Carbenicillin has been used for several years in complicated infections and shown to be effective in urinary tract infections. The antibacterial activity of this drug was shown against most
E. coli and
Enterobacter (Cloaca) strains. Most indole-positive
Proteus species were susceptible to carbenicillin. The MIC for
Pseudomonas strains was much higher than that for
Proteus species and carbenicillin. However as is known urinary excretion of carbenicillin is quite rapid and the concentration in urine easily attains several hundreds micrograms per ml. This phenomenon might explain the good clinical response in urinary tract infections. Therefore, we have administered rather large dose of carbenicillin against complicated urinary tract infections,most of which were due to
Pseudomonas strains to see dose related response.In this paper the results of management of urinary tract infections by 8g per day of carbenicillin is presented in comparison with that by 4g per day.Of 30 patients 18 were chronic
Pseudomonas infections.From other 6 chronic infections,
2 E. coli,2 Klebsiella, 1
Cloaca and 1
Proteus mirabilis strains were isolated.In the remaining 6 acute pyelonephritis cases, 5
E. coli and 1
Klebsiella bacteriuria were revealed. Among 18
Pseudomonas infections 11 were cured by carbenicillin 3 showed temporary eradication of bacteriuria and 4 no response (resulted in failure). The MIC for
Pseudomonas isolates were mostly 12.5 or 25mcg/ml excepting two 250mcg/ml, and no clear dose related response was shown in this study.The efficacy rate in other 6 chronic cases was 50%. In acute cases carbenicillin medication was fully effective.Being compared with previous case in which 4g of carbenicillin was the daily dose (5cure,4 relapse and 3 failure in 12 chronic
Pseudomonas infections),8g course is shown to be effective in diminishing relapse rate.
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