The Japanese Journal of Antibiotics
Online ISSN : 2186-5477
Print ISSN : 0368-2781
ISSN-L : 0368-2781
Volume 50, Issue 3
Displaying 1-4 of 4 articles from this issue
  • I. SUSCEPTIBILITY DISTRIBUTION
    YOSHIAKI KUMAMOTO, TAIJI TSUKAMOTO, TAKAOKI HIROSE, AKIFUMI YOKOO, YOS ...
    1997 Volume 50 Issue 3 Pages 219-250
    Published: March 25, 1997
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
    The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 704 bacterial strains isolated from patients with urinary tract infections (UTIs) in 11 hospitals during the period of June 1995 to May 1996. Of the above bacterial isolates, Gram-positive bacteria accounted for 29.8% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 70.2% and most of them were Escherichia coli. Susceptibilities of several isolated bacteria to antimicrobial agents were as followed;
    1. Enterococcus faecalis Ampicillin (ABPC) and imipenem (IPM) showed the highest activities against E. faecalis isolated from patients with UTIs. The MIC90s of them were 1μg/ml. Vancomycin (VCM) and piperacillin (μ) were also active with the MIC90s of 2μg/ml and 4μg/ml, respectively. The others had low activities with the MIC90S of 16μg/ml or above.
    2. Staphylococcus aureus including MRSA VCM showed the highest activities against S. aureus isolated from patients with UTIs. Its MIC90 was 1μg/ml against both S. aureus and MRSA. Arbekacin (ABK) was also active with the MIC90 of 2μg/ml. The others except minocycline (MINO) had very low activities with the MIC90s of 64μg/ml or above.
    3. Staphylococcus epidermidis ABK and MINO showed the strongest activities against S. epidermidis isolated from patients with UTIs. The MIC90s of them were 0.25μg/ml. VCM was also active with the MIC90 of 1μg/ml. The MIC90s of cephems ranged from 2μg/ml to 16μg/ml in 1994, but they ranged from 8μg/ml to 128μg/ml in 1995. These results indicated that some resistances existed among S. epidermidis to cephems.
    4. Streptococcus agalactiae All drugs except gentamicin (GM) were active against S. agalactiae. ABPC, cefmenoxime (CMX), IPM, erythromycin (EM), clindamycin (CLDM) and clarithromycin (CAM) showed the highest activities. The MICs for all strains were lower than 0.125μg/ml. The MIC90s of the others were 2μg/ml or below.
    5. Citrobacter freundii IPM showed the highest activity against C. freundii isolated from patients with UTIs. Its MIC90 was 1μg/ml. GM was also active with the MIC90 of 2μg/ml. Cefpirome (CPR), cefozopran (CZOP) and amikacin (AMK) were also active with the MIC90s of 4μg/ml. Penicillins and cephems except CMX, CPR and CZOP showed low activities with MIC90s of 256μg/ml or above.
    6. Enterobacter cloacae IPM showed the highest activity against E. cloacae. The MICs for all strains were equal to or lower than 1μg/ml. MINO and tosufloxacin (TFLX) were also active with the MIC90s of 8μg/ml.Penicillins and cephems except CPR and CZOP showed lower activities with the MIC90s of 256μg/250(32) THE JAPANESE JOURNAL OF ANTIBIOTICS 50-3 Mar. 1997 ml or above.
    7. Escherichia coli Most of antimicrobial agents were active against E. coll. Particularly CPR, CZOP and IPM showed the highest activities against E. coll. The MICs for all strains were equal to or lower than 0.5μg/ml. CMX and TFLX were also active with the MIC90s of 0.125μg/ml or below. Penicillins were slightly active with MIC90s of 128μg/ml or above.
    8. Klebsiella pneumoniae K. pneumoniae was susceptible to all drugs except penicillins, with MIC90s of 2μg/ml or below. Carumonam (CRMN) had the strongest activity against K. pneumoniae, the MICs for all strains were equal to or lower than 0.125μg/ml. Comparing with the result of 1994, the sensitivities of K. pneumoniae against all drugs had obviously changed into a better state. For example, the MIC90s of cephems ranged from 0.25μg/ml to 16μg/ml in 1994, but they were all lower than 2μg/ml in 1995.
    9. Proteus mirabilis P. mirabilis was susceptible to a majority of drugs.
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  • II. BACKGROUND OF PATIENTS
    YOSHIAKI KUMAMOTO, TAIJI TSUKAMOTO, TAKAOKI HIROSE, AKIFUMI YOKOO, YOS ...
    1997 Volume 50 Issue 3 Pages 251-264
    Published: March 25, 1997
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
    Clinical background was investigated on patients with urinary tract infections (UTIs) from whom 785 bacterial strains were isolated in 11 hospitals during the period from June, 1995 through May, 1996.
    1. Distributions of age and sex of patients and type of infections Among the patients examined, those with ages 50 years or older were the most frequent (males: 80.5%, females: 69.7%), and, among females, those with ages in the 20's were 12.6%. With regard to types of infections, more than a half of infections among males were of complicated types, but most of infections among females were of uncomplicated types, especially among females of ages less than 60 years.
    2. Ages of patients and types of pathogens The higher the ages of patients, the lesser became the isolation frequencies of Proteus spp. and Serratia spp., but the higher were those of Klebsiella spp. and Pseudomonas spp.
    3. Effect of antibiotic use on isolation frequencies of pathogens Use of antibiotics decreased pathogens isolated from patients with uncomplicated UTIs drasti-cally (237 isolates before antibiotics compared to 33 after). Even isolated pathogens from patients with complicated UTIs decreased drastically with the use of antibiotics when indwelling catheters were not in use (200 isolates before antibiotics compared to 83 after), but when indwelling catheters were in use, antibiotics apparently failed to decrease the isolation frequency.
