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1 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 11 ) (MRSA) penicillin-resistant Streptococcus pneumoniae (PRSP) 3 I.
2 12( 12 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb ) (1985) 2), (1990) 3), (2001, 2002) 4 6) CDC ) II. 1. (surgical site infection) (remote infection) 1 5) ) ,8) 1.
3 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 13 )
4 14( 14 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. CRP ) 4.
5 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 15 ) / 1g 10 5 CFU 5,6) LPS, ) 1) 2) 3) 4) 5) 8. 1) (1)
6 16( 16 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. (2) 2) (1) (2) 1 (3) b - Time above MIC MIC 1 (4) 4 (5) / 3) (1) (2) (3) (4) / 3 (5) (6) ampicillin (ABPC) fosfomycin (FOM) FOM
7 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 17 ) 6. cefotetan (CTT) 4 / FOM b- III. 1. ABPC, piperacillin (PIPC), ampicillin/cloxacillin (ABPC/MCIPC) sulbactam/ampicillin (SBT/ABPC), cefazolin (CEZ), cefotiam (CTM), cefmetazole (CMZ), cefminox (CMNX) CTT, flomoxef (FMOX), FOM 11 b- FOM 2. 7, 8, 9 MIC
8 18( 18 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. 7. MIC (mg/ml)
9 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 19 ) 8. (1)
10 20( 20 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. 8.
11 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 21 ) 9.
12 22( 22 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. ABPC ABPC/MCIPC SBT/ABPC ABPC 11 Enterococcus faecalis PIPC Staphylococcus aureus, Staphylococcus epidermidis Enterobacter cloacae Pseudomonas aeruginosa CEZ CTM CMZ FMOX CEZ, CTM Bacteroides fragilis FOM ABPC/MCIPC S. aureus, S. epidermidis, E. faecalis E. cloacae ) CEZ 2.46 CTT 2.58 CMNX 2.48 FOM PIPC 40% ABPC/MCIPC 36.4% 11 FOM 138 CMZ, FMOX, FOM PIPC FOM PIPC, CEZ, CTM, CMZ ABPC CEZ, ABPC/MCIPC, FOM, CMNX 4 2% FOM %, 0.004%, 1 (0.001%) 86)
13 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 23 ) 10.
14 24( 24 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. 11.
15 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 25 ) 12.
16 26( 26 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. 13.
17 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 27 ) IV. ABPC CEZ CTM FMOX b -
18 28( 28 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. 1 MRSA 55 75% 87 89) PRSP 50% 90) b- 3 PBP b- b- FOM in vitro in vivo MIC FOM MIC PIPC FOM 91) B. fragilis group PIPC FOM CTT ceftriaxone (CTRX) MRSA MRSA MRSA MRSA V. 3 b - FOM 1) : , ) 94: , 1985
19 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 29 ) 3) 6: , ) , ) 49(S-B): 71 89, ) (1) 18(S-1): , ) MANGRAM, A. J.; T. C. HORAN, M. L. PEARSON, et al.: Guidline for prevention of surgical site infection, Hospital Infection Control Practices Advisory Committee. Infect. Control Hosp. Epidemiol. 20: , ) Prog. Med. 21: , ) Ampicillin 56: , ) Ampicillin Jpn. J. Antibiotics 37: , ) Aminobenzyl Penicillin J. Antibiotics, Ser. B 18: , ) Aminobenzyl-Penicillin Chemotherapy 16: , ) Chemotherapy 36: , ) T-1220 Jpn. J. Antibiotics 30: , ) T-1220 Chemotherapy 25: , ) T-1220 Chemotherapy 25: , ) XIV. Piperacillin Jpn. J. Antibiotics 34: , ) 34: , ) T-1220 Chemotherapy 25: , ) Aminobenzyl Penicillin Methlchloropheylisoxazolyl Penicillin (ViccillinS) 31: , ) Sulbactam Ampicillin Chemotherapy 36(S-8): , ) Sulbactam Ampicillin Chemotherapy 36(S-8): , ) FRANK, U.; E. SCHMIDT-EISENLOHR, A. JOOS-WURTTEMBERGER, et al.: Concentrations of sulbactam/ampicillin in serum and lung tissue. Infection 18: , ) Sulbactam Ampicillin Chemotherapy 36(S-8) , ) Sulbactam Ampicillin Chemotherapy 36(S- 8): , ) Sulbactam Ampicillin, Chemotherapy 36(S-8): , ) Sulbactam/Ampicillin Jpn. J. Antibiotics 42: , ) Sulbactam/Ampicillin Jpn. J. Antibiotics 42: , ) 1g cefazolin 15: , ) Ceftezole Cefazolin Chemotherapy 24: , ) CIMMINO, P. & T. GARACI: Tissue levels of cefazolin in man after parenteral administration. Antibiotica. 11: 31 44, ) COLE, D. R. & J. PUNG: Penetration of cefazolin into pleural fluid. Antimicrob. Agents Chemother. 11: , ) Cefazolin 2,3 Cephalosporin Chemotherapy 22: , ) Cefazolin 43: , ) CEZ CET 29: , ) CEFAZOLIN (CEZ) 39: , ) Cefazolin 14: , ) LIMON, L. L. y; C. A. T. TIRAD, F. FLORES-MERCADO, et al.: Treatment of suppurative otitis media in paediatric patients. J. Int. Med. Res. 3: , 1975
