Japanese Journal of Chemotherapy
Online ISSN : 1884-5886
Print ISSN : 1340-7007
ISSN-L : 1340-7007
Volume 51, Issue 6
Displaying 1-9 of 9 articles from this issue
  • Toru Masaoka
    2003 Volume 51 Issue 6 Pages 321-324
    Published: June 25, 2003
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
    Fever is frequently observed in patients with hematological disorders, especially neutropenia. Their positive blood culture is usually low, and the condition is variousely termed. suspicious of sepsis, fever of unknown origin, etc. Although many such patients respond well to antibacterial or antifungal agents, suggesting infection, they are excluded from the clinical studies of antibiotics due to the lack of documented infection evidence. Given the rapid progression of the symptoms and their high mortality the diagnosis of febrile neutropenia (FN) is proposed. FN is now approved in 56 countries as an indicative diagnosis of antibiotics. Because of unknown etiology, guidelines for its empirical treatment were reported by the infectious Disease Society of America (IDSA) and frequently revised up to 2002. We started an FN study in Japan and published Japanese guidelines in 1998. We have also conducted a confirmatory study. This article reviews the difference in American and Japanese guidelines and their prejected revison.
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  • Toshiharu Matsushima, Shigeru Kohno, Akira Watanabe, Shosaku Abe, Nobu ...
    2003 Volume 51 Issue 6 Pages 325-339
    Published: June 25, 2003
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
    As a part of our survey of guidelines from the Japanese Respiratory Society (JRS) regarding the treatment of community-acquired pneumonia, we assessed the safety, clinical efficacy, and antibacterial activity of cefotiam, a second-generation cephalosporin antimicrobial, in actual clinical treatment of mild to moderate community-acquired pneumonia in Japan. Cases were classified in accordance with JRS guidelines as: bacterial pneumonia in which the causative organism was unknown (type A), bacterial pneumonia in which the causative organism was presumed (type B), or pneumonia in a special environment and condition (type E). Cefotiam was effective in 80.5%(268/333) of the type A cases, 81.7%(49/60) of the type B cases, and 85.7%(12/14) of the type E cases. These levels of efficacy are similar to those obtained 20 years ago when cefotiam was first introduced, and they underscore the continuing usefulness of this drug. The similarity of the results obtained against bacterial pneumonia type A and type B also indicates that the guidelines made it possible to accurately identify bacterial pneumonia even when the causative organism was unknown, supporting the usefulness of these guidelines (in selecting appropriate antibiotic treatment). Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and Klebsiella pneumoniae were isolated before treatment in many cases. The efficacy of cefotiam was quite high against all of these organisms (89.8%[44/49], 86.7%[26/30], 80.0%[12/15], and 83.3 %[10/12], respectively), and the eradication rates were also favorable (88.5%[23/26], 87.5%[14/16], 85.7%[6/7], and 100%[6/6], respectively), suggesting that good therapeutic effects can be obtained when these guidelines are used to identify the type of community-acquired pneumonia and to select appropriate antibiotics.
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  • Takashi Yokoyama, Yoshio Takesue, Fumiya Shigeta
    2003 Volume 51 Issue 6 Pages 340-346
    Published: June 25, 2003
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
    A combined β-lactamase inhibitor plus penicillin preparation, sulbactam sodium/ampicillin sodium (UNASYN®-S), was used to treat perforative peritonitis, and the following results were obtained. Of 36 patients who were enrolled in the study, efficacy was evaluated in 22 patients, and their peritonitis was secondary to appendiceal perforation in 11 cases, duodenal perforation in 9 cases, gastric ulcer perforation in 1 case, and traumatic small intestinal perforation in 1 case. The overall efficacy rate was 90.9%(20/22), and the efficacy in the 10 cases in which the pathogens had been isolated and identified was 80.0%(8/10). Assessment of bacteriological response showed that 10 of the 12 pathogens were eradicated. The safety evaluation showed that 1 of the 36 patients enrolled in the study had adverse drug reactions of increases in AST (GOT), ALT (GPT), and ALP values.
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  • Shigehiko Ito, Shiro Nakamura, Tetsuro Muratani, Tetsuro Matsumoto
    2003 Volume 51 Issue 6 Pages 347-351
    Published: June 25, 2003
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
    A 63-year-old man with a history of severe acute pyelonephritis due to extended-spectrum β-lactamase (ESBL) producing isolate was admitted hospital July 30, 2002, with blunt thoracic injury. His history and family history were unremarkable. He underwent indwelling thoracic tube drainage for hemopneumothorax, and epidural intubation for a rib fracture pain. He was given cefazolin for antimicrobial prophylaxis. On hospital day 12, he had a temperature of 38.8°C after urinary catheter insertion. He developed a persistent fever with chills. Escherichia coli were isolated in cultures of blood and urine specimens on August 14, 2002. The result of antibiotic susceptibility against isolates predicted the presence of ESBL producing strain. He was Immediately treated for 6 days with tazobactam/piperacillin (TAZ/PIPC) (0.3g/2g×2/day) iunder a diagnosis of acute pyelonephritis. TAZ/PIPC was effective, but 7 days after treatment was stopped, he underwent a relapse. He was treated for 10 days again. With TAZ/PIPC, resolved the urinary tract infection. He was discharged September 18, 2002. The results of PCR and Sequence showed that ESBL was UOE-2 (CT-XM-14). Results of DNA restriction fragment length polymorphism by pulse fi eld gel electrophoresis showed that the 2 isolates, one from the first infection, and the other from the relapse, were the same clone. TAZ/PIPC is effective for treating urinary tract infections with ESBL producing E. coli. The occurrence of infections caused by ESBL-producing strains thus require consideration in such cases.
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  • [in Japanese]
    2003 Volume 51 Issue 6 Pages 352
    Published: June 25, 2003
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    2003 Volume 51 Issue 6 Pages 354-356,374
    Published: June 25, 2003
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese]
    2003 Volume 51 Issue 6 Pages 375-384
    Published: June 25, 2003
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese]
    2003 Volume 51 Issue 6 Pages 385-389
    Published: June 25, 2003
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
    Download PDF (655K)
  • [in Japanese], [in Japanese]
    2003 Volume 51 Issue 6 Pages 390-394
    Published: June 25, 2003
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
    Download PDF (624K)
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