CLINICAL RESULTS OF LATAMOXEF ON PERTUSSIS

Abstract

Latamoxef (LMOX), a newly developed antibiotic of the oxacephem group, was used for treatment of pertussis in 66 patients of 26 days to 7 years and 9 months old. The clinical and biological effects of LMOX could be evaluated in 60 of them (20 serious cases, 39 moderate cases and 1 slight case). The dose of LMOX, which varied from 37.5 to 200mg/kg and averaged 68.0mg/kg, was injected or infused by intravenous drip method in 2 to 4 divided doses daily for the period ranging from 4 to 21 days and averaging 7.7 days.
1. Of 49 cases treated with LMOX alone, the drug was evaluated to be effective in 48.9% on day 7 of treatment and in 85.1% on day 14. Of 11 cases treated with LMOX and r-globulin in combination, the drug was evaluated to be effective in 10 on day 7 and in all on day 14. Thus, of all cases LMOX was evaluated to effective in 56.9% on day 7 of treatment and in 87.9% on day 14.
2. The clinical effect of LMOX was analysed by the number of days from the onset of the disease until the start of treatment. The proportion of effective cases on day 7 of treatment was 70, 52.9% and 30.8%, when the treatment was started days 0-7, days 8-14, and days 15-21 of disease, respectively. LMOX was effective in 3 of 7 cases in which its administration was started on day 22 or later. Generally, the drug appeared to be more effective when its administration was started earlier. In addition, the proportion of effective cases on day 14 of treatment was 90.0, 88.2, 76.9 and 85.7% respectively. A similar tendency to that in the evaluation on day 7 was observed in these cases. Although the number of cases treated with LMOX and γ-globulin in combination was a few, the result appeared to be more favorable in them than in those treated with LMOX alone.
3. LMOX was administered at a daily dose of 40-80mg/kg to 40 of 49 cases treated with it alone. The drug was evaluated to be effective in 44.7% of them on day 7 of treatment and in 86.8% on day 14. Many of the cases treated with LMOX at a daily dose higher than 80mg/kg were in a serious condition. The drug was evaluated to be effective in 66.7% of them on day 7 of treatment and in 77.8% on day 14.
4. Bordetella pertussis was detected before starting LMOX in 9 cases. It was removed by the treatment in 87.5% of them. Fifty-five strains including isolated and conserved ones were examined for sensitivity to 4 antibiotics. These agents were more effective in the order of CPZ>LMOX>EM>ABPC.
5. No clinically significant side effects were found in 66 cases treated with LMOX. Laboratory tests demonstrated a slight rise of GOT level in only 1 case.
The results suggest that LMOX is superior to ordinary antibiotics in effectiveness. In addition, LMOX seems to be a useful drug for cases in a serious condition or in which oral medication is difficult, since it is an intravenous administration drug.