The Japanese Journal of Antibiotics
Online ISSN : 2186-5477
Print ISSN : 0368-2781
ISSN-L : 0368-2781
Volume 60, Issue 6
Displaying 1-6 of 6 articles from this issue
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    2007 Volume 60 Issue 6 Pages 321-334
    Published: December 25, 2007
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
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  • HIROSHIGE MIKAMO, KAORI TANAKA, KUNITOMO WATANABE
    2007 Volume 60 Issue 6 Pages 335-343
    Published: December 25, 2007
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
    Various analysis based on PK-PD (pharmacokinetics-pharmacodynamics) theory were performed forprediction on the efficacy of antimicrobial agents for infectious diseases. However, there have been few reports when causative organisms would be anaerobic bacteria. Although the antimicrobial activity of fluoroquinolones against anaerobes has been weak, gatifloxacin (GFLX), moxifloxacin (MFLX), and garenoxacin (GRNX) are considered as anti-anaerobic quinolones in recent days. Therefore, we investigated prediction on the efficacy of fluoroquinolones for anaerobic infections using Monte Carlo Simulation.
    Although the target attainment of fluoroquinolones (levofloxacin, GFLX, and MFLX) on AUC/MIC value has not established yet, we have assumed 40 and 125 as the target attainment of AUC/MIC value. GFLX and MFLX would be effective against anaerobic infections caused by Prevotella intermedia, Fusobacterium nucleatum, Micromonas micros, which are the causative organisms for respiratory tract infections. From these results, GFLX and MFLX would be effective against anaerobic infections in respiratory tract as anti-anaerobic fluoroquinolones.
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  • KEIZO YAMAGUCHI, YOSHIKAZU ISHII, MORIHIRO IWATA, NAOKI WATANABE, NOBU ...
    2007 Volume 60 Issue 6 Pages 344-377
    Published: December 25, 2007
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
    The antibacterial activity of meropenem (MEPM) and other parenteral antibiotics against clinical isolates of 876 strains of Gram-positive bacteria, 1764 strains of Gram-negative bacteria, and 198 strains of anaerobic bacteria obtained from 30 medical institutions during 2006 was measured. The results were as follows;
    1. MEPM was more active than the other carbapenem antibiotics tested against Gram-negative bacteria, especially against enterobacteriaceae and Haemophilus influenzae. MEPM was also active against most of the species tested in Gram-positive and anaerobic bacteria, except for multi-drug resistant strains including methicillin-resistant Staphylococcus aureus.
    2. As for Pseudomonas aeruginosa, all of the MEPM-resistant strains were resistant to imipenem (IPM). MEPM showed low cross-resistant rate both againt IPM-resistant P. aeruginosa (41.8%) and ciprofloxacin-resistant P. aeruginosa (33.3%).
    3.The proportion of extended-spectrum β-lactamase (ESBL) strains was 4.3% (6 strains) in Escherickia coli, 1.1% (1 strain) in Citrobacter freundii, 21.7% (5 strains) in Citrobacter koseri, 3.1% (4 strains) in Klebsiella pneumoniae, 3.3% (3 strains) in Enterobacter cloacae, 0.8% (1 strain) in Serratia marcescens, and 4.9% (2 strains) in Providencia spp. The proportion of metallo-β-lactamase strains was 3.1% (10 strains) in P. aeruginosa.
    4. Of all species tested, there were no species, which MIC90 of MEPM was more than 4-fold higher than those in our previous study. Therefore, there is almost no significant decrease in susceptibility of clinical isolates to meropenem.
    In conclusion, the results from this surveillance study suggest that MEPM retains its potent and broad antibacterial activity and therefore is a clinically useful carbapenem at present, 11 years after available for commercial use.
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  • YOSHIO KOBAYASHI, YUKO SUMITANI, KAYOKO SUGITA, YASUHIRO KATOHNO
    2007 Volume 60 Issue 6 Pages 378-386
    Published: December 25, 2007
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
    Using broth micro-dilution method, we studied the susceptibility of 180 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis to meropenem (MEPM) and reference agents. All strains were isolated from the blood of patients admitted to Keio University Hospital between January 2006 and November 2006. The results were as follows:
    1. MEPM showed greater potency against Gram-negative bacteria than the other carbapenems including doripenem in particular. A metallo-β-lactamase producing multi-drug resistant P.aeruginosa strain was detected.
