VOL. 23 NO. 3 CHEMOTHERAPY 1067 Table 2 Sensitivity of gram positive cocci isolated from various diagnostic materials Table 3 Sensitivity of gram nega

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1 1066 CHEMOTHERAPY MAR Table 1 Sensitivity of standard strains

2 VOL. 23 NO. 3 CHEMOTHERAPY 1067 Table 2 Sensitivity of gram positive cocci isolated from various diagnostic materials Table 3 Sensitivity of gram negative bacilli isolated from various diagnostic materials

3 1068 CHEMOTHERAPY MAR Fig. 1 Staphylcoccus aureus (91 strains) Fig. 4 Shigella (14 strains) Fig. 2 Ĉ-streptococcus (51 strains) Fig. 5 Escherichia coli (102 strains) Fig. 3 Enterococcus (59 strains) Fig. 6 Klebsiella aero genes (113 strains)

4 VOL. 23 NO. 3 CHEMOTHERAPY 1069 Fig. 7 Enterobacter aerogenes (12 strains) Fig. 10 Proteus vulgaris (22 strains) Fig. 8 Enterobacter cloacae (32 strains) Fig. 11 Proteus mirabilis (28 strains) Fig. 9 Morganella (24 strains) Fig. 12 Pseudomonas aeruginosa (60 strains)

5 1070 CHEMOTHERAPY MAR Fig. 13 Serum levels of Tobramycin (4 Healthy male adults, 80 mg, i.m.) Table 4 Serum levels of Tobramycin (4 Healthy male adults, 80 mg, i.m.)

6 VOL. 23 NO. 3 CHEMOTHERAPY M.N. 33 yr., 56 kg Table 5 Urinary excretion of Tobramycin (4 Healthy male adults, 80 mg, i.m.) 2. T.T. 34 yr. 66 kg 3. H.H. 33 yr. 58 kg. 4. N.H. 28 yr. 64 kg Fig. 14 Urinary excretion of Tobramycin (Average of 4 healthy male adults, 80 mg, i.m.) Table 6 Tissue concentration of Tobramycin ( Rat (Wistar) 20 mg/kg, km. Average of 3 rats )

7 1072 CHEMOTHERAPY MAR Fig. 15 Tissue concentration of Tobramycin Rat (Wistar) 20 mg/kg, i.m. ( Average of 3 rats. ) Fig. 17 Tobramycin concentration in sputum (Case 3 : 54 yrs. Female, Wt. 38 kg, 80 mg, i.m., Bronchiectasis) Table 7 Remaining rate of Tobramycin after mixing with various rat organs Fig. 18 Clinical course of case 1 (47 yrs., Male, Wt. 52 kg, Lung abscess) Fig. 16 Tobramycin concentration in sputum (Case 2 : 48 yrs. Female, Wt. 44 kg, 80mg, i.m., Bronchiectasis.)

8 VOL. 23 NO. CHEMOTHERAPY 1073 Fig. 20 Clinical course of case 3 (54 yrs., Female, Wt. 38 kg Bronchiectasis) Fig. 19 Clinical course of case 2 (48 yrs., Female, Wt. 44 kg Bronchiectasis, Sinuitis paranasalis)

9 1074 CHEMOTHERAPY MAR. 175 Table 8 Clinical laboratory data before and after administration of Tobramycin

10 VOL. 23 NO. 3 CHEMOTHERAPY ) KocH, K.F. & J.A. RHOADES : Structure of nebramycin factor 6, a new aminoglycosidic antibiotic. Antimicr. Agents & Chemoth. 309 `313, ) MEYER, R.D.; L.S. YOUNG & D. ARMSTRONG: Tobramycin (nebramycin factor 6) : in vitro activity, against Pseudomonas aeruginosa. Appl. Microbiol. 22 (6) : 1147 `1151, ) SAGGERS, B.A. & D. LAWSON : In vivo penetration of antibiotics into sputum in cystic fibrosis. Arch. Dis. Childh. 43: 404 `409, 1968

11 1076 CHEMOTHERAPY MAR LABORATORY AND CLINICAL STUDIES ON A NEW ANTIBIOTIC, TOBRAMYCIN MASARU NASU, ATSUSHI SAITO and KOHEI HARA The Second Department of Internal Medicine, Nagasaki University School of Medicine Laboratory and clinical studies were under taken on tobramycin, a newly developed aminoglycoside antibiotic, and the following results were obtained. 1) The comparative study of the antibacterial activity with gentamicin was made for clinical isolates (201 strains of gram-positive cocci and 407 strains of gram-negative bacilli) and 17 standard strains kept in our department. Tobramycin showed antibacterial activity similar to that of gentamicin against each strain except Pseudomonas aeruginosa against which tobramycin showed better antibacterial activity than gentamicin by 1 to 2 test tubes. 2) Blood levels and excretion into urine after intramuscular injection were determined in healthy adults. Blood level reached a peak at one hour after the injection. The average peak level after 80 mg intramuscular injection was 4.6 Đg/ml. The blood level of 1.1 Đg/ml was still observed at 6 hours. The excretion into urine was 77.4% on an average within 6 hours. 3) Tissue levels were measured in rats. The tissue level was the highest in the kidney, followed by those in serum, the lung and the liver. 4) The maximum sputum level in patients with bronchiectasis after 80 mg intramuscular injection was 1.3 Đg/ml. The ratio of maximum sputum level to maximum blood level was 0.09 to ) Tobramycin was administered to one patient with lung abscess (causative bacteria was unknown) and two patients of bronchiectasis (causative bacteria were E. coli and H. influenzae, and Proteus vulgaris). The daily dosage given was 160 to 240 mg. The clinical response was unsatisfactory in all cases. The application of the drug to refractory respiratory tract infections was also discussed. 6) No serious side effect was observed except pain at injection site in one case out of three.

VOL. 23 NO. 3 CHEMOTHERAPY 1379 Table 1 Susceptibility of clinical isolated strains to Tobramycin

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