Ceftazidime(SN401)の基礎的臨床的検討 (CEFTAZIDIME(CAZ,SN-401)<特集>)
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MICs of ceftazidime (CAZ, SN401) against 25 clinical isolates of <I>S. aureus, E. coli, K. pneumoniae, P. mirabilis, E. cloacae, S. marcescens, H. influenzae</I> and <I>P. aeruginosa</I> were compared with those of latamoxef (LMOX) and cefoperazone (CPZ), except <I>H. influenzae</I> and <I>P. aeruginosa</I>. For <I>H.influenzae</I>, LMOX and ampicillin (ABPC), for <I>P. aeruginosa</I>, CPZ, cefsulodin (CFS), cefpiramide (CPM) and gentamicin (GM) were used for comparison.<BR>MICs of CAZ varied from 6.25-12.5μg/ml for <I>S. aureus</I>, which were about the same as those of LMOX, and for most strains of <I>E. coli</I>, <I>K. pneumoniae</I> and <I>P. mirabilis</I>, MICs of CAZ were ≤0.2μg/ml, which were also similar to those of LMOX and CPZ. For <I>E. cloacae</I> and <I>S. marcescens</I>, CAZ showed a wide range of MICs in the same order as those of LMOX and CPZ, but as for <I>S. marcescens</I>, the activity of CAZ was superior to that of the other 2 drugs. Against <I>H. influenzae</I>, MICs of CAZ were ≤0.2μg/ml, which were similar to those of LMOX and lower than those of ABPC. When compared with CPZ, CFS, CPM and GM, CAZ showed the MICs of ≤3.13μg/ml for 84% of <I>P.aeruginosa</I>, which indicated the highest activity among these drugs.<BR>After 2g of CAZ was administered by 1 hour i. v. drip infusion to a patient with aseptic meningitis in the convalescent stage, the CAZ level in cerebrospinal fluid 7 hours after aministration was 1.80μg/ml, which demonstrated good penetration of CAZ into cerebrospinal fluid.<BR>In the clinical evaluation, a total of 18 patients (7 with respiratory tract infections (RTI) comprising 6 with pneumonia and 1 with infected bronchiectasis, 2 with biliary tract infections (BTI), 6 with urinary tract infections (UTI), 2 with septicemia and 1 with meningitis) were treated with CAZ at a dose of 1.0g twice a day either one-shot intravenously or by drip infusion.<BR>CAZ was effective in 5 out of the 6 cases of pneumonia and in 1 case of infected bronchiectasis due to <I>E. coli</I>. Also, clinical response of CAZ was evaluated as good in 1 case out of the 2 cases of BTI, and fair in the other, in which cholangioma was found as the underlying disease. In the 6 cases of UTI, clinical response was evaluated as excellent in 2 cases, moderate in 3, poor in 1 case. In 2 cases of septicemia and 1 case of meningitis, clinical response was good.<BR>The strain of <I>P. aeruginosa</I> was isolated from 1 case of pneumonia and 3 of UTI, and the organisms were eradicated in 3 cases and replaced in 1 case by administration of CAZ.<BR>Neither abnormality in laboratory findings nor clinical side effect was noted.
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