Genital herpes is the leading viral sexually transmitted disease in Japan and its treatment is a great matter of concern. From the pathogenetical viewpoint, there are two types of infection, namely the primary and the recurrent or provoked type, the latter being caused by reactivation of latently infected herpes simplex virus (HSV). In women, 41.5%% of genital herpes has been caused by HSV-1 and the remaining 58.5% by HSV-2. Fifty eight per cent of the acute type, mainly primary infection, was caused by HSV-1 and 42.0% by HSV-2. The recurrence rate within one year after primary infection was 86%% for HSV-2 and 25 for HSV-1 patients. On the other hand 84.3%% of the recurrent type and 87.8% of the provoked type were caused by HSV-2. Although three nucleoside analogs (Acyclovir, Valacylovir, Famciclovir) have been developed for treatment of herpes virus infection, and are currentoly being used in the USA and UK, only acyclovir (ACV) is available for the systemic treatment of genital herpes in Japan. The regimen permitted by social insurance for the treatment of genital herpes is ACV 200 mg orally five times a day for five days. The duration of administration is shorter than that being used in the USA (7-14 days) and seems to be too short because in several patients the HSV culture is still positive after 5 days of administration of ACV. To prevent recurrence, suppressive therapy using ACV has been introduced but has not yet been approved by social insurance. Biological response modifiers such as PS-K (a protein-bound polysaccharide) or Lactoferrin are being tried to reduce the recurrence rate. The susceptibility of HSV strains to ACV which had been isolated in 1970 s, 1980s, and 1990 s was examined by a plaque assay which elucidated an almost similar susceptibility among these isolates.

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術後感染予防薬の投与方法について, 外科系7科の医師を対象にアンケート調査した, 回答者数 (回答率): 406/643名 (63%). 投与方法として,(1)「点滴静注で才投与する」の全医師の合意率は86%であり,(2)「初回は手術直前 (開始30分前から直前の間) に投与開始する」は72%,(3)「手術車有効濃度を保つように, 長時間の手術では追加投与する」は67%であった. 4半数以上の医師が合意した無菌手術における薬剤投与期間は,一 般外科では2日以内と一番短かったが, 脳神経外科では7日以内と長かった. その他の科は3～4日であった.(6) 一般外科において, 術野感染を予防目的とする医師と全術後感染を予防目的とする医師の間では, 前者において有意 (P<0.05) に投与期間が短かつた

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耳漏を伴う小児急性化膿性中耳炎の33症例58検体において病原細菌の薬剤耐性化について調査・検討した.耳漏においてはStreptococcus pneumoniaeが33%(33例中11例), Haemophilus influenzaeが21%(33例中7例) に分離されたが, 上咽頭擦過液ではS. pneumoniaeが全体の64%(25例中16例), H. influemaeが52%(25例中13例) と高率に分離された。肺炎球菌が確認された20症例ではペニシリン耐性肺炎球菌 (PRSP: penicillin resistant S. pmumoniae) が65%13例/, penicillinintermediately resistant S. pneumoniae (PISP) が15%(3例), penicillin susceptible S. pncumoniae (PSSP) が20%(4例) の割合を占めており, PRSPではpenicillin GのMICのピークが2μg/mLと高値を示した。分離培養された肺炎球菌について経口セフェム薬であるcefaclor, cefdinir, cefpodoxime, cefditoren (CDTR) の感受性を測定したところ, 薬剤によってかなりの違いがみられ, MICが累積ですべて1μg/mL以下だったのはCDTRのみだった.H. influcnzacについてもMICがすべて1μg/mL以下だったのはCDTRのみで, 回薬剤は0.125μg/mLのラインでは累積で80%のMICが下回っていた。

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今回, われわれが保管する臨床分離ESBL産生グラム陰性桿菌のCTX-M-1系β-ラクタマーゼ産生菌5株, CTX-M-2系β-ラクタマーゼ産生菌23株, SHV-12型ESBL産生菌19株, SHV-2型ESBL, SHV-24型ESBL, TEM-26型ESBL産生菌がそれぞれ1株の計650株を対象として, isepamicin (ISP) をはじめとしたアミノグリコシド系薬およびβ-ラクタム系薬のMICを測定した.ISPのMICrangeは0.12～32μg/mLであり, MIC₅₀, MIC₉₀はそれぞれ0.5μg/mL, 2μg/mLであり, 各種ESBL産生菌に対する有用性が示唆された.

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