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Volume 50, Issue 8
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[in Japanese]1997 Volume 50 Issue 8 Pages 669-682
Published: August 25, 1997
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESS -
JUN IGARI, MATSUHISA INOUE, TAKESHI NISHINO, NAOKI WATANABE, NOBUYUKI ...1997 Volume 50 Issue 8 Pages 683-703
Published: August 25, 1997
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSResearch groups were formed in 20 institutions nationwide to investigate carbapenem resistance of clinical isolates. Activities of various antibacterial agents, principally carbapenems, were tested against clinical isolates collected from these institutions. The broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of 17 antibacterial agents for 1,326 strains of 11 bacterial species isolated at the institutions between October and December 1994.
The results are as follows:
1. Carbapenems exhibited strong antibacterial activities against MSSA and Streptococcus pneumoniae. Their activities against Enterococcus faecalis were comparable to that of ABPC. Carbapenems showed low activities against MRSA.
2. OFLX exhibited the greatest antibacterial activity against Haemophilus influenzae, followed by MEPM. Antibacterial activities of the other carbapenems were comparable to those of FMOX, CTM, and ABPC.
3. The carbapenems showed high activities against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Bacteroides fragilis group. Their activities were greater than those exhibited by other β-lactam antibacterial agents. The carbapenems also exhibited stronger antibacterial activities against Serratia marcescens than the other β-lactam antibacterial agents, but some resistant strains were detected.
4. The antibacterial activities of carbapenems against Pseudomonas aeruginosa were comparable to those of CAZ, AZT, AMK.View full abstractDownload PDF (1645K) -
KOJI O'HARA, AKIO NAKAMURA, FRITZ SHIGENOBU, JIA CHEN, TETUO SAWAI1997 Volume 50 Issue 8 Pages 704-710
Published: August 25, 1997
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSIt is well known that fosfomycin (FOM) shows the combination effects with some other antibiotics. Suck effects have not been known against Klebsiella pneumoniae, however.
In this report, combination effects of FOM with β-lactam, aminoglycoside, and macrolide antibiotics were investigated against clinical isolates of both FOM-susceptible and resistant Klebsiella pneumoniae.
FOM had synergistic activities with β-lactams such as ampicillin (ABPC) and cefminox (CMNX), and macrolide antibiotics as erythromycin (EM) and midecamycin (MDM) against all strains tested. Among β-lactams, penicillin V showed synergistic actions against FOM-susceptible strain of Tf341A and additive actions against FOM-resistant 3 strains with FOM. Pheneticillin was synergistic with FOM against FOM-highly susceptible strain Tf341A and the additive or nearly synergistic effects against other strains. FOM with amoxicillin was synergistic against Tf341A, and FOM-resistant strain of Tf170B and additive against other strains.
While the activities of combination of FOM with kanamycin or dibekacin against FOM-susceptible 2 strains were additive, those with amikacin were synergistic. Five different aminoglycosides tested showed antagonistic activities with FOM against 3 FOM-resistant strains.
From these results, FOM appears to be is clinically useful in treating FOM-susceptible and resistant strains of Klebsiella pneumoniae in combination of 4 antibiotics such as ABPC, CMNX, EM, and MDM.View full abstractDownload PDF (821K) -
SUSUMU SATO, TOMISATO MIURA, EMI KUDO, YUKIO KUDO, YOSHIHIKO SAITOH, I ...1997 Volume 50 Issue 8 Pages 711-716
Published: August 25, 1997
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSWe determined in vitro combined effects of vancomycin (VCM) plus carbapenems (CRBs) on 12 methicillin-resistant Staphylococcus aureus (MRSA) which are resistant to CRBs.
Combinations of VCM plus imipenem (IPM) and VCM plus panipenem (PAPM) and VCM plus meropenem (MEPM) indicated synergistic effects, fractional inhibitory concentration (FIC) indices of ≤0.05, against 67%, 75%, 67% of the strains, respectively.
Against forty two percent of strains tested, 1 MIC of VCM was equal to 1 MBC, and similarly, IPM, PAPM and MEPM had 1 MIC=1 MBC against 42%, 67% and 75% of the strains tested, respectively.
