Cefuroximeの基礎的臨床的検討 (Cefuroxime(CXM)<特集>)
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Cefuroxime, a new cephalosporin antibiotic, was studied fundamentally and clinically, and the following results were obtained.<BR>Cefuroxime was compared with cefoxitin and cefazolin in antibacterial activity against various Gram-negative bacilli isolated from clinical materials. Against E. coli cefuroxime was more active than cefazolin. Against E. cloacae cefuroxime was the most active. Against P. vulgaris cefoxitin was the most active, MICs of cefuroxime and cefazolin being distributed mostly at 100 μg/ml. Against other <I>Proteus</I> sp. cefuroxime and cefoxitin were slightly more active than cefazolin. Against <I>Citrobacter</I> cefuroxime was slightly more active than the other two drugs.<BR>Cefuroxime 1, 500 mg was given by drip infusion to two patients with external cholecystostomy. Their peak serum levels were 140 μg/ ml and 48 μg/ml respectively by 1-hour drip infusion and by 2-hours drip infusion; these peaks being observed at the end of each infusion. Peak bile levels were 22. 0 μg/ml and 23. 4 μg/ml respectively. Urinary recoveries were 95. 2% within 6 hours and 76. 9% with in 12 hours respectively by 1-hour drip infusion and by 2-hours drip infusion.<BR>Repeated administration of cefuroxime 750 mg was given 3 times 8-hourly to 2 patients by intravenous injection or drip infusion. In one of these cases, serum levels were about 30 μg/ml both at the end of drip infusion and at 30 minutes after intravenous injection, and further determination was impos sible after 8 hours. In the other case, severely ill with sepsis plus DIC, peak serum level after drip infusion was 115 μg/ml while serum level at 8 hours, 29 μg/ml, and this suggests the accumulation effect of the drug.<BR>Cefuroxime therapy was given to 16 patients in total: 8 with respiratory tract infection, 4 with biliary tract infection, 2 with urinary tract infection and 1 with sepsis and 1 with subacute bacterial endocarditis. Clinical efficacy was assessed in 15 of the 16 cases; 1 case was excluded because of unassessability. Remarkable clinical results were obtained; good and excellent in 13 cases, and fair and poor in 2 cases. Since the subjects were mostly severe cases, the majority of the dosage regimen was 1, 500 mg 3 times daily<BR>As the side effect of the drug, eruption was noticed in 1 case, allergic fever in 1, eosinophilia in 2 and slight elevation of GPT in 2.
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