    2.Acomparison of the antibacterial activity of MEPM with that in our previous studies 1997-1998, 1999, 2002-2003, and 2004 showed no marked increase in MEPM-resistant clinical isolates. These results suggest that MEPM retains its potency as the agent of choice in treating serious infections.
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  • HIROSHIGE MIKAMO
    2007 Volume 60 Issue 6 Pages 387-393
    Published: December 25, 2007
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
    An optimal regimen for the use of ceftazidime(CAZ)(one of injectable antimicrobial agents in cephem family) against Pseudomonas aeruginosa infection was explored, using Monte Carlo simulation. Pharmacokinetic parameters needed for Monte Carlo simulation were derived from the existing data for healthy adults, and the data on MIC distribution of CAZ against clinically isolated bacterial strains reported by Working Group of Forum on Microbial Resistance. When CAZ was used within the currently approved dosage and administration for adults (4 g/day at maximum), intravenous administration of CAZ, 1 g, t. i. d., per day was found to have the highest probability to achieve the target of maximum bactericidal activity for cephems, i. e., 60-70%T>MIC (time above MIC). The probability to achieve the same target was the second highest with two intravenous CAZ, 2 g, b. i. d., per day, and third with CAZ, 1 g, b. i. d., per day. These results suggest that when treating P. aeruginosa infection with CAZ, for which T>MIC serves as PK/PD parameter, increasing the frequency of dosing is effective method to reinforce its efficacy, and that CAZ, t. i. d., per day is an optimal dosage and administration within the range of the regimens described in its package insert.
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  • YOUK SUMITANI, YOSHIO KOBAYASHI
    2007 Volume 60 Issue 6 Pages 394-403
    Published: December 25, 2007
    Released on J-STAGE: May 17, 2013
    JOURNAL FREE ACCESS
    Recently, PK/PD (pharmacokinetics/pharmacodynamics) analysis for the antimicrobial dosage method became one of the popular categories in chemotherapy and infectious disease societies world wide. Carbapenems are often used for empiric therapy because of its broad-spectrum and activities against microogrganisms. PK/PD analysis is well studied in some antibiotics includingcarbapenems and it is necessary also from the point of view of prevention for emergence of resistant strains. We report the result of the analysis for the effective dosage regimens of meropenem, biapenem and doripenem against Pseudomonas aeruginosa infection based on PK/PD theory with the MIC distributions against the strains isolated from the patients blood at Keio University in 2004 and 2006. The highest target attainment rate for the free drug 40% time above the MIC (40%T≥MIC) in traditional infusion with the MIC distribution against P. aeruginosa isolated from the patients blood at Keio University Hospital in 2004 was as follows: 90.89% in 500 mg every 6 hours regimen for meropenem, 83.25% in 300 mg every 6 hours regimen for biapenem, 81.73% in 250 mg every 6 hours regimen for doripenem in the approved maximum daily dose for each agent. The highest target attainment rate for the free drug 40%T≥MIC in Prolonged infusion with the MIC distribution against P. aeruginosa isolated from the patients blood at Keio University Hospital in 2004 was as follows: 100% in 500 mg every 6 hours regimen for meropenem, 83.97% in 300 mg every 8 hours regimen for biapenem, 99.98% in 500 mg every 8 hours regimen for doripenem in the maximum daily dose for each agents. The highest target attainment rate for the free drug 40%T≥MIC in traditional infusion with the MIC distribution against P. aeruginosa isolated from the patients blood at Keio University Hospital in 2006 was as follows: 80.57% in 500 mg dose in every 6 hours regimen for meropenem, 56.70% in 300 mg every 6 hours regimen for biapenem, 69.44% in 250 mg every 6 hours regimen for doripenem in the maximum daily dose for each agent. The highest target attainment rate for the free drug 40%T≥MIC in prolonged infusion with the MIC distribution against P. aeruginosa isolated from the patients blood at Keio University Hospital in 2006 was as follows: 89.35% in 500 mg every 6 hours regimen for meropenem, 60.84% in 300 mg every 6 hours regimen for biapenem, 82.78% in 500 mg every 8 hours regimen for doripenem in the maximum daily dose for each agent. The target attainment rates for the free drug Css/MIC≥1 with continuous infusion were lower than the target attainment rates for the free drug 40%T≥MIC in the regimens of prolonged infusion intermittent dose regimens in all three agents using both of the MIC distributions against P. aeruginosa in 2004 and 2006. The result of the PK/PD analysis for meropenem, biapenem and doripenem indicated that intermittent dose with Prolonged infusion was the best method to obtain higher target attainment rate.
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