[in Japanese]

View full abstract

Antimicrobial activities were examined for 6 antibiotics, mainly oral cephems, including cefpodoxime (CPDX), cefaclor (CCL), cefroxadine (CXD), cefixime (CFIX), ampicillin (ABPC), and erythromycin (EM), against 50 strains of methicillin-sensitive Staphylococcus aureus (MSSA) isolated from children with pediatric infection based on minimum inhibitory concentration (MIC) levels measured using the method established by the Japan Society of Chemotherapy.
MIC levels of oral cephems were in the decreasing order of CFIX, CXD, CPDX and CCL. ABPC showed a wide MIC distribution; namely, its MIC levels against some strains were lower than those of CCL, whereas ABPC had higher MIC levels against some other strains than CFIX. MIC levels of EM were always higher than those of the oral cephems examined and ABPC.
MIC levels of CPDX against MSSA were always lower than 0.8μg/ml, whereas MIC levels against MSSA of all of the other oral cephems examined, CCL, CXD and CFIX, were higher than 1.56μg/ml at their highest.
Considering overall results, CPDX appeared to be the best oral antibiotic in the treatment of pediatric patients when compared with other antibiotics examined.

View full abstract

Bacterial species isolated from postoperative infections during the period from July 1982 to June 1993 were studied regarding isolation frequencies of different species in different years in a joint research project involving nine (9) university hospitals in Japan. The obtained results are summarized as follows.
(1) Altogether, 1,453 strains were isolated with 153 strains obtained during the most recent one year from July of 1992 through June of 1993. The most numerous source of isolation was postoperative intra-abdominal sepsis.
(2) Gram-positive cocci were the most often isolated, among them methicillin-resistant Staphylococcus aureus was isolated in increasing frequencies until June, 1992.
(3) In the last one year, Enterococcus spp. was isolated the most from postoperative infections followed by Staphylococcus spp. and Pseudomonas spp. Rates of isolation of anaerobic bacteria were relatively low with annual isolation frequencies ranging 8 to 15 per cent.

View full abstract

To evaluate the antibacterial activity of a monobactam antibiotic, aztreonam (AZT), MICs of AZT and other antibiotics against clinical isolates collected at 36 participating institutions after January 1992 were determined using the agar plate dilution method (size of inoculum, 10⁶cfu/ml) according to the Japan Society of Chemotherapy standard. The antibiotics that were tested along with AZT included piperacillin (PIPC), cefoperazone (CPZ), and amikacin (AMK). AZT was found to be more active against Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris, Morganella morganii, and Providencia rettgeri than CPZ, PIPC, and AMK. AZT was also more active against Serratia marcescens than the other antibiotics, but about 6% of the strains tested were resistant to AZT with MIC of 12.5μg/ml. Against Enterobacter cloacae and Citrobacter freundii, however, was more active AMK than AZT. AZT showed a normal activity distribution with a single peak at the MIC of 3.13-6.25μg/ml against Pseudomonas aeruginosa, and 35% of inoculum was resistant with high MIC values (MIC ≥ 25μg/ml).
Activities of AZT against Haemophilus influenzae and Neisseria gonorrhoeae were comparable to those of CPZ.

View full abstract

We evaluated clinical effects and toxicities of a combination of fosfomycin (FOM) and clavulanic acid/ticarcillin (CVA/TIPC) for treatment of infections complicated with hematolagical disorders in 61 patients. Fifty-eight patients were evaluable, including 40 with acute leukemia, 13 with malignant lymphoma and 5 with other hematological disorders.
Clinical efficacies were excellent in 21 cases, good in 13 cases, fair in 2 cases and poor in 22 cases. The efficacy rate was 58.6%(34 cases/58 cases). This treatment was also effective in 12 of 20 cases in which granulocyte counts were less than 500/μl through the course of administration.
No subjective side effects were observed. Abnormal values in laboratory tests were noted in 1 case. Mild elevations of GOT and GPT were observed.
Thus, the combination of FOM and CVA/TIPC is an effective and safe regimen for the treatment of infections in patients complicated with hematological disorders.

