日本化学療法学会雑誌第59巻第5号
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- ゆみか いいはた
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1 Streptococcus pneumoniae Haemophilus influenzae Moraxella catarrhalis S. pneumoniae H. influenzae M. catarrhalis S. pneumoniae H. influenzae M. catarrhalis S. pneumoniae H. influenzae M. catarrhalis
2 S. pneumoniae μ μ μ H. influenzae μ β μ β μ Key words Streptococcus pneumoniae Haemophilus influenzae Moraxella catarrhalis S. pneumoniae H. influenzae S. pneumoniae H. influenzae β β β S. pneumoniae H. influenzae M. catarrhalis I
3 S. pneumoniae H. influenzae M. catarrhalis Streptococcus pyogenes S. pneumoniae H. influenzae M. catarrhalis S. pyogenes S. pneumoniae μ μ μ H. influenzae β β μ β μ β μ χ II
4 Cases collected 207 Safety analysis 167 Cases excluded from safety analysis 40 Reason for exclusion No visit after prescription 18 Violation of inclusion criteria 3 Frequency of administration ( 2 days) 19 Cases excluded from efficacy analysis 42 Reason for exclusion Administration inadequate ( 3 days) 4 Efficacy unassessable 3 Concomitant topical antibiotics 35 Efficacy analysis 125 Fig. 1. Case breakdown. Table 1. Subject summaries Item Category Cases % Cases examined Gender male female Age (years) mean SD Body weight (kg) mean SD Severity before administration mild moderate severe Infected site right left both Concomitant use of Incident frequency First time gastrointestinal drugs Recurrent recurrent acute otitis media other Daily dosage rounded off to one dosage Frequency of administration per day/body weight. One case discontinuated the drug for 3 days (total duration of exposure: 8 days). Item Category Cases % Onset time 0 day day before days before days before days before mean SD Antibiotics administered within 1 month no yes Daily dosage (mg/kg) mean SD Frequency of administration per day Duration of administration (days) Once Twice Three times mean SD mean SD no yes unknown 1 0.6
5 Table 2. Clinical efficacy by background data Clinical efficacy Efficacy Item Category Cases excellent good fair poor (%) Cases examined Result ( 2 test) Age (years) mean SD Severity before administration mild moderate severe Incident frequency First time Recurrent recurrent acute otitis media other Risk factors Day care attendance no nursery kindergarten unknown Sib no yes unknown Swimming club no yes unknown Pacifier no yes unknown Co infection in family no yes unknown S. pneumoniae H. influenzae M. catarrhalis S. pyogenes S. pneumoniae H. influenzae M. catarrhalis S. pneumoniae H. influenzae M. ca-
6 Table 3. Clinical efficacy by causative organism Infection Causative organism Cases Clinical efficacy Efficacy excellent good fair poor (%) Monobacterial S. pneumoniae PSSP PISP PRSP H. influenzae BLNAS BLNAR BLPAR M. catarrhalis S. pyogenes Polybacterial S. pneumoniae H. influenzae S. pneumoniae M. catarrhalis S. pneumoniae S. pyogenes H. influenzae M. catarrhalis S. pneumoniae H. influenzae M. catarrhalis Table 4. Bacteriological efficacy by causative organism Organism Strains Bacteriological efficacy Eradication eradicated decreased unchanged (%) S. pneumoniae PSSP PISP PRSP H. influenzae BLNAS BLNAR BLPAR M. catarrhalis S. pyogenes tarrhalis S. pyogenes S. pneumoniae H. influenzae M. catarrhalis S. pneumoniae H. influenzae M. catarrhalis S. pneumoniae H. influenzae S. pneumoniae H. influenzae M. catarrhalis S. pyogenes S. pneumoniae μ μ μ μ μ μ μ μ H. influenzae μ μ μ μ M. catarrhalis μ μ S. pyogenes μ
7 Other 27.5% S. pneumoniae 27.2% PRSP 18.9% PISP 32.6 % PSSP 48.4% Strains examined 95 S. pyogenes 0.9% S. aureus 8.9% M. catarrhalis 12.9% H. influenzae 22.6% BLPAR 8.9% BLNAR 44.3% BLNAS 46.8% Strains examined 349 Cases examined 175 Strains examined 79 Fig. 2. Distribution Causative-organism. III S. pneumoniae S. pneumoniae H. influenzae M. catarrhalis S. pneumoniae H. influenzae M. catarrhalis S. pneumoniae
8 Table 5. Antibiotic susceptibility by causative organism MIC ( g/ml) Causative organism Strains Antibiotics range MIC50 MIC90 S. pneumoniae 95 FRPM AMPC CDTR CFPN CFDN PCG PSSP 46 FRPM AMPC CDTR CFPN CFDN PCG PISP 31 FRPM AMPC CDTR CFPN CFDN PCG PRSP 18 FRPM AMPC CDTR CFPN CFDN PCG H. influenzae 79 FRPM AMPC CDTR CFPN CFDN ABPC CVA/AMPC BLNAS 37 FRPM AMPC CDTR CFPN CFDN ABPC CVA/AMPC BLNAR 35 FRPM AMPC CDTR CFPN CFDN ABPC CVA/AMPC BLPAR 7 FRPM AMPC CDTR CFPN CFDN ABPC CVA/AMPC M. catarrhalis 45 FRPM AMPC CDTR CFPN CFDN S. pyogenes 3 FRPM AMPC CDTR CFPN CFDN
9 Gender Age (years) Daily Dose (mg/kg) Duration of administration (days) Table 6. Adverse diarrhea reaction FRPM administration Duration of administration until ADR (days) Days required for outcome (days) Outcome Concomitant use of gastrointestinal drugs male Unknown for no 5 Unknown Unknown No visit after ADR male Discontinued 2 3 Improved No female Discontinued 3 6 Recovered Antibiotic-resistant lactic acid bacteria female Discontinued 2 5 Recovered Antibiotic-resistant lactic acid bacteria female Discontinued 2 7 Recovered No female Discontinued 4 1 Recovered No male Discontinued 5 5 Recovered Antibiotic-resistant lactic acid bacteria male Discontinued 2 1 Improved No MedDRA/J 12.1 Difficult 4.6% Moderate 33.3% Impossible 0% Very good 22.2% Good 39.8% Cases examined 108 Fig. 3. Palatability Drug. H. influenzae M. catarrhalis S. pneumoniae H. influenzae M. catarrhalis S. pneumoniae H. influenzae S. pneumoniae H. influenzae S. pneumoniae μ μ μ μ S. pneumoniae μ μ μ μ S. pneumoniae S. pneumoniae H. influenzae μ μ
10 H. influenzae H. influenzae
11
12 Streptococcus pneumoniae Haemophilus influenzae Moraxella catarrhalis S. pneumoniae H. influenzae M. catarrhalis S. pneumoniae μ S. pneumoniae μ S. pneumoniae μ
日本化学療法学会雑誌第57巻第6号
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