Piperacillin (PIPC) has excellent antibacterial activities against Streptococcus pneumoniae, including penicillin-resistant Streptococcus pneumoniae (PRSP), and Haemophilus influenzae, including beta-lactamase-negative, ampicillin-resistant Haemophilu.s influenzae (BLNAR). To demonstrate this clinically, we evaluated the clinical efficacy of PIPC on pneumonia and secondary infection with chronic respiratory disease in which S. pneumoniae or H. influenzae was considered a prophlogistic bacteria.
We found that the clinical efficacy ratio was 98.4% in all patients, and disappearance of S. pneumoniae and H. influenzae was 92.9% and 95.8%, sufficiently fulfilling the intended purpose. Bacteriological efficacy was 96.9% in monomicrobial infection (S. pneumoniae: 100%, H. influenzae: 93.8%) and 84.2% in polymicrobial infection. Monomicrobial and polymicrobial infections became negative in 92.2%. When a patient was treated based on infection with S. pneumoniae or H. influctizae, even in mixed infection, sufficient clinical effect was obtained in those with or without mixed infection.
The minimum inhibitory concentration (MIC) of PIPC for S. pneumoniae and H. influenzae isolated in this study was as follows: for S. pneumoniae, the range of MIC was ≤0.06-4μg/mL and MIC₉₀ was 4μg/mL; and for H. influenzae, the range of MIC was 0.06-8μg/mL and MIC₉₀ was 0.25μg/mL. The antibacterial activity against penicillin-intermediate S. pneumoniae (PISP), PRSP, and BLNAR was 4 μg/mL of MIC₉₀ for PISP+PRSP and 0.25μg/mL of MIC₉₀ for BLNAR.
PIPC is thus clinically effective against patients with pneumonia and (with) secondary infection in chronic respiratory disease by S. pneumoniae including PISP and PRSP, and H. influenzae including BLNAR. S. pneumoniae and H. influenzae are highly probable prophlogistic bacteria of community-acquired pneumonia and secondary infection in chronic respiratory disease. In view of this, PIPC should prove to be an appropriate anti bacterial drug for empiric therapy for patients with community-acquired pneumonia and secondary infection in chronic respiratory disease.

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Telithromycin (TEL), an oral ketolide antibiotic, is currently available as a 300 mg tablet. To facilitate administration, a reduced-size tablet, about 75% of the currently available formulation in volume, was developed. As part of this development, we conducted dissolution and bioequivalence studies in human subjects to evaluate formulation bioequivalence. In the dissolution study, an average exceeding 85% of both currently available and reduced-size tablets dissolved in all test solutions within 15 minutes. Since results met criteria in bioequivalence study guidelines, dissolution profiles for both formulations were determined to be equivalent. In the bioequivalence study where a single dose of 600 mg was administered to 36 male and female subjects, mean ratios between reduced-size and currently available tablets for the maximum plasma concentration (C_max) was 94.2% and the area-under-plasma-concentration-time curve (AUG_0-z) was 97.0%. The two-sided 90% confidence interval was 80-125%, within the bioequivalence acceptance limit. The two formulations were therefore determined to be equivalent.
Overall results thus indicate that TEL reduced-size and currently available tablet formulations were biologically equivalent.

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The in vitro antichlamydial activity of telithromycin (TEL) against fresh clinical isolates of Chlamydia trachomatis (18 isolates) from patients with cervicitis in 1999 (April to August) was examined versus clarithromycin (CAM), erythromycin (EM), and azithromycin (AZM).
Results showed that the MIC range and MIC₉₀ were TEL (0.008-0.031 μg/mL, 0.031 μg/mL), CAM (0.008-0.031 μg/mL, 0.031μg/mL), EM (0.125-0.25μg/mL, 0.25 μg/mL), and AZM (0.063-0.25 μg, /mL, 0.25μg/mL).
TEL showed high antichlamydial activity similar to CAM and was about 8 times as potent as EM and AZM in MIC₉₀.
This suggests that TEL is clinically effective against C. trachomatis infections.

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We studied annual changes in the susceptibility of 300 strains of Helicobacter pylori (H. pylori, 100 strains/year) isolated from clinical specimens of untreated pacients for 3 years from the year after the application of the reimbursement of medical fee to antibiotic eradication of H. pylori.
We found little difference among MIC ranges of clarithromycin (CAM) in 3 years and MIC₉₀ for strains isolated yearly was 16 μg/mL, unchanged in these 3 years. Similar trends were seen in MIC₅₀ and MIC₈₀ which also showed little change. The minimum amoxicillin (AMPC) MIC range was 0.015 μg/mL annually for 3 years and the maximum MIC was 0.5 μg/mL in 2003. Little change in MIC₅₀ MIC₈₀ and MIC₉₀ was seen in these 3 years. H. pylori strain resistance to CAM in 2002 was slightly higher at 19% over the 14-15% seen in the other 2 years.
We concluded that H. pylori susceptibility to CAM and AMPC change little in the 3 years from the year the application of medical fee reimbursement was approved for H. pylori eradication.

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