriaxone removal. Second abdominal ultrasound confirmed the disappearance of sludge at 3 weeks later.

• Advances in pediatric surgery
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• 제20권2호
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• pp.62-64
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• 2014

Gallbladder stones in children are not common without underlying hemolytic diseases or other risk factors like obesity. Ceftriaxone, a third generation cephalosporin, is known to make biliary precipitations that can be mistaken for biliary stones. We here report two children with biliary pseudolithiasis with different treatment modalities. One child was mistaken for symptomatic gallbladder stones and underwent elective laparoscopic cholecystectomy, while the other child, after thorough history taking on the ceftriaxone medication, was suspected of biliary pseudolithiasis and was treated conservatively. Both children had the history of usage of ceftriaxone in previous hospitals for infectious diseases. The ceftriaxone history of the first child was missed before the surgery. When gallbladder stones are found in children without any underlying diseases, specific history taking of the usage of ceftriaxone seems to be absolutely required. In this case, immediate interruption of the antibiotic could resolve the episode and avoid unnecessary surgical procedure.

• 한국임상약학회지
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• 제8권1호
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• pp.54-58
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• 1998

The stability of ceftriaxone sodium 100 mg/ml in the water for injection was tested at two temperature conditions (refrigerator and room temperature) and two storage containers (vitro and syringe). The stability of each sample was determined by high-performance liquid chromatography while storing for 5 days at room temperature and 27 days at refrigerator. The concentration of ceftriaxone sodium was 100 mg/ml which the hospital usually use as a filling preparation for I.V. push or Y-site injection. There was no significant difference between the storage in vials and syringes. There was no significant difference in the change of concentration until storing the reconstituted ceftriaxone sodium injection for 2 days at room temperature and 14 days at refrigerator. In conclusion, the ceftriaxone sodium 100 mg/ml in the water for injection can be stored in vial or syringe for 2 days at room temperature and 14 days at refrigerator after preparation.

• 한국임상약학회지
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• 제14권2호
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• pp.96-99
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• 2004

Aminophylline, ceftriaxone 및 ampicillin/sulbactam (Unasyn)을 미숙아용 고영양수액제에 직접 첨가하거나 Y-site로 투여하는 경우의 안정성에 관해 조사하였다. Aminophylline 주사액 (25mg/mL) $300{\mu}l$와 ceftriaxone sodium (37.5 mg/mL) 2mL를 각각 고영양수액제 직접 첨가하였다. 또한 Y-site에서의 안정성 조사를 위해 ceftriaxone sodium (37.5 mg/mL)을 고영양수액제에 각각 1:1 및 1:2 부피비가 되도록 혼합하였고 Unasyn (25mg/mL)은 고영양수액제와 1:1의 부피비로 혼합하였다. 이상과 같이 조제한 혼합액을 $25^{\circ}C$와 $4^{\circ}C$에 보관하여 aminophylline은 48시간 동안 그리고 항생제들은 24시간 동안의 경시변화를 HPLC를 이용하여 분석하였다. Aminophylline은 위 보존조건에서 48시간동안 안정하였다(변화율 <$10{\%}$). Ceftriaxone sodium을 고영양수액제에 직접 첨가한 경우 ceftriaxone의 잔존률은 $25^{\circ}C$에서 4시간째에 $90.5{\pm}1.8{\%}$이었고 $4^{\circ}C$에는 $95.1{\pm}1.4{\%}$로 측정되었다. Y-site에서의 안정성과 관련하여 ceftriaxone sodium을 고영양수액제와 1:1로 혼합한 경우 양 보존조건에서 ceftriaxone은 24시간 동안 안정하였으나 1:2로 혼합한 경우에는 $4^{\circ}C$ 보관 시에만 안정하였고 $25^{\circ}C$에서는 24시간째에 약 $14{\%}$ 정도 분해되는 것으로 나타났다. 한편, Unasyn의 경우 ampicillin은 24시간째에 $4^{\circ}C$ 보관 시에만 안정하였고 $25^{\circ}C$에서는 24시간째에 약 $14{\%}$정도 분해되는 것으로 나타났다. 한편, Unasyn의 경우 ampicillin은 24시간째에 $4^{\circ}C$에서는 안정하였으나 $25^{\circ}C$에서는 $30{\%}$까지 감소되는 것으로 분석되었고 sulbactam은 24시간째에 온도와 관계없이 안정한 것으로 나타났다. Ceftriaxone sodium을 TPN과 Y-site 혼합 후 1-2시간 이내에 침천이 형성되었고 Unasyn의 경우에는 12시간째에 침천이 형성되었다. 혼합액의 pH나 색상은 연구기간 동안 일정하였다. 이러한 연구결과에 기초할 때, aminophylline은 고영양수액제와 혼합가능하고 ceftriaxone과 Unasyn은 고양양수액제와 혼합시 최소 1시간 동안은 안정한 것으로 평가되었다.

