The present paper compares the clinical effectiveness and safety of cefoxitin an cefazolin against bacterial pneumonia in 154 in-patients in a well controlled, comparative study using 2g b. i. d. of each drug via intravenous drip infusions.
The following results were obtained on clinical and bacteriological responses, degrees of improve. ment of clinical symptoms, clinical and laboratory findings _ and side Pfferts:
1. No statistically significant difference was obtained between the clinical effectiveness of cefoxitin and cefazolin in 86 cases of bacterial pneumonia. The clinical effectiveness of cefoxitin was found to be inferior to that of cefazolin with statistical significance, however, when comparison was made on the basis of both mycoplasmal and primary atypical pneumonia as a single group (34 pts.) and on the basis of all the pneumonia cases (120 pts.).
2. Also, no statistically significant differences were observed between the two drugs on the degrees of improvement of clinical symptoms, clinical findings, laboratory and bacteriological findings with the exception that cefoxitin was found to be inferior to cefazolin in terms of the degree of improvement of fever.
3. With regard to the frequency of side effects, there was no statistically significant difference between the two drugs.

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Sixty-four strains of gentamicin-resistant gram-negative bacilli isolated from clinical specimens at Hamamatsu Medical Center in 1977 were tested for susceptibility to th e β-lactam antibiotics such as cephalothin, cefazolin, carbenicillin and sulbenicillin, and the aminoglycoside such as amikacin, entamicin, tobramycin and dibekacin. According to the MIC, the resistance pattern was determined 25 strains of Serratia marcescens, 16 strains of Citrobacter freundii and 16 strains of Proteus p. It was noticed that all the strains except two were resistant to the β-lactam antibiotics, while 0.7% of the strains were sensitive to amikacin; they showed slightly more resistance to tobramycin d dibekacin than to gentamicin.

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We tried to evaluate the efficacy of an immunostimulator, OK-432, against advanced cancers of emale sex organs. The patients selected were 24 cases with ovarian cancer, 23 cases with uterine cervix cancer and 3 cases with uterine corpus cancer. OK-432 was used alone, or in combination with radiation, or with radiation plus bleomycin, carbazilquinone or FT 207. The effects of OK-432 were examined with respect to leukocyte counts, lymphocyte counts, Tlymphocyte population ratioand lymphocyte blastogenesis induced by PHA, M/H subunit ratio of lactic dehydrogenase as well as local findings against tumor. The decrease in tumor size or in peritoneal fluid was judged as a loci sign of good response to therapy.
In 5 cases treated with OK-432 alone, one case was judged as a good responder locally. There were two cases in which the peripheral lymphocyte count was elevated over 110% of the initial value after therapy. Without exception, all cases had elevated T lymphocyte population ratios and enhanced responses of their lymphocytes to PHA.
OK-432 in combination with radiation therapy, 12 cases responded well in the immunologic function tests and judged as good. Out of 20 cases treated with OK-432 in combination with radiation therapy, 12 cases responded well in the immunologic function tests and judged good in the local findings. In this treatment group, about a half showed increases of the host reactions and the other half showed decreases of less degree than usual, indicating a preventive effect of OK-432 against treatment-induced suppression of immune functions.
There were 7 good responders locally in 10 cases treated with a combination of OK-432, radiation and bleomycin with a tendency of decreased host reactions.
In 10 cases treated with OK-432 and carbazilquinone, 5 cases were judged as good. Host functions were elevated in half of these cases.
In 5 cases treated with OK-432 and FT 207, there were 2 cases judged as good. Peripheral lymph. cyte count and T lymphocyte population ratio were increased in most cases, but the values of PHAinduced lymphocyte blastogenesis were rather decresed in 4 cases.
Although there was one good responder locally out of the 5 cases treated with OK-432 alone, the local antitumor effect was judged in sufficient when this preparation was used alone. Prevention of treatment-induced immune suppression by OK-432 can be expected in combination therapy.

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The minimum inhibitory concentration (MIC) of 10 different antibiotics for 7 species of Propionibaterium (total 96 strains) isolated from human skin, feces and dental plaque were determined by the tandardized plate dilution technique.
Almost all of test species of Propionibacterium were resistant to 4 aminoglucosides (kanamycin, treptomycin, aminodeoxykanamycin and fradiomycin), but were sensitive to ampicillin, cephaloridine, not observed. nidecamycin, tetracycline, chloramphenicol and fusidic acid, although a strain of P. jensenii isolated rom feces was found to be resistant to tetracycline.
The difference of MIC of 11 antibiotics for 2 serotypes of P. acnes isolated from human skin was not observed.
The repression of lipase activity of Propionibacterium by tetracyclin was studied with our agar plate method modified SIERRA'S one, and it was observed more than a concentration of 0.1μg/ml of he antibiotic.

