BASIC AND CLINICAL STUDIES ON CEFDINIR IN URINARY TRACT INFECTIONS
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We carried out the basic and clinical studies on cefdinir (CFDN), a new oral cephem antibiotics.<BR>1. Antibacterial activity<BR>The <I>in vitro</I> activity of CFDN, ampicillin (ABPC), cefixime, cefaclor and cefuroxime was determined by the MIC 2000 system (10<SUP>5</SUP> inoculum size) against organisms clinically isolated from urinary tract infections.<BR>The peak MIC of CFDN against <I>Staphylococcus aureus</I> and <I>Staphylococcus epiderrnidis</I> was 0.78μg/ml and 0.10μg/ml, and was superior to that of the other drugs tested.<BR>The peak MIC of ABPC against <I>Enterococcus faecalis</I> was 1.56μg/ml and superior to that of CFDN by three dilution steps. was resistant to all the drugs tested.<BR>Against Gram-negative bacteria, the peak MIC of CFDN against <I>Escherichia coli</I>, <I>Klebsiella pneumoniae, Proteus mirabilis</I> and Indole- positive was 0.20μg/ml, 0.10μg/ml, 0.10μg/ml and 1.56μg/m, respectively. However, CFDN had no antibacterial activity against <I>Enterobacter</I> spp., <I>Serratia marcescens</I> and <I>Pseudomonas aeruginosa</I> with peak MICs of≤100μg/ml.<BR>2. Clinical efficacy<BR>CFDN was given to 34 patients with urinary tract infections: 6 with acute uncomplicated cystitis (AUC) and 28 with complicated urinary tract infections (C-UTI). A dose of 50 mg b. i. d. was administered orally to patients with AUC for 5-7 days. A dose of 100 mg or 200 mg t. i. d. was administered orally to patients with C-UTI for 5-10 days. Twenty-six cases, 5 with AUC and 21 with C- UTI, were evaluable by the criteria of the Japanese UTI Committee.<BR>In the AUC cases, overall clinical efficacy was excellent in 3 and good in 2, with an efficacy rate of 100%.<BR>In the C-UTI cases, overall clinical efficacy was excellent in 10, good in 6, and poor in 5, with an efficacy rate of 76.2%. The overall clinical efficacy rate classified by the type of infection was 9/11 in group 4, 4/7 in group 6, 2/2 in group 2 and 1/1 in group 1, respectively.<BR>As to bacteriological response, all of 6 strains isolated from patients with AUC and 27 of 32 strains isolated from patients with C- UTI were eradicated, the eradication rate being 84.4%.<BR>Five strains appeared after CFDN treatment: one each of <I>Staphylococcus haemolyticus, Staphylococcus lentus, Enterococcus faecium, Pseudomonas cepacia</I> and <I>Xanthomanas maltophilia</I>.<BR>3. Side effects<BR>No adverse reactions were noted in any of the patients. In laboratory findings, a slight elevation of GOT, GPT due to CFDN was observed in one case.
- 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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