VOL.27S-1 CHEMOTHERAPY 109 Klebsiella, Proteus, Pseudomonas Streptococcus Fig. 1 Concentration in blood and in CSF after intravenous drip infusion of

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1 VOL.27S-1 CHEMOTHERAPY 109 Klebsiella, Proteus, Pseudomonas Streptococcus Fig. 1 Concentration in blood and in CSF after intravenous drip infusion of 4.9 g Mezlocillin Streptococcus pneumonzae pneumoniae

2 110 CHEMOTHERAPY JAN.1979 Table 1 Clinical result of Mezlocillin (Case 1) Table 2 Laboratory findings before and after administration of Mezlocillin (Case 1) Fig. 2 31y. Male Purulent meningitis

3 VOL.27 S-1 CHEMOTHERAPY 111 Table 3 Sensitivity of Streptococcus pneumoniae isolated Fig. 3 Pulumonary abscess 47y. male Table 4 Clinical result of Mezlocillin (Case 2) Table 5 Laboratory findings before and after administration of Mezlocillin (Case 2)

4 CHEMOT 112 Photo 1 Before treatment (Case 2) 以上 に わ た り計195gの with Mezlocillin Photo 2 大 量 連続 投 与 に もか かわ らず, 考 2) 化 膿 性 髄 膜 炎1例,肺 3) 按 肺炎 球 菌 に よ る化膿 性 髄膜 炎 の1 4) Penicillin剤 の 開発 に よ り治 癒症 例 が経 験 され る よ うに た な った が,依 然重 篤 感 染 症 の 一 つ に加 え られ て い る 本 例 では 分 離 原 因菌 と しての 肺 炎球 菌 がPCGに 比 しむ し ろす ぐれ た感 受性 を示 した こ とか ら,さ らに 肺炎 球 菌 の 株 数 を 増 加 して 本剤 の抗 菌 力 を他 のPenicillin剤 と比 較 第1例 5) 一 日 量16 20gを11日 以 上Cephalexin, 得た の乱 れ もみ られ なか った こ とは重 症 感 染 症 に 対 して 有用 結 新 半 合 成penicillin系 語 抗 生物 質,Mezlocillinに つい 1) 体 液 中濃 度 はB. T3輸 液500mlに subtilis ATCC 6633芽 胞 を用 ソ リタ 溶 解 して2時 間 で点 滴 静 注 した と こ ろ,血 中 濃度 は投 与 終 了直 後52.5μg/ml,6時 μg/mlで 2) zolyl 後 に0.36μg/mlで 献 裕,倉 又 利 夫: penicillinの Methylchlorophenylisoxa- 体 液 中 濃 度 測 定 法,感 受 性 デ ィ ニ シ リ ン分 解 酵 素 抵 抗 性 に 関 す る 検 討 な らび に 臨 床 経 験 Chemotherapy 3) 裕,倉 benicillinの 間 で0.5 あっ て効 果不 十 分 で あ 投 与 し満足 す る治 療 成績 を 12(Suppl): 5 13, 1964 (2): あ った 髄 液 内濃 度 は105分 後 に3.2μg/ml, 150分 後 に0.82μg/ml,210分 た Doxycyclineに 文 ス ク 法,ペ で測 定 した Mezlocillin 4gを 清 電 解 質 の 異 常 は 認 め られ 1) BODEY, G. P. & T. PAN : Mezlocillin : In vitro studies of a new broad-spectrum penicillin. Antimicrob. Agents and Chemother. 11 (1): 7479, 1977 て基 礎 的,臨 床 的検 討 を 行 な った いて 薄 層cup法 対す す ぐれ て い た 以 上 に わ た り計195gの にMezlocillinを 以上 に わた り大 量 投 与 を行 な った が 臨 床 的 に も な 薬 剤 の1つ に 今後 加 え られ る可 能性 が うか が われ た Pneumoniaeに なか った あ る また重 症 感 染 症 と して の髄 膜 炎 に1日 臨 床 検 査 上 も,腎 機 能 に対 す る影 響,電 解 質 の バ ラ ンス にMezlocillin の成 績 を得 た か ら 分 離 し たStrePt. 大 量 投 与 に も か か わ らず,血 っ た 各1例 gを11日 化 膿 症1例 効1列 副 作 用 は 臨 床 的 に も 諸 検 査 値 上 も認 め られ な か っ す る こ とは 本症 の治 療 に有 意 な 資料 を提 供 す る可 能性 が 量16 20 効1例,有 る 本 剤 の 抗 菌 力 はMIC 0.003μg/mlと 例 に 使 用 し,著 効 を み と め た 肺 炎 球 菌 性 髄 膜 炎 は 1979 On the 5th day afther the course of treatment with Mezlocillin (Case 2) を 投 与 し,著 血 清 電 解 質 は依 然正 常 範 囲 内 で あ った 今 回Mezlocillinを JAN. HERAPY 4) 又 利 夫,丸 山 勇,中 島 季 陸: 基 礎 的 臨 床 的 検 討 Chemotherapy , 裕:T-1220の 験 Chemotherapy Car 基礎 的検 討 な ら び に 臨 床 経 25(2): , 1977

5 CHEMOTHERAPY LABORATORY AND CLINICAL STUDIES ON MEZLOCILLIN YUTAKA KANAZAWA Department of Internal Medicine, Toyosaka Hospital Laboratory and clinical investigation of the new semi-synthetic penicillin, mezlocillin, has been conducted. 1. Body fluid specimens were assayed for antibacterial activity by the cup-plate method using B. subtilis ATCC 6633 as the test organism. Intravenous drip infusion of 4 gm of mezlocillin in 500 ml Sorita T 3 in 2 hours, yielded plasma antibiotic concentration of 52.5 Đg/ml at the end of the infusion, 0.5 Đg/ml at 6 hours after the end of infusion. The concentration in the CSF was determined to be 3.2, 0.82 and 0.36 Đg/ml at 105, 180 and 210 minutes respectively. 2. A patient with purulent meningitis and another with pulmonary abscess were treated with the antibiotic, of whom one responded with a remarkable improvement and the other showed a moderate improvement. 3. A profound antibacterial activity of the drug was demonstrated against a strain of Streptococcus pneumoniae isolated from the first case, with an MIC of Đg/ml. 4. Neither adverse signs in clinical symptoms nor abnormal findings in the laboratory examinations that could be interpreted as side effects were noticed. 5. No evidence of serum electrolyte inbalance was noticed even in one case treated with high doses (16-20 g/day) of mezlocillin for 11 days. The antibiotic was effective in 2 patients with purulent meningitis and with pulmonary abscess, respectively.

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