The investigation of susceptibility of Vibrio parahaemolyticus, Vibrio alginolyticus and NAG vibrio to various antibiotics were performed. One hundred and twenty-seven strains of V. parahaemolyticus that include 64 strains of clinical and 63 strains of environmental isolates were susceptible to chloramphenicol (CP) and tetracycline (TC), but resistant to ampicillin (ABPC), cefazolin (CEZ) and streptomycin (SM). The susceptibility distribution in the environmental isolates were nearly similar to that of the clinical isolates. Any different pattern were not found between the Kanagawa-positive strains and the negative strains. A strain of V. parahaemolyticus isolated from a patient in Thailand showedhigh resistance to CP, TC, ABPC, CEZ and SM. The susceptibility distribution of 30 strains of V. alginolyticus that isolated from lobsters, were similar to V. parahaemolyticus. We measured the susceptibility of 30 strains of NAG vibrio isolated from patients and environments. The most strains (76.6%) of NAG vibrio showed a little value of minimum inhibitory concentration, especially to β-lactam antibiotics, but 23. 3% strains showed resistance to the tested antibiotics.

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The concentrations of cefmenoxime (CMX) in serum and the tonsil after intravenous administration were investigated in order to study the definit doses of CMX against tonsillitis. Doses of 20 mg/kg, 30 mg/kg and 40 mg/kg of CMX were given intravenously in 13, 3 and 3 patients respectively. Immediately after i. v. injection, patients underwent tonsillectomy. The CMX concentrations in serum and tonsil were measured at scheduled intervals after administration. Fitting curves were computed from measured concentration of CMX in serum and the tonsil. The regression equations were as follows;
20 mg/kg: Serum concentration (S. C.)=94.219×(0.971)^t Tonsil concentration (T. C.)=17.393×(0.962) ^t
30 mg/kg: S. C.=149. 21×(0.969) ^t, T. C.=21.27×(0.978)^t
40 mg/kg: S. C.=281.175×(0.973)^t, T.C.=24.804×(0.987) ^t (t: time after administration)
Curves of CMX concentration in the tonsil for intravenous drip injection were simulated from these equations and figurized as a function of time by a microcomputer. This simulation suggested that 2 hours drip injection could maintain CMX concentration of 0.78μg-3.13μg/g in the tonsil for much longer time than 1 hour drip or one shot injections when the same dose of CMX was administered.
Based on these results, we proposed a preferable usage of CMX against tonsillitis, that is, to use 20-30 mg/kg of CMX drip infusion twice a day.

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The clinical effectiveness and safety of T-1982 were compared with those of cefmetazole (CMZ) in respiratory tract infections in the randomized double blind method.
289 patients were administered with one gram of T-1982 or two grams of CMZ by intravenous drip infusion twice a day for 14 days.
The results were as follows;
1) Clinical efficacy rates were 87.1% for T-1982 group and 83.3% for CMZ group in overall cases; with 86.7% for T-1982 and 84.8% for CMZ in bacterial pneumonia, 77.8% for T-1982 and 83.3% for CMZ in mycoplasmal pneumonia or primary atypical pneumonia, and 88.7% for T-1982 and 82.1% for CMZ in the cases without pneumonia, respectively. Thus no significant difference was observed between the T-1982 group and the CMZ group.
2) The bacteriological responses of the patients to T-1982 and CMZ were favorable in 98.2% and 98.1%, respectively. No significant difference was observed.
3) No significant difference was noted between the two drug groups in incidence of adverse reaction.
4) As for the usefulness of the both treatment, committee judged to he useful with T-1982 in 82.1% of the cases and CMZ in 78.6%. Statistical tests showed no significant difference.
From the results of this trial, it was concluded that T-1982 was as effective and as useful as CMZ in the treatment of respiratory tract infections as a 1/2 daily dose that of CMZ.

