STUDIES ON SYNERGISTIC ACTION AGAINST PENICILLIN AND CEPHALOSPORIN RESISTANT BACTERIA

Section II: Clinical evaluations of synergistic action in urinary tract infections

Abstract

For clinical evaluations of the combination therapy, ten patients suffering from complicated urinary tract infections were selected. In two chronic pyelonephritis patients, the bacteriological studies of pathogens, the determination of blood and urine levels of drugs (preceding cephaloridine therapy, employing larger amount of drug) were performed. Though no bacteriological response was observed by preceding administration of larger amount of cephaloridine, prompt sterilization of urine was achieved by the combination of lesser amounts of cephaloridine and methicillin. Satisfactory correlation of clinical course and laboratory study was observed in these cases. Among other eight patients prompt sterilization was observed in five, significant decrease in bacterial count in urine in one. Relapse of bacteriuria was noticed in two, one of which had neurogenic bladder and the other had indwelled uretero-cutaneostomy tubes. In one case, acute renal failure has developed during the course, however, prompt recovery was noticed by discontinuance of the medication. In one Pseudomonas bacteremia case, the combination of carbenicillin and methicillin was unsucecssful. The preventive employment of the combination of cephaloridine and methicillin for wound infection was satisfactory in one. On the data of laboratory investigations and clinical findings, problems of the combination therapy were discussed.