View full abstract

To conduct pharmacokinetic and clinical studies on newly developed L-627 (biapenem) against various infections in pediatrics, a study group was organized and a joint research by 15 institutions and their related hospitals was undertaken. Informed consents of subjects were obtained prior to the study. The obtained results are as follows.
1. Plasma concentrations and urinary excretion
Pharmacokinetics of L-627 in children was studied in 29 subjects using 30 minutes intravenous drip infusion of 6mg/kg and 12mg/kg. Maximum plasma levels of L-627 was observed at the completion of drip infusion and were 25.1μg/ml with administration of 6mg/kg and 39.2μg/ml with administration of 12mg/kg on average. Dose dependency was noted in C_max. and AUC with these doses. Maximum blood levels in all of the 5 participated sucklings under the age of one year were similar to the average. As for urinary excretion, L-627 was excreted 66.0% with administration of 5mg/kg and 62.3% with 12mg/kg.
2. Cerebrospinal fluid concentrations
Cerebrospinal fluid concentrations ranged from 0.76 to 8.54μg/ml in 30-240 minutes after the completion of drip infusion with dose of 20-40mg/kg in 9 subjects with purulent meningitis, when they were measured within 3 days after the initiation of the treatment with L-627.
3. Clinical results Thirty-three cases of exclusion and drop-out were deducted from a total of 330 cases, hence 297 cases were evaluated as the subjects in the study for analysis of clinical effects. As for clinical effects in group A where pathogenic bacteria were detected, 166 out of 173 were rated as effective or above, hence the efficacy rate of 96.0% was obtained. In group B where pathogenic bacteria were not detected, 114 out of 124 cases were rated as effective or above, thus the efficacy rate was 91.9%, which is similar to that of the group A. The overall efficacy rate was 94.3% in the entire 297 cases. The rates of “excellent” responses out of the cases rated as effective or above were 62.7%(104/166) in the group A and 55.3%(63/114) in the group B, thus the rate was markedly high in the former group.
Efficacy rate for each pathogenic strain was also high, and that in subjects infected by a single pathogenic strain was 96.7%(145/150) and that in subjects infected by two or more pathogenic strains was 91.3%(21/23).
As for the bacteriological effect 74 (94.9%) out of 78 strains of Gram-positive bacteria and 115 (93.5%) out of 123 strains of Gram-negative bacteria disappeared. Even among examples of poor responses, the eradication rates were high: including 57.1% for MRSA and 71.4% for Pseudomonas aeruginosa. Besides, 2 out of 3 strains of Bordetella pertussis were eradicated. The overall bacterial eradication rate was 94.0%.
The efficacy rate of L-627 was 93.0%(93/100) in cases where other antibacterial drugs were administered for more than 3 days and proved to be ineffective. The rate of “excellent” response out of the 93 cases was 51.6%(48/93). The bacterial eradication rate for Gram-positive bacteria was 96.6%(28/29) and that for Gram-negative bacteria was 93.9%(31/33).
4. Side effects and abnormal laboratory data
A study on the safety was conducted in 316 cases to evaluate side effects and in 313 cases to evaluate abnormalities in laboratory data. Side effects were noted in 10 cases (3.2%), consisting of 11 events: skin rash in 4, diarrhea in 4, erythema in 1, abdominal pain in 1 and pyrexia in 1.
Abnormalities in laboratory data were found in 46 cases (14.7%), consisting mainly of elevations in platelet count, increases in eosinophils and elevations of transaminase. Side effects and abnormalities in laboratory data were not particularly serious and disappeared or returned to normal with discontinuation or completion of the treatment with L-627.

View full abstract

Clinical effects of combined use of Shouhu-san and mequitazine in 8 cases with recurrent vaginal candidiasis in obstetrics and gynecology were studied, and the following results were obtained.
Shouhu-san was orally administered to 8 patients, with recurrent vaginal candidiasis, using a daily dose of 7.5g. The duration of treatment was between 14 to 28 days. Also mequitazine was used in combination, with a daily dose of 6mg.
The clinical responses were good in all 8 and the efficacy rate was 100%. The microbiological eradication was obtained in all 8 cases of Candida albicans.
Neither subjective nor objective side effects were observed.
These results suggest that a combination of Shouhu-san and mequitazine appears to be useful of immunologic aspects against recurrent vaginal candidiasis.

View full abstract