Ceftazidime(SN401)の臨床効果について--臨床効果と炎症組織内濃度の関連 (CEFTAZIDIME(CAZ,SN-401)<特集>)
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Ceftazidime (CAZ, SN401) is a new semisynthetic cephalosporin, with marked resistance to β-lactamase, low MICs for gram-negative bacilli, and a broad spectrum of antibacterial activity against various species of pathogenic bacteria, including <I>Haemophilus influenzae</I>, <I>Enterobacter cloacae</I>, <I>Citrobacter freundii</I>, <I>Serratia marcescens</I>, Indole-positive <I>Proteus</I>, and <I>Pseudomonas aeruginosa</I>. The patients (14 females and 9 males, with ages ranging from 11 to 85 years) were treated in the period between Aug.'81 and Apr.'82 at the Departments of Surgery and Internal Medicine of Tenshi Hospital. The patients consisted of 13 with acute peritonitis (10 due to acute appendicitis, 2 due to intestinal obstruction and 1 due to cecal CROHN's disease), 5 (6 episodes) with acute or subacte cholecystitis and cholangitis, and 5 with skin and soft tissue infections.<BR>To some of the patients, CAZ was given intravenously at a dose of 1 g before operation, and CAZ concentrations in serum, body fluids and infected tissues were determined.<BR>To outpatients, CAZ was given intravenously at a dose of 0.5 or 1 g once a day for 3 to 4 days.<BR>To hospitalized patients with mild or moderate infections, CAZ was given intravenously at a dose of 0.5 or 1 g twice a day for 3 to 9 days, and to those with severe infections at a dose of 1 or 2g twice a day for 10 days.<BR>Clinical response was excellent in 8 cases, good in 16 cases, fair or poor in none. No clinical adverse effect was noted. Pathogenic organisms were identified in 17 cases, and in 7 cases of them, the infections were due to multiple organisms. There were a total of 25 strains consisting of 16 strains of <I>Escherichia coli</I>, 4 strains of <I>Klebsiella pneumoniae</I>, 2 of Bacteroides fragilis, 2 of <I>P. aeruginosa</I>, and 1 of <I>E. cloacae</I>.<BR>In most of the cases in which pathogenic bacteria were identified, concentrations of CAZ in purulent ascites, common duct bile, gallbladder bile and its wall, infected appendix, and infected soft tissues were higher than the MICs of CAZ against pathogenic bacteria.<BR>From the above results, ceftazidime is considered to be a useful drug for the therapy of skin and soft tissue infections, biliary tract and intra-abdominal infections.
- 公益社団法人 日本化学療法学会の論文
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