The antibiotic dosage regimen for UTI in spinal cord injury patients which was injected into paralytic muscle was evaluated pharmacokinetically and by clinical efficacy. The model drug used was cefotiam (CTM) which was indicated for many cases of those patients.
In order to study the pharmacokinetics of this drug, 1g of CTM was injceted intramuscularly in 4 cases of traumatic cervical spinal cord injury, 1 case of traumatic lumbar spinal cord injury and 1 case of suspected anterior spinal artery syndrome. Furthermore, this administration was continued for six days with twice daily doses to study the clinical effects. The control data (healthy volunteers) for comparison was obtained from the literature.
Serum levels of CTM in the patients were lower than those in the control immediately after the administration, but became higher from one hour after the administration. The pharmacokinetic parameters showed a delay in absorption and elimination compared with the control.
Clinically, this regimen was effective except in 1 ease which had undergone alternation of the organism to P. aeruginosa immediately before the administration, and all cases showed no side effects.
We concluded that the this dosage regimen can be considered effective and very useful for UTI in spinal cord injury patients.

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In this report, the enhancing effects of non-ionic surfactants on the rectal absorption of GM and CET in various experimental animal species were studied.
The absorption enhancing effects were observed in all animal species by the coadministration of non-ionic surfactant. However, efficacy for the enhancement differed among animal species.
Surfactants strongly enhanced the rectal absorption of GM and CET in rabbits. The enhancing effect on dogs was only one half of that on rabbits. From these results, the order of the enhancing efficacy of surfactants on the rectal absorption is considered as follows:
rabbit>rat>beagle dog≥mongrel dog>man
It is concluded that dogs are the most appropriate experimental animal among animals studied for the study of rectal absorption of water soluble antibiotics.

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The interactions of piperacillin (PIPC) or carbenicillin (CBPC) on the phagocytosis and killing of rabbit polymorphonuclear leukocytes (rabbit PMN) were studied in 7 strains of 5 species of bacteria.
The rabbit PMN phagocytized and killed easily 3 strains of them, but that did not phagocytize and kill 4 strains of them. The phagocytosis and killing in presence of an approximate minimum inhibitory concentration of PIPC or CBPC was activated, and the interactions in presence of PIPC were superior to those of CBPC. Especially, PIPC activated strongly the phagocytosis and killing of rabbit PMN on S. aureus FDA 209P, K. pneumoniae Y-41, and P. aeruginosa S-68 that CBPC had not activated.
P. aeruginosa S-68 formed filamentous by pre-treating of PIPC (10μg/ml), while that formed normal by pre-treating of CBPC (10μg/ml). The bacteria of filamentous form were phagocytized and killed more easier than that of normal form by rabbit PMN.

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Cinoxacin was employed to treat women diagnosed as having acute simple cystitis. The therapeutic efficacy was investigated not simply in terms of the cure rate during the treatment period. but also in terms of the recurrence rate during the one week following the completion of the antibiotic administration. In this way, an investigation was made of the degree of sufficiency of the curative effect provided by the cinoxacin therapy.
The patients were female cases of acute simple cystitis which fulfilled the UTI criteria. These patients were divided into four groups on the basis of the daily dosage of cinoxacin that was administered: 800mg, 400mg, 200mg and 100mg (all of these dosages were divided into two doses); the treatment period with each of these dosages was 3 days. A total of 138 patients were evaluated as showing excellent clinical efficacy at the time of completion of the treatment. These patients were administered a placebo for an additional 7 days, and then they were investigated for any recurrence of the inflammatory symptoms. This investigation was carried out as a comparative study by the double-blind method.
(1) A total of 82 patients were investigated for recurrence of the inflammation; recurrence was judged to be positive in 22 of these patients, for a recurrence rate of 26.8%. There were no significant differences seen between the recurrence rates recorded for the four cinoxacin dosage groups.
(2) The cases of recurrence were judged to be cases of reinfection when either the species of the bacterium or the serotype of E. coli isolate at that point was different from that of the bacterium isolated prior to the cinoxacin treatment. Only when the species at the time of recurrence was the same as that of the initially-isolated species, was the recurrence judged to be a case of relapse. Calculation of the reinfection rate and the relapse rate gave values of 8.5% (7/82) and 18.3% (15/82), respectively. The relapse rates as a function of the dosage group showed the following values: 8.0 in the 800 mg group, 17.6% in the 400mg group, 26.1% in the 200mg group and 23.5% in the 100mg group. Thus, it is seen that the relapse rate was somewhat lower in the 800 mg administration group. No clear differences were seen between the rates of reinfection for the four cinoxacin dosage groups.
(3) The bacteria that were isolated following the recurrence were found to show MICs that mostly fell within the range of 1.56 to 3.13μg/ml. This distribution was very similar to the distribution shown by the bacteria that were isolated prior to the cinoxacin therapy.
(4) No correlation was found to exist between the recurrence rate and the bacterial count at the time that the cinoxacin therapy was started.

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A new in vitro kinetic model was devised for evaluating the bactericidal activity of antibiotics in combination under dynamic condition. This model accurately reproduced the observed serum levels of two antibiotics after combined administration.
The bactericidal efficacy of cefazolin (i. v.)-gentamicin (i. m.) combination was investigated in this model. When 2 strains of E. coli were used as the test organism, the advantage of combination was demonstrated.

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The determination of causative bacteria in respiratory tract infection is difficult because of contamination with normal flora in the oral cavity and/or upper respiratory tract. We studied if “sputum washing in an anaerobic chamber” was usuful for determination of causatives in anaerobic respiratory tract infections and obtained the following results.
1) Non-spore forming anaerobic bacteria such as Peptococcus, Propionibacteriurn, Veillonella, Fusobacterium and Bacteroides were isolated at high rate from throat swab in both healthy volunteers and patients with respiratory tract infection and we comfired that anaerobic culture of expectorated sputum was useless for determination.
2) We applied the same procedure as sputum washing to suspension of anaerobic bacteria such as Peptococcus, Veillonella, Fusobacterium, Bacteroides and Clostridium in an anaerobic chamber. We observed very small decrease of viable cell counts.
3) We determined the causatives of various respiratory tract infection by washing expectorated sputum in an anaerobic chamber. Thus the causatives were determined in 36 of 54 samples obtained before chemotherapy and anaerobic bacteria was observed as causatives in 13 of 36 samples obtained before chemotherapy.
4) We compared the results of determination of causatives by washing in an anaerobic chamber with those by quantitative culture method and found that the former was more useful than the latter for determination of causatives in anaerobic respiratory tract infections.
From the above results we recommend “sputum washing in an anaerobic chamber” as one of useful method for determination of causatives of respiratory tract infection due to anaerobic bacteria.

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