20 30( 30 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. 39) Cefotiam (SCE-963) Chemotherapy 27(S-3): , ) Cefotiam Jpn. J. Antibiotics 36: , ) Cefotiam (SCE-963) Chemotherapy 27(S-3): , ) (V) Cefotiam (SCE-963) Chemotherapy 27(S-3): , ) Cefotiam (SCE-963) Chemotherapy 27(S-3): , ) Cefotiam Jpn. J. Antibiotics 35: , ) Cefmetazole 53: 66 74, ), Cefmetazole Jpn. J. Antibiotics 40: , ) CS-1170 Chemotherapy 26(S-5): , ) Cefmetazole Chemotherapy 27: , ) Cefmetazole Chemotherapy 30: , ) CS : , ) 44: , ) CS-1170 Cefazolin 31: , ) Cefmetazole 52: , ) CS-1170 Chemotherapy 26(S- 5): , ) 75: , ) CS-1170 Jpn. J. Antibiotics 32: , ) MT-141 Chemotherapy 32(S-5): , ) MT-141 Chemotherapy 32(S-5): , ) Cefminox Piperacillin Jpn. J. Antibiotics 45: , ) Cefminox Chemotherapy 42: , ) Cefminox Jpn. J. Antibiotics 43: , ) (XXII) MT-141 Chemotherapy 32(S-5): , ) Cefminox 37: , ) Cefminox 36: , ) Cefminox 3: , ) Cephamycin Cefminox Jpn. J. Antibiotics 38: , ) Cefminox Jpn. J. Antibiotics 38: , ) Cefotetan (YM09330) Chemotherapy 30(S-1): , ) Flomoxef. Jpn. J. Antibiotics 41: , ) 6315-S (Flomoxef) Chemotherapy 35(S-1): , ) 6315-S (Flomoxef) RTI Chemotherapy 35(S-1): , ) 6315-S (Flomoxef) Chemotherapy 35(S-1): , ) 6315-S (Flomoxef) Chemotherapy 35(S-1): , ) (XXIX) 6315-S (Flomoxef)
21 Feb. THE JAPANESE JOURNAL OF ANTIBIOTICS ( 31 ) Chemotherapy 35(S-1): , ) 6315-S (Flomoxef) ), 6315-S (Flomoxef) Chemotherapy 35(S-1): , ) 6315-S (Flomoxef) ) Fosfomycin Chemotherapy 23: , ) Fosfomycin-Na Jpn. J. Antibiotics 31: , ) Fosfomycin Jpn. J. Antibiotics 35: , ) S 18: , ) Fosfomycin Jpn. J. Antibiotics 37: , ) Fosfomycin sodium Jpn. J. Antibiotics 38: 47 57, ) Fosfomycin sodium Jpn. J. Antibiotics 36: , ) Fosfomycin-Na 29: , ) Fosfomycin sodium 10 prospective 48: , ) MRSA 46: , ) 72: , ) : , ) Streptococcus pneumoniae 51: , ) Fosfomycin Chemotherapy 23: , 1975 ANTIMICROBIAL PROPHYLAXIS IN SURGERY NAGAO SHINAGAWA Department of Surgery, Nagoya Midori Municipal Hospital Antimicrobial prophylaxis is widely performed in any surgical procedures to prevent postoperative infections. However, we have neither double-blind placebo-controlled studies nor sufficient surveillance of postoperative infections that are common in Europe and the United States, and therefore there is little convincing scientific basis accounting for the validity of this therapy. In addition, prophylactic agent is still uncovered by medical insurance despite the persistent arguments as to its necessity. To establish the guidelines in our own country, a greater deal of evidence needs to be accumulated. Strategies for antimicrobial prophylaxis should be determined based on the types of possible postoperative infections and the classifications of operations according to contamination levels in individual operative fields. This process may involve the precise selection of prophylactic agents for suspected contaminating bacterial species in each operative organ and their administration
22 32( 32 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 57 1 Feb. regimens suitable for the individual surgery. Upon selection of prophylactic agents for postoperative infections, various conditions should be considered: e.g., susceptibility, resistance, blood concentrations, urinary excretion, transition into body fluid and tissues, and adverse reactions. The first and second generations of cephem and cephamycin derivatives can be the first choice, but the use of various other antibacterial agents may be necessary for resistant bacterial strains such as methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant Streptococcus pneumoniae (PRSP). Cyclic therapy based on penicillins (including mixtures), cephems (including cephamycins) and fosfomycins also seems useful for such resistant strains. At present, there is only limited evidence supporting the importance of prophylactic agents. Controlled trials employing well-designed protocols that endure scientific criticism must be done with due consideration for medical economics.
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