    4. Surgical procedures and types of causative organisms for UTIs Escherichia coli was the most frequently isolated organism from uncomplicated cases of UTIs. From cases of complicated UTIs without indwelling catheters, nterococcus faecalis was the most frequently isolated, followed by E. coli, P. aeruginosa and Klebsiella spp. When a surgical procedures were not done, E. coli was isolated most frequently. From cases of complicated UTIs with indwelling catheters, P. aeruginosa, E. faecalis and S. aureus were the organisms that were mainly isolated, with isolation frequencies of 23.9%, 17.3% and 12.7%, espectively. When no surgical procedures were used, isolation frequencies of P. aeruginosa, Klebsiella spp. and E. faecalis were 25.7%, 14.3%, and 14.3%, respectively.
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  • HIDENORI MEGURO, ITARU TERASHIMA
    1997 Volume 50 Issue 3 Pages 265-271
    Published: March 25, 1997
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
    Azithromycin (AZM) preparations in fine granules and capsules were evaluated in 36 pediatric patients with various infections.
    In patients with pneumonia caused by Moraxella catarrhalis, Haemophilus influenzae or Mycoplasma pneumoniae, bronchitis, pharyngitis, scarlet fever, whooping cough, or campylobacter enteritis, AZM was found effective in 94.4% (34/36). As for the bacteriological efficacy of AZM, all of 12 strains identified were found eradicated by the treatment. Plasma T 1/2 (24-48 hrs.) of AZM in fine granules, given two patients at 10 mg/kg body weight once daily for 3 days, were 41.5 and 51.4 hours, while AUC0-∞was 7.45 and 13.44mg·hr/ml. The rates of AZM recovered in the urine samples from two pediatric patients in the first 81 hours of treatment, when it is given in fine granules at 10 mg/kg body weight once daily for 3 days, were 6.27% and 11.0%.
    Data from 43 patients were included for drug safety evaluation.
    Neither adverse reactions nor abnormal laboratory changes were observed.
    In conclusion, AZM was found useful in treatment of pediatric infections.
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  • TAKASHI MOTOHIRO, KENSUKE NAGAI, SHUJI YAMADA, NAOKI TSUMURA, TAKASHI ...
    1997 Volume 50 Issue 3 Pages 272-297
    Published: March 25, 1997
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
    Azithromycin (AZM), a new oral macrolide antibiotic, in 10% fine granules or 100 mg capsules was given to pediatric patients to treat various infections. The following results were obtained in our studies of AZM for its antibacterial activities against clinical isolates, its pharmacokinetics, its efficacy, and its safety.
    1. MICs of AZM, erythromycin (EM) and clarithromycin (CAM) were determined against a total of 57 strains all at 106 cfu/ml. Among Gram-positive cocci, MICs of AZM ranged from 0.78 to> 100 μg/ml against Staphylococcus aureus (20 strains), from 0.05 to 0.1 μg/ml against Streptococcus pyogenes (11 strains), and from 0.0125 to 3.13μg/ml against Streptococcus pneumoniae (10 strains). These MICs were similar to those of the other macrolides. Among Gram-negative bacilli, MICs of AZM were 0.05μg/ml against Moraxella subgenus Branhamella catarrhalis (1 strain), from 0.78 to 3.13μg/ml against Haemophilus influenzae (9 strains), 0.78μg/ml against Haemophilus parainfluenzae(1 strain) and 6.25 μg/ml against Salmonella sp.(1 strain). These values were similar to or lower than those of the other macrolides. Against Mycoplasma pneumoniae, MICs of AZM were ≥0.0008 μg/ml in three strains. One strain of M. pneumoniae showed tolerance to AZM at MIC 25 μg/ml. The other agents exhibited higher MIC than AZM against this organism.
    2. Plasma samples were collected from five patients receiving fine granules and four patients receiving capsules for drug level determination. The patients received AZM at 10.0-16.3 mg/kg body weight once daily for 3 days. Drug concentrations in plasma at two hours after Day 3 dosing were in a range between 0.02 and 0.19μg/ml for fine granules and were in a range between 0.11 and 0.42 μg/ml for capsules.
    3. Urine samples were collected from four patients receiving fine granules and four patients receiving capsules. Drug levels were determined to be 3μ/ml at post-treatment 48 hours for fine granules and post-treatment 72 hours for capsules. Urinary excretion rates of AZM in three patients on capsules lied in a range between 4.69 and 10.17%.
    4. Effectiveness of AZM in fine granules was evaluated in 128 patients having a total of 19 different infections. AZM was rated “excellent” in 51 patients, “good” in 63, “fair” in 8, “poor” in 6, resulting in an efficacy rate of 89.1%. Effectiveness of AZM in capsular form was evaluated in 23 patients with five different infections. AZM was found “excellent” in 13 patients and “good” in 10, resulting in an efficacy rate of 100%.
    5. AZM in fine granules eradicated 45 strains of 54 in 8 different bacteria. AZM in capsules eradicated 9 strains of 10 strains in 6 different bacteria.
    6. As for adverse reactions, one patient complained of eruption, one vomiting, one loose stool, five diarrhea, when administered with fine granular form of AZM. One patient on AZM capsules experienced urticaria and vomiting.
    7. As for abnormal laboratory changes, three patients were found with decreased WBC, seven with increased eosinophil, two with increased GOT and GPT, one with increased GPT. They were all on fine granular form of AZM. As far as abnormalities found in patients administered with AZM in capsular form, two showed decreased WBC, one decreased WBC along with increased eosinophil, and three increased eosinophil.
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