A comparative study of Cefuroxime with Cefazolin for bacterial pneumonia and chronic respiratory tract infections was carried out by the double blind method. Each one of the antibiotics was given in doses of 750 mg i. v. three times daily for seven to fourteen days.
1. Cases subject to analysis: Of 201 cases recruited in this trial, 149 (Cefuroxime 72, Cefazolin 77) were adopted by Committee in evaluation on clinical efficacy and 197 (Cefuroxime 96, Cefazolin 101) were adopted by Controller after judged by doctors in charge. The background characteristics of the patients in Cefuroxime and Cefazolin treated groups were almost the same.
2. Overall clinical efficacy judged by Committee: Cefuroxime was significantly superior to Cefazolin in judgement on the 7 th day of treatment in the “excellent” rate of total cases and of moderate cases, and in the efficacy of cases with infection due to gram positive cocci, etc.
Cefuroxime showed also a tendency to be superior to Cefazolin in the “excellent” rate of patients with pneumonia, the efficacy rate of moderate cases and in the clinical efficacy in chronic respiratory tract infections, etc.
3. Overall clinical efficacy judged by doctors in charge: As for the overall clinical efficacy in total cases, there was no significant difference between Cefuroixme and Cefazolin in both judgements on the 7 th day of treatment and at the end of treatment.
4. Improvement of clinical findings: As for the degree of improvement in chest X-ray findings on the 14 th day of treatment compared with the initial ones, Cefuroxime was significantly superior to Cefazolin in cases adopted by Committee and showed a tendency to be superior to Cefazolin in cases adopted by Controller. Besides, Cefazolin showed a tendency to be better than Cefuroxime in property and volume (only cases adopted by Committee) of sputum in the judgement after three days treatment.
5. Bacteriological response classified by clinical isolates from sputum: Cefuroxime showed a tendency to eradicate Heamophilus at a higher rate than Cefazolin.
6. Side effects and abnormal laboratory findings due to the medication: As for the incidence of side effects including abnormal laboratory findings, there was no significant difference between Cefuroxime and Cefazolin in both judgements by Committee (186 cases) and those by doctors in charge (197 cases).
7. Clinical usefulness judged by doctors in charge: Cefuroxime showed a tendency to be superior to Cefazolin in usefulness rate (judged as useful or slightly useful). From the results obtained, it has been concluded that Cefuroxime is a useful antibiotic for treatment of bacterial pneumonia and chronic respiratory tract infections.

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E. coli (997 strains) isolated from clinical specimen in the Kanto Teishin Hospital in the year 1977 was identified by API-Code system and sensitivity patterns for 10 antibiotics were determined by mono-disc method. All data obtained were put into computor by batch treatment for statistical study, and following results were obtained.
Concerning antibiotic sensitivity and biotype distribution, remarkable differences were observed between the clinical isolates depending upon each derived source. Average sensitivity for 10 antibiotics of the isolates from sputum and those from biles were 49.3% and 82.9% respectively. The former shower much lower sensitivity than the latter, and the difference was specially notable for SM, TC, CP, ABPC and CBPC.
Concerning about biotype distribution three types were dominant in numbers: A) 5144572, B) 5144552, C) 5144512. As a whole they formed 51.1% of total strains, meanwhile, the isolates from biles formed only 23.6% of the isolates from the same specimen source.
Existence of correlation between the biotype and antibiotic sensitivity was observed, i. e. the sensitivity rate for SM, ABPC, CBPC was significantly low in the following biotype strains: 5144572, 5144532 and 5044552.
Those informations obtained from routine laboratory data would open the way to analyse the ecological state of enterbacteriaceae including E. coli, which would confer some basic data related to the mechanism of opportunistic infections from those organisms.

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During a four years period from Jan. 1975 to Dec. 1978, we had 64 cases of urinary tract infection with Serratia marcescens. The infections with Serratia marcescens were seen in 2.0-8.2% of hospitalized patients and 0.4-2.6% of out-patients. Sixty-three of these cases (98.4%) were of complicated urinary tract infections, and we recognized the influence of indwelling catheter in 41 cases (64%). Especially, all of the hospitalized cases (48 cases) had experienced instrumentation or catheterization of urinary tact. Fifty-nine cases (92.2%) had received the use of antimicrobial agents, and 67.2% of them were β-lactam antibiotics.
An epidemiological survey was carried out with O-serotyping using the antiserum by Toshiba Kagaku Kogyo Co., Ltd. In the hospitalized cases, hospital acquired infections were seen in 38 cases (79.2%). Serotype 16 strains were the most common, and high incidence in one certain period (Sept. 1976-Sept. 1977). These results indicated that the urinary tract infection with Serratia marcesccens in our ward was probably nosocomial infection.

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Cefoxitin therapy of complicated urinary tract infections in geriatric patients incurable by treatment with other β-lactam antibiotics was successful in improvement of clinical signs, and in eradication of the causal organisms from the urine. Of 9 cases employed, 4 cases recovered completely, and 4 cases fell into the bacterial substitution with other Gram-negative bacilli and fungi. In the last one case, though the urinary counts of bacteria were reduced significantly, the treatment failed in complete elimination of the causal organisms from the urine.
The susceptibilities of the isolates to cefoxitin more or less decreased during the first treatment with other antibiotics, and most of them were estimated as resistant ones in regard of MIC values. Nevertheless, the antibiotic was stable to hydrolysis by β-lactamase in sonicates of these isolates, but its bioactive concentration was more or less reduced by contact with corresponding whole cells. Thus the effect of cefoxitin on elimination of urinary counts of bacteria was discussed both in connection with its stability to hydrolysis by the crude β-lactamase preparations and reduction of its bioactive concentration with whole cells of the isolates. In some populations of causal organisms, other mechanisms than hydrolysis by β-lactamase may participate in resistance to the antibiotic. Because the cells with such resistance mechanisms should survive the therapy, and subsequently multiply after the treatment, a few cases failed in complete elimination of the organisms from the urine even by treatment with cefoxitin.

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Clinical investigations with cefaclor granula, a new cephalosporin derivative, were performed with the results which may lead to the following conclusions: Cefaclor granula was orally administered to 25 cases of representative acute infections in the otorhinolaryngologic field, and it was excellent in 14 cases, good in 10 cases and fair in one case. When the cases in which excellent and good effects were obtained were considered together, the ratio of effectiveness was 96 per cent (24 cases). No side effect was observed in these 25 cases.

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Clinical investigation on 9, 3''-di-o-acetyl midecamycin (MOM) showed the following results.
1. MOM showed an inhibitory action against gram positive cocci.
2. MOM was applied singly 600 mg per day for the mild respiratory tract infection, and excellent or good results were obtained in 16 cases out of 20 cases.
3. Side effect was observed in 2 cases, that showed slight GOT and GPT elevation one week after the start of MOM administration.

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