MRSA感染による副鼻腔炎に対するABKを用いたネブライザー療法

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  • ABK NEBULIZER THERAPY FOR PARANASAL SINUSITIS CAUSED BY MRSA INFECTION

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Although various antibacterial agents can be used for the treatment of paranasal sinusitis caused by MRSA, ABK (arbekacin; HabekacinTM) is one of the drugs of choice. ABK is currently approved for clinical use mainly intravenously, only in Japan. But, even when it is administered by topical nebulization, either intermittently or continually, it has proved to be of excellent clinical benefit.<BR>The drug was administered by topical nebulization to five cases of sinusitis caused by MRSA at St. Mary's Hospital in Himeji. Following its administration, the sinus infection was eliminated effectively in all the cases, without any associated side effects such as ototoxicity, nephrotoxicity or development of drug resistance. Furthermore, the cost of treatment is about twelve times lower than when it is administered intravenously. Although the infection was eliminated in all the cases, when the drug is administered by topical nebulization two of them later showed relapse of the MRSA infection, and needed repetition of the initial treatment protocol. In the five aforementioned patients with sinusitis caused by MRSA this new and effective drug was applied each week topically between four and twenty-nine times, on average, 11.4 times. In each of the cases, additional chemotherapy was selected as needed. Before each administration, 8.3 mg of ABK was dissolved in 1.0 cc of normal saline, and the drug was nebulized via the Jet-type nebulizer, FN-D 3100. The nebulizer treatment was administered intermittently in the outpatient clinic. Based on these results, it is recommended for the treatment of sinusitis caused by MRSA, that ABK be administered by topical nebulization, in addition to oral or intravenous antibiotic therapy. In the case of mere MRSA colonization, on the other hand, the administration of ABK alone is recommended until the organisms are eliminated.

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