セフェム系抗生物質の中耳炎耳漏内濃度と臨床効果について

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The in vitro antibactrial activity against various isolates from otitis media, the serum and otorrheal levels and the clinical effects of cephem antibiotics were investigated to obtain data pertinent to the treatment of otitis media with systemic administration of the antibiotics.The in vitro antibacterial activity was determined by the re-revised MIC assay procedure of the Japanese Society of Chemotherapy. Antibiotic concentrations in the serum and aural discharges were measured by the thin agar layer-cup and sensitivity disc assay on specimens obtained from patients after an intravenous dose of 1-2g of cefinetazole (CMZ) or cefazolin (CEZ), using Micrococcus luteus ATCC 9341 and Bacillus subtils ATCC 6633, respectively, as test organisms.Therapeutic responses were assessed in patients receiving 1-2g b. i. d. of CMZ by i. v. drip or single shot, employing a set of criteria formulated in our department. Results:1) Sensitivity tests showed increased activity against Haemophilus influenzae and indol-positive Proteus.2) The level of cephem antibiotic in otorrhea were characterized by an approximately five-fold increase in acute otitis media as compared to that in chronic conditions and by greater and longer-sustained concentrations in cases of more pronounced inflammation. The level of CMZ in otorrhea was almost the same as that of CEZ, another cephem antibiotic used as a standard.3) CMZ therapy was effective in 100% of the acute otitis media cases and in 56% of the chronic cases. Although the efficacy of systemic CMZ administration in otitis media was remarkable, some of the chronic inflammation cases required additional local administration.4) Clinico-bacteriologically, CMZ proved effective against H. influenzae, Proteus spp. and Staphylococcus aureus as well, which was consistent with the results of bacteriological studies.
耳鼻咽喉科臨床学会の論文

セフェム系抗生物質の中耳炎耳漏内濃度と臨床効果について

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