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Volume 53, Issue 12
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YOSHIHITO OTSUKA, TAKAKO YOSHIBE, MIHO NAMIOKA, TAKAYUKI EZAKI2000 Volume 53 Issue 12 Pages 643-651
Published: December 25, 2000
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSIn vitro combination effect of teicoplanin and β-lactams was investigated against 109 MRSA strains isolated from a variety of clinical specimens at the Social Health Insuarance Medical Center during the period from January 1994 thrugh February 2000. TEIC+panipenem (PAPM) was revealed by microbroth dilution method-based checkerboard method, to exhibit synergistic effect of min. FIC index ≤0.5 against all the 109 strains. The combination of TEIC and flomoxef (FMOX) was shown to have synergistic effect on 108 strains (99.1%). The combination of TEIC and cefepime (CFPM) was shown to have synergistic effect on 96 strains (88.1%). The combination of TEIC and cefmetazole (CMZ) was shown to have synergistic effect on all the 109 strains (100%). The mean value of min. FIC indices obtained from each of the combinations was 0.1259 as to TEIC+PAPM, 0.2019 as to TEIC+FMOX, 0.3257 as to TEIC+CFPM and 0.1995 as to TEIC+CMZ, in other words, the combi-nation of TEIC+PAPM showed the lowest value of all the combinations. While MIC80 was 2.0μg/ml when TEIC was used alone, it was ≤0.06μg/ml when used together with PAPM, and 0.13μg/ml when used together with FMOX, respectively. While MIC80 was 3.2μg/ml when PAPM was used alone, it was 0.5μg/ml when used together with TEIC. Meanwhile, the value for FMOX was changed from≤μg/ml to 4.0 μg/ml. When TEIC was used in combination with CFPM, MIC80 was found to be 0.5μg/ml. Similar to the case of the concurrent use with FMOX, the value obtained by combination with CMZ was 0.13μg/ml. While MIC80 was 128μg/ml when CFPM was used alone, it was 8.0μg/ml when used together with TEIC, whereas the value for CMZ was decreased from 64μg/ml to 2.0 μg/ml. In conclusion, TEIC's antibacterial activity was shown to be accentuated by any of the combinations.View full abstractDownload PDF (938K) -
SHIOMI ISHIGO, TERUHIKO TAMAYA, SHIGENORI MATSUBARA, HARUKI SAWAMURA, ...2000 Volume 53 Issue 12 Pages 652-659
Published: December 25, 2000
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSThe frequency and the antibacterial sensitivity of Streptococcus pneumoniae strains isolated from 6 key hospitals (in 5 areas) and 1 otorhinolaryngology clinic in Gifu Prefecture from February to March, 1999, were investigated with several antibiotics.
A total of 128 strains of Streptococcus pneumoniae were isolated throughout the study: 47 strains (36.7%) of penicillin-susceptible S. pneumoniae (PSSP), 51 strains (39.8%) of penicillin-intermediate S. pneumoniae (PRSP), and 30 strains (23.4%) of penicillin-resistant S. pneumoniae (PRSP); the resistant bacteria being relatively prominent.
In these hospitals, PSSP was isolated by 38.8% in all the key hospitals and by 30% in the otolaryngology clinic with almost no discernible difference. PISP was isolated by 63.3%, higher in the otolaryngology clinic and PRSP by 28.6%, higher in the key hospitals conversely.