• 생명과학회지
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• 제17권10호
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• pp.1426-1433
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• 2007

우리는 ESBL 유전자를 포함하는 세균의 항생제 내성 패턴을 조사하기 위해서 부산에 있는 임상실험실로부터 Klebsiella pneumoniae 한 균주를 수집하였다. 그 세균은 이중 디스크 확산법에 의해 ESBL을 생성하는 Klebsiella pneumoniae라는 것이 밝혀졌고 PCR과 DNA 염기서열분석을 통하여 세 가지의 ESBL gene (TEM-1, SHV-12, CTX-M-15)이 포함되어 있다는 것이 확인되었다. 그리고 그 세 가지 유전자의 특징을 알아내기 위해서 우리는 이 균주로부터 교차접합시험, 형질전환시험, 클로닝(SHV-12 gene)등을 이용하여 재조합균주를 배양하였다. 이렇게 각기 재조합된 균주들을 한천평판희석법을 이용하여 3세대 cephalosporin 항생제 (ceftazidime, cefotaxime, ceftriaxone)에 대한 최소억제농도의 측정하고 비교 분석하였다. Klebsiella pneumoniae (NO. 60031)의 MIC는 ceftazidime ($30\;{\mu}g/ml)$, cefotaxime ($30\;{\mu}g/ml$), ceftriaxone ($30\;{\mu}g/ml$)이 각각 ${\geq}256\;{\mu}g/ml,\;128\;{\mu}g/ml,\;128\;{\mu}g/ml$이었고, E. coli $RG176^{Na(r)}$에 교차접합 시킨 conjugant 균주의 MIC는 ceftazidime, cefotaxime, ceftriaxone이 각각 ${\geq}256\;{\mu}g/ml,\;64\;{\mu}g/ml,\;128\;{\mu}g/ml$이었다. E. coli $DH5{\alpha}$에 형질전환 시킨 transformant 균주의 MIC는 ceftazidime, cefotaxime, ceftriaxone이 각각 $128\;{\mu}g/ml,\;32\;{\mu}g/ml,\;32\;{\mu}g/ml$를 나타내었고, SHV-12 gene 만을 분리하여 E. coli $DH5{\alpha}$에 클로닝 시킨 균주는 ceftazidime, cefotaxime, ceftriaxone이 각각 $128\;{\mu}g/ml,\;8\;{\mu}g/ml,\;32\;{\mu}g/ml$을 나타내었다. 결국 conjugant 균주와 transformant 균주는 세 가지의 내성유전자를 가졌다는 공통점은 있으나 conjugant 균주의 MIC가 transformant 균주의 MIC보다 높게 나타나는 차이점을 보였다. 또한 SHV-12 gene 만을 분리하여 E. coli $DH5{\alpha}$에 클로닝 시킨 균주는 ceftazidime, ceftriaxone에 내성을 발현하였지만 cefotaxime에 대해서는 내성을 발현하지 않았다.

• 대한수의학회지
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• 제54권1호
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• pp.27-30
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• 2014

The jejunum is the longest part of the small intestine and its lumen is mainly involved in the absorption of the nutrients. The present study was conducted to evaluate the effects of metronidazole, ceftriaxoine sodium and their combination on the stenotic index of the end to end jujunal anastomotic site. To accomplish this, 20 healthy stray dogs were subjected to end to end jejunal ansastmosis. Dogs in Group A (control) underwent jejunal anstomosis with no antibiotic prophylaxis, while those in Group B received surgery and metronidazole alone at 50 mg/kg, those in Group C received ceftriaxone sodium intravenously at 30 mg/kg body weight prior to surgery and dogs in Group D were given metronidazole in combination with ceftriaxone sodium at 50 mg/kg and 30 mg/kg, respectively, 2 h before surgical intervention. No significant difference (p > 0.05) in the stenotic index was observed at 14 days after jejunal anastomosis. These findings indicate that prophylactic administration of metronidazole and ceftriaxone sodium alone or in combination had no significant effect on the stenotic index of the jejunum.

