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The in vivo distribution of drugs is an important basis for the selection of antimicrobial drugs. Such as bacterial meningitis, it is appropriate to use a higher concentration of antibiotics in cerebrospinal fluid; Hepatobiliary system infection should choose the higher concentration of bile, and should be combined with possible pathogenic bacteria for drug selection.

I. the distribution of antibiotics in cerebrospinal fluid

1, can pass through the normal blood-brain barrier:

Antibacterial drugs: chloramphenicol, sulfonamides, tinidazole, metronidazole, cephalosporins, fosfomycin, isoniazid, pyrazinamide.

Antifungal drugs: fluconazole, itraconazole, voriconazole, flucytosine.

Antiviral drug: aciclovir.

2, only meningitis can penetrate the blood-brain barrier:

Antimicrobial agents: ampicillin, penicillin G, carbenicillin, amoxicillin, tikacillin, piperacillin, mezlocillin, azlocillin; cefuroxime, cefoxitin, certain third-generation cephalosporins (ceftizoxime, Ceftriaxone, Cefotaxime, Ceftazidime), Cefepime, Cefpirome; Aztreonam, Meropenem; Vancomycin, Daptomycin; Neomycin, Acetylspiramycin, Levofloxacin, Ofloxacin Ciprofloxacin; amikacin; clindamycin, ornidazole; rifampicin, ethambutol.

Antifungal drug: Amphotericin B.

II. the distribution of antibiotics in bone tissue

1, can achieve effective drug concentration to kill pathogens:

Lincomycin, clindamycin, cefotiam, fosfomycin, fluoroquinolones, vancomycin, fusidic acid (0.3 to 2 times the reachable blood concentration).

2, in large doses can also reach a certain concentration in the bone:

Penicillins and cephalosporins such as methicillin, dicloxicillin, cefuroxime, cefamandole, cefotaxime, ceftriaxone, ceftazidime, and the like can achieve effective therapeutic concentrations in bone tissue.

III. the distribution of antibiotics in prostate tissue

Antibacterial drugs are mostly low in prostate tissue and prostatic fluid. The following classes of antimicrobial agents can achieve effective concentrations in prostatic fluids and their tissues:

Erythromycin and other macrolides, compound sulfamethoxazole, trimethoprim (TMP), rifampicin.

Fluoroquinolones (eg Ofloxacin, Ciprofloxacin, Levofloxacin, Lufloxacin, Pefloxacin, Lomefloxacin, Moxifloxacin, etc.)

Tetracyclines (Doxycycline, Minocycline, Tetracycline)

β-Lactams (piperacillin, cefotiam, cefotetan, ceftizoxime, cefoperazone, cefepime, cefpirome, cephradine sodium, aztreonam)

IV. Distribution of antibiotics in bile

1, bile in high concentration of antibacterial drugs:


Tetracyclines (tetracycline, doxycycline, minocycline, tigecycline)

Macrolides (erythromycin, erythromycin ethylsuccinate, azithromycin, dirithromycin, clarithromycin)

Lincomycins (lincomycin, clindamycin)

Nitroimidazoles (metronidazole, tinidazole, ornidazole)

Antifungal (Itraconazole, caspofungin, micafungin)

Beta-lactams (mezlocillin, piperacillin, amoxicillin, ampicillin, cephalexin, cefathiamidine, cefotiam, cefamandole, cefmetazole, cefixime, ceftriaxone, ceftriaxone Pine, cefoperazone, cefpiramide, cefminox, cephalosporium fluoride, cephalosporin, aztreonam)

Quinolones (piphenic acid, ofloxacin, fleroxin, lomefloxacin, sparfloxacin, ciprofloxacin, gemifloxacin, moxifloxacin)

2, bile in effective concentrations of antibacterial drugs:


Quinolone (norfloxacin, levofloxacin, fleroxin)

Beta-lactams (cefoxitin, cefotetan, cefuroxime, ceftazidime, ceftizoxime, cefotaxime, cefepime, cefpirome, cephradine sodium, ertapenem, panipenem Imipenem)

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