小児科領域における９，３″‐ジ‐Ｏ‐アセチルミデカマイシン（ＭＯＭ）の基礎的ならびに臨床的検討

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  • LABORATORY AND CLINICAL STUDIES OF MOM (9, 3''-DI-OACETYL MIDECAMYCIN) IN PEDIATRIC FIELD
  • ショウニカ リョウイキ ニ オケル 9 3 di o acetylmideca

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The authors have carried out the laboratory and clinical studies of MOM and obtained the following results:<BR>1. The sensitivities of S. aureus: 114 strains, S. pyogenes: 144 strains and S. pneumoniae: 35 strains to MOM, MDM and EM were distributed widely. In particular, two peaks existed clearly in the distribution of sensitivities to EM. The sensitivity of the superior peak of these two was higher by one to three tubes than the peak of MOM in three species. However, the frequency of the resistant strains to EM was the highest among these three drugs. The sensitivities of B. pertussis: nine strains to these drugs were below 0.39μg/ml and those to EM were the highest. The sensitivities of H. influenzae: 12 strains to MOM and MDM were above 12.5μg/ml.<BR>2. The serum concentrations and urinary excretion rate of MOM dry syrup were measured in 22 pediatric patients by oral administration at the dose of 10mg/kg and in 24 patients at the dose of 20mg/kg. The peak of mean serum concentrations of MOM for the 10mg/kg group and the 20mg/kg group were 0.756μg/ ml and 1.010μg/ml respectively at one hour after administration. The mean urinary recovery rates of MOM for the former group and for the latter were 1.67% and 2.46% respectively for six hours after administration.<BR>3. The clinical responses of MOM were excellent in 53 cases, good in 174, fair in 28 and poor in 45 out of 300 cases, i. e. 39 cases with pharyngitis, 57 with tonsillitis, 35 with bronchitis, 17 with pneumonia, 79 with mycoplasmal respiratory tract infection, 45 with scarlet fever, 26 with whooping cough, one with S. S. S. S. and one with otitis media. Overall efficacy rate was 75.7%. The difference in the efficacy rate was not statistically significant when the clinical response was compared among groups of four different daily dose, i. C. below 20mg/kg, 21-30mg/kg, 31-40mg/kg and above 41 mg/ kg. Fifty-eitht out of 117 strains isolated were eradicated. The clinical side effects of MOM in 378 cases (including drop-out cases) were observed in 14 cases (3.70%), i. e. four cases of exanthema and 10 cases of gastro-intestinal abnormality like diarrhea. No severe side effects like hepatitis were observed. As to the clinical laboratory findings of MOM, a slight elevation of GOT in three cases, GPT in two cases, GOT-GPT-total bilirubin in one case and the eosinophilia in four cases were observed, but these were mild.

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