The MIC90s in PISP and PRSP were determined with the antibiotics. In result, only cefditoren (CDTR) showed favorable antibacterial activities with the MIC90 of 0.78μg/ml among penicillins or oral cephems. The MIC90s of carbapenems such as imipenem (IPM), meropenem (MEPM), and panipenem (PAPM) were less than 0.39 μg/ml; particularly, PAPM showed the highest antibacterial activities. Among new quinolones such as tosufloxacin (TFLX), levofloxacin (LVFX), sparfloxacin (SPFX), and ciprofloxacin (CPFX), TFLX showed the highest antibacterial activities with the MIC90 of 0.39 μg/ml. Other agents showed very low antibacterial activities as the MIC90s were 25 μg/ml in minocycline (MINO) and more than 100 μg/ml in clarithromycin (CAM) and clindamycin (CLDM).View full abstractDownload PDF (778K) -
YUJI YOSHIYAMA, TOMOKO YAZAKI, MOTOKO KANKE, DENIS BEAUCHAMP2000 Volume 53 Issue 12 Pages 660-666
Published: December 25, 2000
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSTeicoplanin, a glycopeptide antibiotic, is marketed in a number of European countries and has recently been put on the market in Japan. The spectrum of antibacterial activity of teicoplanin is equivalent or superior to that of vancomycin. The aim of the present study is to examine the nephrotoxicity of teicoplanin compared with vancomycin in rats. Wistar male rats, housed in a light-controlled room at room temperature for 1 week, were used. They were injected with either 15 or 50 mg/kg/day of teicoplanin or 50 or 200 mg/kg/day of vancomycin at 13: 00 daily for 14 days. The rats were randomly assigned to groups of five rats each and were housed individually in metabolic cages to collect urine. Urine samples were collected 24 hours prior to the drug treatment and every 24 hours thereafter for 14 days. N-Acetyl-β-D-glucosaminidase (NAG) activity was determined in the supernatant and expressed in international units per total urine collected for 24 hours. The group which was given vancomycin 200 mg/kg/day had ignificantly elevated urinary NAG levels compared with the other groups (p<0.05). No significant differences were observed in the NAG levels in urine among the remaining three groups. These results suggest that the nephrotoxicity of teicoplanin may be only one-fourth that of vancomycin in rats. It appears that by extrapolating the dose amount required for the treatment in humans to rats, the high dose of teicoplanin was set at 50 mg/kg/day and that of vancomycin, 200 mg/kg/day. The recommended dose for teicoplanin will probably be 200 mg/day compared to 2 g/day of vancomycin. If the teicoplanin dose is only one-tenth that of the vancomycin dose, then teicoplanin should be better tolerated than vancomycin in terms of nephrotoxicity.View full abstractDownload PDF (3714K) -
KOUJI MATSUDA, MATSUHISA INOUE2000 Volume 53 Issue 12 Pages 667-671
Published: December 25, 2000
Released on J-STAGE: May 17, 2013
JOURNAL FREE ACCESSMinimum inhibitory concentration (MIC) has been generally used to evaluate the activity of antimicrobial agents. However, there is some discrepancy between clinical efficacy and the MIC value. We studied the relationship between initial bactericidal activity of imipenem (IPM), panipenem (PAPM), meropenem (MEPM), ceftazidime (CAZ) and amikacin (AMK) and the respective MIC values against Psudomonas aeruginosa PAOl. Initial bactericidal activity was defined as percent reduction of initial bacterial cell concentration (106cells/ml) after 1 hour incubation following addition of antibiotic. The concentration of antibiotic used in this experiment was the blood level of each antibiotic at 3 hours after administration by drip infusion of the usual dose (IPM, PAPM and CAZ were 1 g for 1 hour drip infusion, MEPM was 1 g for 0.5 hours drip infusion and AMK was 200 mg for 1 hour drip infusion, respectively). The antibiotic concentration of IPM, PAPM, MEPM, CAZ and AMK were 8.77 pg/ml, 6.37 pg/ml, 4.12 pg ml, 12.0 pg/ml and 5.18 pg/ml, respectively. MICs of IPM, PAPM, MEPM, CAZ and AMK were 2 μg/ml, 64 μg/ml, 1 μg/ml, 1 μg/ml and 2 μg/ml, respectively.
Initial bactericidal activity of IPM, PAPM, MEPM, and CAZ against P. aeruginosa PAOl was 98.2%, 86.1%, 48.1%, and 43.4% reduction in bacterial concentration, respectively. AMK shows the strongest initial bactericidal activity with more than 99.9%. The killing speed of IPM was obviously the most rapid among the three carbapenems. The MIC of PAPM was significantly higher than the other antibiotics, and the initial bactericidal activity of PAPM was second to IPM. We can classify antibiotics into two groups based on initial bactericidal activity against P. aeruginosa; one class is antibiotics having rapid initial killing such as AMK, IPM and PAPM, the other is CAZ, MEPM showing slow initial killing.View full abstractDownload PDF (513K)
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