Combinations of VCM plus IPM and VCM plus PAPM and VCM plus MEPM showed synergistic effects, hence a fractional bactericidal concentration (FBC) index of 50.50, against 42%, 50%, 75% of the strains, respectively, and the combination of VCM plus MEPM was most synergistic.
These results suggest that combination therapy of VCM with CRB is useful for the treatment of MRSA infection in patients with renal dysfunction.View full abstractDownload PDF (663K) -
RYOCHI MASAMUNE, YASUO KUNII, ITARU WATANABE, YOUICHI IMAOKA, SATOSHI ...1997 Volume 50 Issue 8 Pages 717-726
Published: August 25, 1997
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSEffects of combination use of a second generation cephem and an aminoglycoside antibiotic isepamicin (ISP), for the treatment of post-surgical infections of the lower digestive tract were examined from a laboratory and clinical perspective.
Thirty-three out of total 35 cases were included in the analysis of the test, while the other 2 cases did not meet the criteria for analysis. ISP was administered in combination with one of the second generation cephems among cefotiam (CTM), cefmetazole (CMZ), or cefuroxime (CXM) for 26 cases of wound infection and 7 cases of peritonitis. The overall efficacy rate was 88%; 92% in wound infection and 71% in peritonitis individually. There was no significant difference in efficacy among different groups.
Bacteriological study showed the combination use of any one of the second generation cephems and ISP was very effective in all 14 cases of infections with a single species of bacterium, the efficacy rate was 100%. It was also effective in 9 out of 10 cases with mixed infections of 2 species of bacteria (90%), but effectiveness was diminished in only 6 out of 9 cases with mixed infections of 3 species (67%). Sixty-nine strains were isolated from the 35 cases, more than half of which (44 strains) were Gram-negative; 14 strains of E. coli (20%), 13 strains of E. faecalis (13%) and 6 strains of P. aeruginosa (9%). The MIC50 and MIC90 were, respectively, 1.56μg/ml and 100μg/ml for ISP, 6.25μg/ml and 100μg/ml for CTM, 12.5μg/ml and 100μg/ml for CMZ, and 25μg/ml and 100μg/ml for CXM. The MICs in any combination uses decreased synergistically according to ISP concentration. Adverse events were observed in 3 out of 35 cases, but they were not severe.
The results indicated that the combination use of a second generation cephem and ISP was useful and should be one of the choices for the treatment of post-operative infections of the lower digestive tract.View full abstractDownload PDF (1952K) -
RINYA SUGITA, KOICHI DEGUCHI, YUTAKA FUJIMAKI, SHINAKO HARADA, KOJI SH ...1997 Volume 50 Issue 8 Pages 727-737
Published: August 25, 1997
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSWe investigated the clinical efficacy in pediatrics sinusitis infections of cefditoren pivoxil granule therapy and its in vitro antibacterial activity against clinically isolated strains. The results are summarized as follows.
The specimens from 343 patients were cultured and 595 strains of bacteria were isolated and identified.
Oral doses of 3 and 5 mg/kg of CDTR-PI were clinically effective at high percentages, 85.1% and 89.5%, respectively, of treated patients.
CDTR-PI at 3mg/kg orally was clinically effective in 80.8% of patients with PCG intermediate S. pneumoniae (PISP) infections, 80.0% of those with PCG susceptible S. pneumoniae (PSSP) infections, 81.8% of those with H. influenzae infections and 78.3% of those with M.(B.) catarrhalis infections among the infections by major causative agents.
The frequent isolates included S. pneumoniae accounting for 33.1%, H. influenzae accounting for 32.1%, M (B.) catarrhalis accounting for 17.6% and S. pyogenes accounting 3.7% of all the isolates. PISP accounted for 16.1% of all the isolates and for 49.8% of the isolates of S. pneumoniae, and were isolated from 28.6% of the 343 patients.
The isolation of PISP was frequent from children of 4 and under especially, and especially frequent from those below age 2. Of the isolates of S. pneumoniae, the biotype frequencies among PSSP were in the order of type I>type II>type III, while those among PISP were in the order of type I<type II with none of type III.
Bacteriologically, an eradication rate of 89.4% was achieved with 3 mg/kg and 93.5% with 5mg/kg of CDTR-PI.View full abstractDownload PDF (1009K)
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