尿路・性器感染症におけるcefluprenamの基礎的・臨床的検討

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  • <I>in vitro</I> antimicrobial activities of cefluprenam and its clinical efficacy in urogenital infections

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We studied in vitro antimicrobial activities and clinical efficacy of cefluprenam (CFLP), a new parenteral cephalosporin developed in Japan, and following results were obtained.<BR>1) in vitro antimicrobial activities of CFLP<BR>The antimicrobial activities of CFLP against 360 strains isolated from patients with urinary tract infection (UTI) were measured by the agar dilution method at an inoculum size of 106 cfu/ml and the results were compared with those of ceftazidime (CAZ), flomoxef (FMOX) and imipenem (IPM).The antimicrobial activities of CFLP against methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, coagulase-negative staphylococci and Enterococcus faecalis were inferior to those of IPM, but superior to CAZ and FMOX.Although CAZ and FMOX were not active against E.faecalis, CFLP showed some activity. Against Escherichia coli, Citrobacter freundii, Klebsiella pneumoniae and Proteus vulgaris, CFLP was the most active among four examined drugs. CFLP was more active than CAZ and FMOX against Enterobacter cloacae, Serratia inarcescens and Pseudomonas aeruginosa.As for the antimicrobial activity against Proteus mirabilis, CFLP was highly active but a little inferior to FMOX and CAZ. Based on the resistance of CFLP to hydrolysis by various types of β-lactamase, CFLP revealed stronger activities than CAZ and FMOX against C.freundii and E. cloacae.<BR>2) Clinical efficacy of CFLP in urogenital infections<BR>The clinical efficacy of CFLP was evaluated in one case with uncomplicated pyelonephritis, 16 cases with complicated UTI, two cases with epididymitis. The efficacy of CFLP judged by the chief doctor in one case with uncomplicated pyolonephritis was fair. In 16 cases with complicated UTI, the efficacy according to the criteria proposed by The Japanese UTI Committee was excellent in 5, moderate in 6, poor in 5, and the overall clinical efficacy rate was 68.8%. The clinical efficacy in 2 patients with epididymitis was evaluated excellent in 1 and good in 1 by the chief doctor.<BR>3) Adverse reaction of CFLP<BR>No adverse reaction was observed in these 19 patients. Elevation of γ-GTP level was noted in one case, which was possibly related with administration of CFLP.<BR>These results indicate that CFLP is one of the most useful antimicrobial drugs in the treatment of urogenital infections.

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