• 약학회지
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• 제50권1호
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• pp.40-46
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• 2006

Square wave voltammetric (SWV) and cyclic voltammetric (CV) behaviors of cefotaxime sodium and ceftriaxone sodium have been investigated in the potential range between -0.10 V and -1.30 V using the phosphate buffers of various pH values ($2.00{\sim}9.10$). Two main peaks observed were irreversible and protons were involved in their electrochemical reductions. The first peaks of these cephalosporin antibiotics are due to the reduction of the azomethine double bond in the methoxyimino group of the side chain at position 7. The second peaks of cefotaxime sodium and ceftriaxone sodium are related to the reductions of the ${\Delta}^3$ double bond and the dioxo moiety of the side chain at position 3, respectively. The calibration curve of cefotaxime sodium in the concentration range between $1.0{\times}10^{-7}M$ and $1.0{\times}10^{-5}M$ yielded the linearity with the correlation coefficient of 0.9998 when the first peak of the antibiotic in a phosphate buffer of pH 3.02 was measured at the conditions of frequency of 120 Hz and pulse height of 50 mV by SWV. The present fast, simple and accurate SWV assay method was applied to determine cefotaxime sodium in the commercial antibiotic powder of injection.

• Archives of Pharmacal Research
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• 제18권4호
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• pp.237-242
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• 1995

For the vioequivalence study of two ceftriaxone injection formulations ($Rocephin{\circledR}$ ; Roche, and Triaxone ; Hanmi0, the HPLC analytical method for the analysis of ceftriaxone in plasma was used. Fourteen healthy volunteers completed the study and each subject were IM in jected signle doses (1 g) of the test and the reference formulations in a two-way crossover design with an one week drug free interval between doses. Following each administration, plasma concentrations of ceftrixone were monitored over a period of 24 h. Bioequivalence parameters $AUC_{24th}, {\;}T_{max}, {\;}C_{max}$ and MRT determined from the data obtained for the two formulations were examined by analyses of variance (ANOVA) and other criteria and tests for bioequivalence. Results of ANOVA and confidence limits of test/reference ratios of $AUC_{24th}, {\;}T_{max}, {\;}C_{max}$ and MRT, and statistical tests indicated the bioequivalence of the two formulations (i.e., test/reference ratio was within $100{\pm}20%$) except for $T_{max}$ The mean of $T_{max}$ showed only 6. 9% difference from the reference but the detection limit was 22.5% which is slightly over the 20% criteria. No pharmacokinetic parameters including Ka, Kel, Vd and Cl indicated significant difference in between the two fomulations. It was concluded that the data yielded fro the two cefriaxone formulations demonstrated that they were bioequivalent.

• Journal of Microbiology and Biotechnology
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• 제28권9호
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• pp.1563-1572
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• 2018

Gold nanoparticles (AuNP) and their conjugates have been gaining a great deal of recognition in the medical field. Meanwhile, extended-spectrum ${\beta}$-lactamases (ESBL)-producing bacteria are also demonstrating a challenging problem for health care. The aim of this study was the biosynthesis of AuNP using Rosa damascenes petal extract and conjugation of ceftriaxone antibiotic (Cef-AuNP) in inhibiting ESBL-producing bacteria and study of in vitro anticancer activity. Characterization of the synthesized AuNP and Cef-AuNP was studied. ESBL-producing strains, Acinetobacter baumannii ACI1 and Pseudomonas aeruginosa PSE4 were used for testing the efficacy of Cef-AuNP. The cells of MCF-7 breast cancer were treated with previous AuNP and Cef-AuNP at different time intervals. Cytotoxicity effects of apoptosis and its molecular mechanism were evaluated. Ultraviolet-visible spectroscopy and Fourier transform infrared spectroscopy established the formation of AuNP and Cef-AuNP. Transmission electron microscope demonstrated that the formed nanoparticles were of different shapes with sizes of 15~35 nm and conjugation was established by a slight increase in size. Minimum inhibitory concentration (MIC) values of Cef-AuNP against tested strains were obtained as 3.6 and $4{\mu}g/ml$, respectively. Cef-AuNP demonstrated a decrease in the MIC of ceftriaxone down to more than 27 folds on the studied strains. The biosynthesized AuNP displayed apoptotic and time-dependent cytotoxic effects in the cells of MCF-7 at a concentration of $0.1{\mu}g/ml$ medium. The Cef-AuNP have low significant effects on MCF-7 cells. These results enhance the conjugating utility in old unresponsive ceftriaxone with AuNP to restore its efficiency against otherwise resistant bacterial pathogens. Additionally, AuNP may be used as an alternative chemotherapeutic treatment of MCF-7 cancer cells.