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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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The clinical efficacy and safety of acetylspiramycin for Mycoplasma pneumonia in children were studied at a dose level of 50 mg/kg/day q.i.d. and the following results were obtained.
Acetylspiramycin showed effect in 24 patients out of 25 (96.0%).
The level of transaminase was increased in 3 cases on admission.
One of them was an uneffective case, and eruption was seen after administrating the drug.
Diarrhea and poor appetite were observed in one case as side effects, and they were controlled easily.
It may be concluded from these results acetylspiramycin was relatively free from side effects and considered to be useful for Mycoplasma pneumonia.

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The absorption, excretion and influence on bowel flora of oral paromomycin sulfate (aminosidine, PRM) were studied in ten normal volunteers taking a normal diet, and the following results were obtained.
1. Serum levels of PRM were observed 0.46 μg/ml at a half hour, 1.14 μg/ml at 1 hour, 1.48 μg/ml at 2 hours, 0.70μg/ml at 4 hours, 0.29 μg/ml at 6 hours and were almost faded out at 12 hours after 4 grams of oral administration.
2. During 0-2 hours, 2-4 hours, 4-6 hours and 6-12 hours, the mean urine concentrations of PRM were observed 56.4 μg/ml, 56.2 μg/ml, 37.1 μg/ml and 13.8 μg/ml, respectively, and the total excretion in the urine by 12 hours were observed 21.14 mg (0.53%).
3. Oral administration of PRM caused fall in Lactobacillus, non spore-forming anaerobic Gram positive bacilli (BEP group) and Peptostreptococcus (P<0.001), Bacteroides (P<0.01). However, after administration was discontinued, reduced bowel flora was returned to the normal range within a few days.
No overgrowth of bowel flora by coliform, Clostridium or yeast was observed. Klebsiella oxytoca and toxigenic Clostridium difficile were not observed overgrowth.
4. No side effect was observed clinically over 2 months.

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Clinical effect of acetylspiramycin, one of macrolide antibiotics, primary atypical pneumonia and serologically proven Mycoplasma pneumonia in children was studied. Twenty-four cases of these pneu-monia (PAP 11, MP 13) in children were selected and acetylspiramycin was given in dose of approximately 30 mg/kg/day orally. Clinical response was evaluated in terms of improvement in fever, cough and chest X-ray. Clinical response was excellent in 4, good in 5, fair in 14 cases and none in 1 case.
No definite adverse effect was observed, however 3 cases showed skin rashes. Two cases showed evanescent small erythematopapulous rash and 1 case developed urticaria on the 2nd to 4th day after this drug was given. These skin rash seemed one of the manifestation of Mycoplasma infections, rather than adverse side effect. One case showed elevated transaminase activity before acetylspiramycin was given and improved on the 2nd week, although this drug was continued. No other side effect was observed.
We were able to use acetylspiramycin only in the form of 200 mg tablet and difficulty of the administration was encountered in children under 5 years of age. Other form (dry syrup, etc.) of this drug should be considered for the clinical use in children.
In conclusion, acetylspiramycin was effective and safe for the treatment of primary atypical pneu-monia and Mycoplasma pneumonia.

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We studied susceptibility of 100 strains of clinically isolated E.coli by disc method tomecillinam. When inoculum size on agar plate was adjusted to 10⁶ cells/ml and 10⁹ cells/ml, respectively 96% and 63% strains were judged sensitive. Thus, in case of mecillinam MIC value as well as susceptibility tested by disc method highly depend on inoculum size and in the hospital laboratory inoculum size on agar plate should be carefully controlled even if it will be troublesome for routine disc examination. As it is suggested that clinical effectiveness of mecillinam will correspond to the result of 10⁶ cells/ml inoculum size, we think the inoculum size should be adjusted 10⁶ cells/ml during the laboratory disc study.

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Investigation was made on the therapeutic effect of a new antibiotic, cefatrizine (CFT), in oral infections according to the following procedure.Results are summarized as follows.
Determination was made on the MIC of CFT against 8 clinical isolates of S. epidermidis, 5 of S. aureus and 7 of E. coli in comparison with those of CEX and ABPC. MICs of CFT against S. aureus were demonstrated 3.13 to 6.25 mcg/ml which were superior to those of CEX and ABPC.
CFT was administered orally in a dose of 500 mg at an hour and a half before the extraction of the impacted wisdom tootch in the mandibula. Dueing the operation, gingival and blood specimens were collected and each CFT level was determined. The mean CFT level in the gingiva reached to 0.95 mcg/ml and that in the blood to 5.77 mcg/ml.
According to these experimental results, CFT was administered to patients with moderate oral infection at a dose of 500 mg and clinical assessment was made according to the criteria established by Japanese S ciety of Oral Surgeons. As the results, the effectiveness rate of CFT was 85%. No serious side effect was observed.
From the results of the present study, CFT may be effective for moderate oral surgery infections.

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Dibekacin was used for the treatment of 5 patients with bacterialr espiratory tract infections (4 cases of Ps. aeruginosa and 1 case of S.marcescens) intravenously.
Serum levels of DKB was observed by the method of enzyme immunoassay (EIA) and bioassay and no differentiation was observed between EIA and bioassay.
Four cases of Ps.aeruginosa and 1case of S.marcescens were all disappeared in 5 or 7 days of administration.
No side effects were observed.
The results obtained in this study indicate that DKB intravenous challenge might become one of the important method on respiratory tract infections.

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The purpose of the study is to evaluate the effect of cephaloridine on renal function, especially blood urea nitrogen and serum creatinine levels in clinical cases. The study was performed in cases given the drug for prophylaxis of postoperative infections and treatment of various infections.
Drip infusion of more than 2 g of cephaloridine (ceporan) for 2 hours was given twice a day to 213 cases.
The dose is thought to make it possible to maintain an effective blood level of the drug.Levels of blood urea nitrogen were measured before and after the administration in 197 cases and serum creatinine was measured in 116 out of 197 cases.
Elevated levels of blood urea nitrogen were observed in 12 cases while abnormal serum creatinine levels were found in 8 cases.
Transient and slight rising of blood urea nitrogen levels was observed in many cases of the prophylactic group due to postoperative catabolism or influence of the surgery.
Based on precise analysis of cases who showed abnormal levels of blood urea nitrogen and serum creatinine, the levels were proved to improve or return to normal and to be unchanged.
So that, it is said that the administration of the drug is not necessarily affect the renal function of clinical cases.

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Susceptibilities to amikacin of 153 strains of 27 bacterial species were determined by the 2-fold agar dilution method in parallel with the diameter of inhibition zone by the single-disc method.
The experiments demonstrated significant correlation between MIC by the dilution method and diameter of inhibition zone in each of conventional assay of the over-night (about 16 hours) incubation, delayed assay (about 24 hours incubation), and rapid assay (after 3-4 or 5-6 hours incubation), thus confirming applicability of the single-disc assay for amikacin.
Analysis of the data obtained by using amikacin disc containing 30 μg revealed the primary regression equation to be: D (diameter, mm) =23.73-8.55 log MIC (μg/ml) in conventional assay, D=29.84-11.53 log MIC (μμg/ml) in delayed assay, D=16.47-4.53 log MIC (μg/ml) in 3-4 hours rapid assay, and D=19.57-6.19 log MIC (μg/ml) in 5-6 hours rapid assay, respectively.
The range of variations in MICs estimated from the diameter of inhibition zone by the disc test was then calculated in comparison with that in MIC determined by the two-fold agar dilution assays, as reference for the experimental errors which may be involved in the estimation of MIC of amikacin by the single-disc assay.

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