Sulfamethoxazole-Trimethoprim合剤の腸管感染症における治療成績および各種腸管病原菌に対するin vitroでの抗菌性

抄録

A total of 150 patients, consisting of cases with bacterial dysentery, typhoid fever, salmonellosis, enteritis from pathogenic Escherichia coli, and stool culture-negative enteritis, were treated with sulfamethoxazole (SMX) -trimethoprim (TMP) combination product.
A comparison of therapeutic indices between SMX-TMP combination product and available antibiotics was made in 80 patients with bacterial dysentery, in whom 38 patients were accompanied with clinical symptoms and the rest were carriers. The clinical materials were comparable in terms of pathogenic organisms, age and sex of the patients in both groups.
The effect of SMX-TMP preparation appeared to be somewhat superior in improving the frequency of defecation and shortening the period of days required for recovery of facal properties to other antibiotic groups. In patients with clinical symptoms, the therapeutic results from SMX-TMP preparation appeared to be slightly inferior to the control antibiotic treated groups in terms of the rapidity at which stool cultures were converted to negative, the rate of re-excretion of pathogenic organisms and the duration of febrile period after the therapy. In carrier patients, SMX-TMP preparation was more effective than the compared antibiotics.
Of 11 patients with Salmonellosis, stool cultures became negative in 2 of the 4 clinically infected and in 3 of the 7 carriers after the treatment. The results in 10 patients with manifest typhoid fever and 5 carriers were classified as effective in 1 and probably effective in 3.
Bacterial strains isolated from hospitalized patients, consisting of 43 strains of Shigella, 7 strains of Salmonella typhosa, a single strain of Salmonella paratyphi, 12 strains of other Salmonella groups, 3 strains of Escherichia coli and 2 strains of Pseudomonas, were tested in vitro to assess their sensitivity to chloramphenicol, tetracycline, nalidixic acid, ampicillin, SMX alone, TMP alone, and SMX-TMP combination mixed at a ratio of 20 : 1.
SMX-TMP combination demonstrated higher antibacterial activities than the other agents in the majority of bacterial strains except for Pseudomonas. In all strains tested the activities of SMX-TMP combination were improved by marked potentiation over those of the drugs when they were used alone.