ANTIBACTERIAL ACTIVITY, BLOOD LEVELS IN HEMODIALYSIS PATIENTS AND CLINICAL EVALUATION IN URINARY TRACT INFECTION OF A NEW MONOBACTAM ANTIBIOTIC, CARUMONAM
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Carumonam, a new N-sulfonated monocyclic β-lactam antibiotic, was evaluated both bacteriologically and clinically on urinary tract infections, and the following results were obtained.<BR>1. Of the standard strains, Gram-negative bacteria were susceptible to carumonam, though Gram-positive bacteria were not. The concentrations required to inhibit the growth of 90% of the clinical isolates of Citrobacter spp.(12 strains), <I>Serratia marcescens</I> (29 strains), <BR>Proteus vulgaris (7 strains) and <I>Morganella morganii</I> (25 strains) were 3.13μg/ml, 0.39μg/ml, 1.56μg/ml and 0.2μg/ml, respectively.<BR>2. Serum levels of carumonam in patients with chronic renal failure were serially detected by bioassay. Serum levels after 0.5g and 1g i. v. injection were very high even on the second day. A further 0.5g and 1g of carumonam were injected i. v. at the beginning of 5-h hemodialysis. Just after dialysis, serum levels of the drug were still high. These results suggest caution in prescribing this agent to patients with chronic renal failure, including patients under hemodialysis.<BR>3. The overall clinical efficacy in 19 patients with complicated urinary tract infections treated with carumonam was 47% covering both "excellent" and "moderate" responses. The rate of efficacy in bacteriuria was 26% "eliminated", 21% "decreased", 21% "replaced" and 32% "unchanged" In 35 urinary isolates from 19 patients with complicated urinary tract infections, the elimination rate was 63%. The elimination rate of Gram-negative rods was 67%.<BR>4. No side effects were observed in any patients. Adverse reactions in laboratory test results were found in 6 of 23 patients, but were probably not attributable to this agent.<BR>We conclude that carumonam is a useful and safe antibiotic for complicated urinary tract infections caused by Gram-negative rods.
- 公益社団法人 日本化学療法学会の論文
公益社団法人 日本化学療法学会 | 論文
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