Enviomycin (EVM) の副作用

抄録

Enviomycin (EVM) is an anti-tuberculous agent, isolated from the culture broth of Strepto myces griceoverticillatus var. tuberacticus N6-130 and it has been used for about four years in clinical therapy.
This paper deals with the clinical investigation on therapeutic effects and adverse reactions of EVM in 134 patients with cavitary pulmonary tuberculosis who had failed to respond to the previous treatment. The study was carried out cooperatively through the participation of 15 national sana toria and a national hospital in the district of Tokai and Hokuriku.
One hundred and thirty four cases were divided into two groups: Group A, “Daily regimen group” and Group B, “Intermittent regimen group” and they were compared with each other with special emphasis on the occurrence of adverse reactions. The background factors were., presented in Table 1.
Seventy two cases of Group A were administered EVM 1g daily intramuscularily for the first three months and thereafter EVM 1g three times a week together with drugs which had been used in each cases before starting this study. Sixty two patients of Group B were administered from the begin ing EVM 1g three times a week together with drugs as described in the case of Group A. The treatment was continued for six months.
Episodes of adverse reactions were observed in 27 cases (20.1%) of 134 patients (Table 2). The eighth cerebral nerve disorder was seen in 13 cases (9.7%), among them only two cases were hearing impairment.
Allergic reactions such as eruption and fever were found mainly in Group B (Table 3) and young women (Table 5). Such a flu-like syndrome appeared at 1.5 months after starting the use of EVM. The fact suggests that daily administration might be better than intermittency in preventing adverse reactions.
The negative conversion rate of bacilli in sputa by culture was 27.1% at the end of 6 months treat ment (Table 6).
In other 13 cases recieving EVM with some other drugs such as RFP, EB, INH, etc. from the begining as the primary treatment, the negative conversion rate of bacilli by culture was 100% and chest radiograms showed improvement in all cases except 2 with far advanced mixed type lesions.