産婦人科領域におけるCephacetrileの基礎的,臨床的検討 (Cephacetrile論文特集号)
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Cephacetrile (CEC) was studied for its antibacterial action, its penetration from maternal serum into umbilical cord serum and amniotic fluid and assessed for its clinical efficacy. The following results were obtaiend : <BR>1) Peak MIC values of CEC for clinical isolates were 0.78 μg/ml for tested strains of <I>Staph. aureus</I>, 6.25u g/ml for the tested <I>E. coli</I> and <I>Klebsiella</I> and 12.5-25μg/ml for <I>Proteus mirabilis</I>. CEC was slightly inferior to CET in respect to MIC value with these particular organisms tested.<BR>2) Peak levels in maternal and umbilical cord serum were obtained at 13.0μg/ml and 8.2μg/ml respectively, 2 hours after administration of 1 g of CEC i. m. The level in umbilical cord serum is approximately 63% that of the maternal serum value.<BR>The peak level obtained in amniotic fluid was 2.4μg/ml at 2.5 hours after intramuscular administration.<BR>Following intravenous administration of lg of CEC, the maternal serum and umbilical cord serum reached peak levels of 12.5μg/ml and 6.2μg/ml respectively. The latter value being about 50% to that of maternal serum. Amniotic fluid level attained to a peak level of 1.7, μg/ml at 4 hours after intravenous administration.<BR>3) CEC at a dose of lg was administered to mothers either intramuscularly or intravenously, and various fetal organ levels were measured at 2 hours following intramuscular administration and 8 hours after intravenous administration. At 2 hours from intramuscular dosing concentrations in the liver and kidney of the fetuses were 0.2μg/g and 0.28μg/g and below trace levels in other organs. At 8 hours from intravenous administration concentrations in fetal organs were below traceable levels.<BR>4) CEC at a dose between 1 to 4g/day was administered to 13 patients, consisting each one case of rupture of the bag, abscess of mammary gland, mastitis and intrauterine infection, 3 cases of pelvicperitonitis and 6 cases of pyelonephritis with an effectiveness rate of 84.6%, having remarkable effectiveness in one case, effectiveness in 10 cases and failure in two cases.<BR>5) Hepatic and renal function symptoms were examined on those 13 patients without any abnormal data attributable to the drug.<BR>No side effects were observed.<BR>6) From laboratory data and clinical findings we consider this antibiotic is useful in the field of obstetrics and gynecology, particularly in respect of its passing the placental barrier effectively and its low toxicity despite the antibacterial activity of this drug being equal, or with some organisms slightly inferior, to that of CET.
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