[in Japanese]

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We evaluated the effectiveness and safety of vancomycin (VCM) alone and in combination with β-lactam antibiotics in the treatment of MRSA infections, and obtained the following results:
1. Effectiveness
(1) In cases of MRSA infections alone, the improvement rate was 71.4% (5/7 patients) with VCM alone and 77.8% (35/45) with VCM in combination with β-lactam antibiotics.
(2) In cases of polymicrobial infections, few cases were treated with VCM alone, but the improvement rate in combination use with β-lactam antibiotics was 71.8% (28/39).
2. Bacteriological effect
(1) In cases of single infection with MRSA, the rate of bacterial eradication was 71.4% (5/7) with VCM alone and 68.2% (30/44) with VCM in combination with β-lactam antibiotics.
(2) In cases of polymicrobial infections, few cases were treated with VCM alone, but the rate of bacterial eradication in combination use with β-lactam antibiotics was 63.2% (24/38) against MRSA and 31.6% (12/38) against polymicrobial agents including MRSA.
3. Safety
Occurrences of adverse reactions and abnormal laboratory test values when VCM was used alone or when it is used in combination with another drug, were about the same in these uses. As a whole, advanse reactions were observed in 16 patients (9.5%).
Main adverse reactions were whole body redness, drug eruption, and rash etc. Abnormal laboratory test values were observed mainly in hepatic functions, and renal functions.
4. VCM concentrations in blood was determined in 38 patients. Doses of 0.5g and 1.0g of VCM was administered by intravenous drip infusion over a period of 1 to 2 hours, and mean blood concentrations 1 to 2 hours after the completion of drip infusion were 25.4μg/ml and 31.5μg/ml, respectively, for the two doses with trough values of 15.2μg/ml and 14.4μg/ml, respectively.
5. Synergic effects between VCM and other antibiotics tested were observed in FIC index against all of the six MRSA strains isolated from six patients, and the clinical effects of improvement or better were obtained against five of them.

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The efficacy and safety of sulbactam/cefoperazone (SBT/CPZ) were evaluated in 42 patients with respiratory tract infections, including pneumonia (29 patients) and lower respiratory tract infections (5 patients).
Overall clinical efficacy rates (excellent+good) were 79% in pneumonia and 80% in respiratory tract infections in 34 patients evaluated for clinical efficacy. It was excellent that the clinical efficacy rate was 92% in mild and moderate pneumonia. Pathogens isolated from sputa were 31 strains, including 8 strains of Pseudomonas aeruginosa, 7 of Streptococcus pneumoniae, 3 of Staphylo coccus aureus and 3 of Haemophilus influenzae. Since the isolates were eradicated in 18 strains, replaced in 3, unchanged in 2 and unknown in 8, the overall eradication rate was 91%. The eradication rates were 89% in beta-lactamase producing strains and 100% in beta-lactamase non-producing strains. The clinical efficacies were good in 3 of 5 patients with beta-lactamase positive sputum, and excellent or good in 19 (83%) of 23 patients with beta-lactamase negative sputum. The eradication rate was 88% in 5 patients with beta-lactamase positive sputum.
One patient experienced a moderate rash. Abnormal laboratory test values were observed in 10 patients (26.3%), but these abnormalities were mild and transient.
These results suggested that SBT/CPZ was effective and safe for the treatment of respiratory tract infections caused by beta-lactamase producing as well as beta-lactamase non-producing bacteria.

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A clinical study was carried out to investigate clinical efficacy and safety of tazobactam/piperacillin (TAZ/PIPC), a newly developed antibiotic agent for injections. The obtained results are as follows:
1. In 10 patients with obstetrics and gynecological infections (7 patients with endometrial infections, one patient with pelvic peritonitis, one patient with ovarian abscess and one patient with BARTHOLIN'S abscess) intravenous drip infusion of TAZ/PIPC, 5.0g/day, was administered for 5 to 10 days. The total doses were 25-50g/body.
2. Clinical efficacy was evaluated in the above cases. As a result, an excellent result was obtained in one patient and good efficacies in 9 patients. The efficacy rate was 100% (10/10). Concerning the clinical bacteriological effect, eradication ratio was 83.3% (5/6). Concerning the bacteriological effect against 11 strains of clinical isolates, 4 strains were eradicated, 6 strains were replaced and one strain was unchanged.
3. Neither subjective/objective side effects nor abnormal laboratory test results were observed upon administration of TAZ/PIPC.
These results suggested the usefulness of tazobactam/piperacillin in obstetrics and gynecological infections.

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Concentrations of ceftriaxone (CTRX) in the serum and the cerebrospinal fluid (CSF) were serially investigated after an intravenous drip infusion of 2g per day to 14 patients with acute cerebrovascular diseases, as they were determined at 30minutes, 3, 6, 24 hours, 3 and 7 days after first administration.
The results obtained are summarized as follows:
1. Serum levels; Peak levels of CTRX in the serum were 162.0±51.2(SD)μg/ml at 30 minutes after administration. Even at 24 hours after intravenous drip infusion, concentrations of CTRX were 14.9±6.15(SD)μg/ml.
2. CSF levels; The CTRX concentrations in the CSF rose to 1.70±1.84(SD)μg/ml at 30 minutes, 3.51±3.31(SD)μg/ml at 3 hours and then decreased to 0.74±0.67(SD)μg/ml at 24 hours after first infusion.
3. CTRX concentrations in serum and CSF after serially repeated infusion for 3 to 7 days were quite similar to the those obtained after the first administration.
The above results indicates that CTRX is useful for the prevention of postoperative infections in the field of neurosurgery.

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In vitro antifungal activities of omoconazole nitrate (OMZ), a novel antifungal imidazole antimycotic drug, are examined against clinical isolates obtained from patients with cutaneous mycosis and its activity was compared with that of bifonazole (BFZ). The clinical isolates tested were 70 of dermatophytes including Trichophyton rubrum (47 isolates), T. mentagrophytes (22 isolates), Microsporum gypseum (1 isolate), and 27 isolates of Candida albicans.
MIC values of OMZ to dermatophytes distributed in a range of ≤0.04 to 0.63μg/ml were similar to those of BFZ (≤0.04 to 1.25μg/ml). MIC values of OMZ to C. albicans were in a range of 0.16 to 2.5μg/ml indicating that OMZ had more potent activities than BFZ (1.25 to 5μg/ml).
These results showed that in vitro antifungal activities of OMZ against clinical isolates of dermatophytes and C. albicans were greater than or similar to those of BFZ.

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