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The pharmacokinetic parameters of CS-1170, a new semisynthetic cephamycin, were calculated an the basis of a one-compartment open model. One gram of CS-1170 was administered intravenously by drip infusion for 1 hour in 4 healthy volunteers and 17 patients with impaired renal function. The results obtained were as follows:
1) Peak concentrations of CS-1170 in serum were achieved 1 hour after beginning of infusion in the volunteers and the patients. The serum half-life of the drug was 0.85 hour in the volunteers, and increased in the patients along with increasing impairment of renal function.
2) Seventy-five per cent of the administered dose was excreted unchanged in the urine during 6 hours after beginning of infusion in the volunteers, while the urinary excretion was reduced in the patients along with increasing impairment of renal function.
3) The mean volume distributions were 10.0 liters in the volunteers and 9. 9 liters in the patients, indicating no significant relationship between the distribution volume of CS-1170 and the renal impairment.
4) The serum and renal clearance of CS-1170 correlated significantly to the creatinine clearance.
It is suggested that the dosage interval should be increased or the dosage lowered according to the creatinine clearance in the patients with impaired renal function.

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The characteristics of biliary excretion and clinical effects of apalcillin (APPC), a new semisythetic penicillin, were studied in patients with biliary tract infections, and the rerults were as follows:
1) Concentrations of APPC in gallbladder bile and tissue were measured after the one shot intra-venous injection of 1 g or 2g of APPC in patients operated for cholecystectomy.
The concentrations of APPC in gallbladder bile and tissue after one shot intravenous injection of 1 g of APPC were averaged 1206.7 μg/ml and 43.1 μg/ml, respectively and after 2g of APPC averaged 1793.9 μg/ml and 73.4 μg/ml, respectively.
2) Bacteriological effects were obtained in 6 cases out of 10 cases detected causative organisms.
MIC of APPC against these organisms were comparatively lower, and most of them were resistant to CBPC or SBPC.
3) The clinical effects were obtained in all 10 cases treated with drip infusion of 1g or 2g of APPC, and the responses were excellent in 2 cases and good in 8 cases.
4) Transient eruptions were observed in 2 cases after one shot intravenous injection, but no side effects and no abnormalities of laboratory findings were shown at treatment with drip infusion.

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Apalcillin (APPC) is a new antibiotic derived from ampicillin. It was used to treat eight patients with biliary tract infections. In five of the eight compliated with mostly cholelithiasis, there was a lapid clinical response to the treatment, whereas no effects were obtained in the two patients compliated with abscess or postoperative disturbance. Relatively good response was observed in a case with carcinoma of bile duct. No. remarkable side effects were observed. APPC seems to be the ntibiotic of choice for such infections.

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APPC, a new semi-synthetic penicllin, was administered to 34 cases of various infections of urinary tract, mostly, by drip infusion of a daily dose of 2g for 5 days.
Of 7 cases with acute infection consisting of 6 cases of pyelonephritis and 1 case of prostatitis, excellent response was seen in 6 cases and good response in 1 case.
Of 27 cases with chronic complicated urinary tract infection consisting of 10 cases of pyelonephritis and 17 cases of cystitis, excellent response was seen in 6 cases, good response in 7 cases, and poor response in 14 cases.
As for the side effect, slight hypotension and dyspnea was noted in 1 case, rash in 1 case, and nausea in 1 case. One case showed elevated GOT, though a causal relation with the drug was unknown.

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The therapeutic effects of cefazolin on the murine pneumonia due to Klebsiella pneumoniae have een studied, utilizing the method for quantitating both intrapulmonary viable bacteria and drug mcentrations.
Klebsiella pneumoniae B-54 inhaled and deposited in the lungs of mice diminished during about 6 ours (initial clearance), and then grew rapidly, making pneumonia throughout the lungs, and killed of the mice within 72 hours.(LD₅₀: 9.7×10 C. F. U./lung). Cefazolin therapy was started 12 ours after infection. M. I. C. of cefazolin against this bacteria is 1.56 μg/ml. Single injection of 50-800 mg/kg of cefazolin was not a curative dose. After s. c. injection of 50 mg/kg, the drug levels murine lungs maintained more than 2 M. I. C. s during 1 hour, however, the bacteria in the lungs tarted to grow at 1 hour after injection, excee ding the number of bacteria before injection 2 to 3 ours after injection.
Then repeated s. c. injeetions of 50 mg/kg of cefazolin were examined. Neither injections q. 12 h. or q. 6 h. were curative. Injections q. 3 h. suppressed the bacterial growth in the lungs, but pneu-Ionia did not cured. Injections both q. 2 h. more than 69 times and q. 1 h. 10 times saved all the lice from pneumonia. The number of viable bacteria in lungs did not decrease gradually, but shored a stationary phase despite of continuous chemotherapy.
The significance of experimental pneumonia, as compared with the reports by WOOD et al.(1941-956), in relation to chemotherapy utilizing the bactericidal antibiotic, cefazolin, was discussed.
On the basis of these results, it may be concluded that administration of antibiotics shoud be started s early as possible, and that a dose and the administration frequency of those antibiotics should be ncreased as high as possible considering side effects.

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