尿路感染症の化学療法に関する研究

抄録

Chemotherapy plays the most important role in the treatment of urinary tract infections. It is necessary for the effective treatment to classify causative microorganisms and to determine drug sensitivity of the bacteria, and administration of chemotherapeutic agents for the treatment of patients with renal failure should be carefully carried out. The author classified 145 strains of the bacteria cultured from outpatients with urinary tract infection at our clinic from January to December in 1966, and examined their sensitivities to 8 of chemotherapeutic agents. E. coli (39.3%) and Staphilococci (11.1%) were most frequently found, and they showed high sensitivity to KM, CL and NF. The results in the present experiment were compared with the results in the experiments described in our 4 preceding reports, and the same tendency in their results was observed.
CP and KM were frequently used for the treatment of 52 in-patients with renal failure from 1962 to 1966. Nephrotoxicity of KM has been reported by many authors, and therefore; I observed the effect of KM on renal function, clinically and experimentally at our department. Serum concentration of KM in anuric patients persisted at so high level as 33 mcg/ml even at 35th hour after single intramuscular injection of 1.0 gm. 24% in an average of KM, however, was eliminated by hemodialysis for 4 hours from serum whose level was 1 hour after intramuscular injection. Three groups of rabbits were made for the observation of the experiments; 1) normal group, 2) impaired renal function group, 3) infected impaired renal function group, and each group of them was further divided into two subgroups according to dosage of KM, small dosage group (50 mg/kg/day) and large dosage group (300 mg/kg/day). Group 1: In the small dosage group, there was no nephrotoxic effect for 20 days. (Group A) In the large dosage group, the mortality caused by KM was 80% within 20 days. (Group B) Group 2: In the small dosage group, all were survived for 20 days. (Group C) All were died within 12 days in the large dosage group. (GroupD) Group 3: The rate of survival for 20 days in the small dosage group was 75%, renal infections were not cured, however. (Group E) The mortality in the large dosage group was 80% for 20 days, and all infections were cured. (Group F) Occurrence of the renal damage which is degeneration of tubular epithelium, caused by KM is found in individuals in whose serum was accumulated.
In conclusion, to the accumulation of KM in the serum of the patient with renal failure should be paid much attention in case KM is administered for the treatment.