On the clinical effects of cefotiam on acute cystitis and changes in form of E. coli in the urine
| Autor: | Washida, Hiroto, Tsugaya, Masayuki, Hirao, Noriaki, Hachisuka, Yusuke, Takeuchi, Kenji, Inuzuka, Kazuhisa |
|---|---|
| Jazyk: | japonština |
| Rok vydání: | 1983 |
| Předmět: | |
| Zdroj: | 泌尿器科紀要. 29(10):1373-1380 |
| ISSN: | 0018-1994 |
| Popis: | Cefem系抗生剤であるCefotiam (CTM:武田薬品)を女性急性単純性膀胱炎に投与し, その臨床効果ならびに尿中濃度と尿中細菌形態変化を検討した.対象は当科を受診し, 上記診断された女性15例で, 年齢は23～75歳, 平均46.9歳であった.CTM投与前に経尿道的に3穴ネラトンカテーテルを留置し, 投与前, 投与後5, 15, 30分毎にカテーテルを開放して採尿し, 尿中一般細菌培養および尿中細菌形態変化の観察に使用し残りを尿中濃度測定, 尿沈渣に供した.尿中細菌の形態変化は透過型微分干渉位相差顕微鏡にて観察・撮影した.MICの測定は日本化学療法学会の標準法に従い, 尿中濃度はP. mirabilis ATCC 21, 100を試験菌とする薄層カップ法により測定した.臨床効果については, 総合評価において15例中14例に著効, 1例に有効で100%の有効率であった.起炎菌は14例にE. coliを認め, CTMのMICは0.05～0.78 μg/ml (106cells/ml接種)であり, 1例にS. epidermidisとの混合感染を認め, 残り1例はS. faecalis単独感染であったが, 100%の消菌率であった.尿中濃度測定ができた5例中4例において静注後5分で296～6893 μg/mlと極めて高濃度にCTMが尿中排泄され, これら4例において投与後30分までに尿中細菌の陰性化, 尿所見の正常化が認められた.8例において, E. coliは投与後5分で完全に溶菌して, 観察が不可能かあるいは観察されるE. coliはspheroplast化, bulge形成, ovoid cell形成を示し, 溶菌に至る様々の形態が観察された.尿中排泄の不良な例では紺野らのin vitroの成績と同様にfilament形成の傾向がうかがわれた.CTM投与後の尿中E. coliの形態変化がin vitroのそれと類似した変化であったことから, CTMは抗菌力を失うことなく尿中に排泄されること, またCTMがすぐれた臨床効果を示したことについて尿中細菌形態変化の観点から裏付けられたと考える Cefotiam (CTM) was administered to female patients suffering from acute cystitis to examine its clinical efficacy and changes in form of the bacteria in urine. CTM was administered to 15 female patients with acute cystitis once a day for three consecutive days (1 g/time in 13 cases, and 0.5 g/time in 2 cases). The overall clinical efficacy was 100%. Bacteriological examination, revealed 13 cases of single infection by E. coli, and one case of E. coli and S. epidermidis (MIC: 0.78 micrograms/ml). MIC of E. coli ranged from 0.05 to 0.78 micrograms/ml. All of the strains were eradicated, the eradication efficacy being 100%. The forms of bacteria in the urine after the administration of CTM were examined in 8 cases (all due to E. coli). Bacteria in urine disappeared or formed a spherical form 5 minutes after the administration of CTM. Disappearance of E. coli was observed in 7 cases at 15 or 30 minutes after drug administration, and with the disappearance, improvements were also observed in the urinary findings. Of these cases, the urinary concentration of CTM was measured in 4 cases. It ranged from 296 to 6, 893 micrograms/ml at 5 minutes after the administration. In one case of deficient excretion in urine, filamentation was observed, and with the rise in CTM concentration in urine, granular changes were observed in the shape of bacteria. CTM's excellent clinical efficacy was substantiated by the changes in the form of bacteria in urine. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|