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Antibiotic excretion into the bile was studied using latamoxef (LMOX) in 14 postoperative cases of biliary atresia patients (infants and children) who had had hepatic porto-enterostomy with Suruga II type enterostomy with the following results:
Group I Excellent excretion which was almost the same as that seen with adult patients
Group IIa Good or poor excretion, depending on the amount of bile flow and liver function
Group IIb Very poor excretion
Group III Good excretion but depending on the amount of bile flow and liver function
Cases showing high total bile acid level in the bile also showed large biliary excretion of antibiotics.
Our study indicates that antibiotics excretion into the bile in infants and children is closely related to the condition of the liver function and biliary passage.

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A patient with drug-induced enterocolitis due to toxin-producing Clostridium difficile developed during cephem antibiotics administration was reported, and laboratory and clinical studies on oral vancomycin (VCM) also were reported.
1. Case report; The case was a 59-year-old male alcoholic. Aortic valve replacement (AVR) was carried out on 25 Jan. 1982 because of aortic steno-insufficiency (ASi). Dissociation of the mediastinum occurred in about a week after AVR operation and resuture of the sternum was done on 17 Feb. Around 15 Feb., blacky soft stool with foul odor, severe abdominal pain and high fever began to develop during the administration of antibiotics, such as CET, CPZ, CTX, CTM and CFS after the first AVR operation. He was diagnosed to have pseudomembranous enterocolitis by colonofiberscopy with biopsy, confirmed by positive fecal culture for C. difficile. He showed a good clinical response to oral VCM treatment.
2. Number of C. difficile and its toxin in diarrhea' stool; C. difficile, 1×10⁴/g of stool in initial number, was eliminated by oral VCM and simultaneously, C. difficile toxin in stool, 10² in initial titer, was reduced to negative 4 days after VCM administration.
3. VCM concentration in stool and urine of the patient; VCM was measured at the concentration of 1, 700pg/g of stool and 6.29μg/ml of urine.
4. Toxin producibility of C. difficile isolated; Toxin produced by C. difficile isolated from the patient was detected by both tissue culture assay and Ouchterlony methods.
5. Drug susceptibility of C. difficile isolated; Against C. difficile, MICs of VCM, CET, CPZ, CTX, CTM, CFS and CXD were 0.78-1. 56μg/ml, 25μg/ml, 50μg/ml, 100μg/ml, >100μg/ml, 100μg/ml, and 100μg/ml, respectively.
6. VCM concentration in serum and urine of 5 healthy adult volunteers; The peak urine level of VCM in 5 healthy adult males was 1.0μg/ml of urine, levels in serum being less than 0.32μg/ml.

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The distribution of 5-fluorouracil (5-FU) in the mesenteric lymph nodes was studied after intraluminal administration in rats and in patients with colorectal cancer.
The results are as follows; In Wistar rats, 5-FU levels in the mesenteric lymph nodes were respectively 0.37, 0.53, 1.25, 0 and 0 times higher than those in peripheral venous blood, at 30, 60, 90, 240 and 360 minutes after intravenous administration (40mg/kg). These ratio were respectively 2.0, 2.6, 2.2, 9.5 and 7.2, at 30, 60, 90, 240 and 360 minutes after intraluminal administration (200mg/kg). In rats with metastatic lymph nodes of inoculated tumor (Ascites hepatoma AH-7974), 5-FU levels were lower in nodes with massive metastasis than in nodes with slight metastasis. In clinical cases, mean 5-FU levels in the mesenteric lymph nodes of the patients with rectal and colonic cancer were 11.4μg/g and 20.4μg/g respectively, after intraluminal administration (30mg/kg). 5-FU levels were high, even in principal nodes and in nodes with massive metastasis.
Intraluminal administration of 5-FU was proved to be valuable for the treatment of metastatic ly-mph nodes of colorectal cancer.

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Whenever new antimicrobial drug are being developed, phase 2 and phase 3 studies are done to evaluate the effectiveness of the drug against urinary tract infections. There is no world-wide standardized method of evaluating antimicrobial drugs. Based on the frequency of bacterial species present in urine, I propose that complicated urinary tract infections accompanied by an underlying disease of the urinary tract, and uncomplicated urinary tract infections should be considered as two separate entities and appropriate and individual investigative procedures be applied.

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