Biapenemの体内動態と外科感染症における臨床効果

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  • Tissue concentrations and clinical efficacy of biapenem in surgical infections

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Biapenem (BIPM) is a new 4β methyl carbapenem antibiotic with a broad antibacterial activity against various types of bacteria and is stable to human renal dehydropeptidase-I. Clinical investigations on BIPM in surgical filed were carried out, and the results were as follows;<BR>1) The concentration of BIPM in plasma and bile were determined in 4 PTCD patients receiving 60 min intravenous drip design infusion of 300 and 600mg of BIPM by crosover design. Peak levels were plasma, 19.2±9.1 and 39.8±19.5g/ml after completion of infusion and thore in bile, were 45±16 and 117±6.1g/ml at 1h, respectivery. It was clearly observed a dose response in plasma and bile levels of BIPM between 300 and 600mg administration.<BR>2) BIPM after a single intravenous infusion of 600mg for 60min showed the fast and good penetration to the abdominal wall and intraabdominal organ tissues: the peak concentration in each tissue was 5.6 (stomach), 0.16 (liver), 2.6 (gallbladder), 0.9 (pancreas), 1.1 (spleen), 3.3 (peritnneum), 3.1 (muscle), and 0.9g/g (subcutanous tissue), respectivery.<BR>3) BIPM at a dose of 300mg was administered once to three times daily for 2 to 14 days to 45 patients: 10 with peritonitis, 6 with appendicitis or diverticulitis, 3 with abdominal abscess, 4 with liver abscess, 7 with cholecystitis or cholangitis, 2 with wound infection, 11 with periproctal abscess and 2 with subcutaneous abscess. The clinical efficacy was excellent in 17 patinets, good in 26, fair in 1 and poor in 1, and the efficacy rate was 95.6%. Bacteriological affects of BIPM in 31 patients were 90.3%. Abnormal laboratory data were observed elevated GOT and GPT and increased platelet count each in 1 patient.<BR>Therefore, BIPM in expected to be a useful antibacterial agent surgical infections.

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