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VOL.30 NO.10 CHEMOTHERAPY 1123 Fig,1 Group B case 6 hepatolithiasis,e.k.66 y.0.,f.45kg Postoperative wound infection Fig.2 Group B case 15 gastric cancer,k.k.60 y.o.,m. Postoperative peritonitis

Fig.3 Distribution of susceptibility of clinical isolates from postoperative infections to CMZ and CEZ before and after CMZ administration Fig. 4 Distribution of susceptibility of clinical isolates from postoperative infections to CMZ and CEZ before and after CMZ administration

1128 CHEMOTHERAPY OCT.1982 Fig.5 Distribution of susceptibility of clinical isolates from postoperative infections to CMZ and CEZ before and after CMZ,admiliktralion Gruup B Fig.6 Distribution of susceptibility of clinical isolates from postoperative infections to CMZ and CEZ before and after CMZ administration Group B

VOL.30 NO.10 CHEMOTHERAPY 1129 Fig.7 Correlation between the effect of CMZ and CEZ on the clinical isolates from postoperative infections before and after CMZ administration Group A Fig.8 Correlation between the effect of CMZ and CEZ on the clinical isolates from postoperative infections before and after CMZ administration Group A

1130 CHEMOTHERAPY OCT.1982 Fig.9 Correlation between the effect of CMZ and CEZ on the clinical isolates from postoperative infections before and after CMZ administration Group 13 Fig.10 Correlation between the effect of CMZ and CEZ on the clinical isolates from postoperative infections before and after CMZ administration Group 8

Fig. 11 MICs of CMZ and CEZ and specific activities of 8-lactamase of isolates from postoperative infections before CMZ administration Fig. 12 MICs of CMZ and CEZ and specific activities of 3-lactamase of isolates from postoperative infections before CMZ administration

CHEMOTHERAPY OCT.1982 Fig.13 Concentration in serum and peritoneal exudate in patients at 2 nd day after gastrectomy for gastric cancer Group Table 22 Distribution of strains isolated for postoperative infectious foci before and after CMZ administration A GPC:Gram positive cocci GNB:Gram negative bacilli

VOL.30 NO.10 CHEMOTHERAPY 1133 Group 13 Table 23 Distribution of strains isolated for postoperative infectious foci before and after CMZ administration GPC:Gram positive cocci GNB:Gram negative bacilli 2) CS-1170(Cefmetazole:CMZ):Chemotherapy 26(Supplement 5), 1978 5) NOVICK, R. P.:Analysis by transduction of mutants affecting penicillinase formation in Staphylococcus aureus. J. Gen. Microbiol. 33: 121. 436, 1963 6) FERRET, C. J.:Iodometric assay of penicillinase, Nature 174:1012-4013, 1954 7) LOWRY, 0. H.;N. J. ROSEBROUGII, A. L. FARR & R. J. RANDALL:Protein measurement with the Folin phenol reagent. J. Biol. Chem. 193:265 275, 1951

CHEMOTHERAPY OCT. 1932 LABORATORY AND CLINICAL STUDIES ON EFFECT OF CEFMETAZOLE ON POSTOPERATIVE INFECTIONS HIDEHIKO SHIMURA, YASUHIRO YAMAMOTO and KIYOSHI KOHARA First Department of Surgery, School of Medicine, Fukuoka University KIYOSHI INOKUCHI, MASAAKI MORIYAMA and RYUICHIRO TAMADA Second Department of Surgery, Faculty of Medicine, Kyushu Univet sity TERUO KAKEGAWA, HIROYOSHI MIZOTE and ATSUSHI FUJIMASA First Department of Surgery, Kurume University, School of Medicine YASUKUNI TSUJI, TOSHIO MIURA and YUZURU NAKAMURA First Department of Surgery, Nagasaki University, School of Medicine MASANOBU AKAGI and KOUSHI SERA Second Department of Surgery, Kumamoto University, School of Medicine TAKETO KATSUKI, TOSHIAKI SETOGUCHI and TOSHIO SHIMAYAMA First Department of Surgery, Miyazaki Medical College HACHINEN AKITA, AKIO SAKOTA and YOUICHIRO KOJIMA Second Department of Surgery, School of Medicine, Kagoshima University YOSHIYUKI SHO and AKIRA HOKAMA First Department of Surgery, Faculty of Health Science, University of the Ryukyus MEGUMI KONO and MASANORI SASATSU Department of Microbiology, Tokyo College of Pharmacy We conducted fundamental and clinical studies on the efficacy of cefmetazole (CMZ) for postoperative infections with the following results: 1) Patients with postoperative infections were divided into groups A and B and used for evalua - tion of the clinical effect of CMZ. In group A CMZ was administered immediately after development of postoperative infections and in group B the drug was applied after other cephem antibiotics had. been proved to be ineffective. In group A CMZ was evaluated to be clinically effective in 22 (85. 7%) out of 28 patients with postoperative wound infection and 4(57. 1%) out of 7 with postoperative peritonitis. In group B the drug was effective in 8(61. 5%) out of 13 patients with postoperative wound infection and in 8 (72. 7%) out of 11 with postoperative peritonitis. 2) Eruption occurred in one case. Thus, the incidence of side effects was 1. 5%. 3) The kinds of bacteria isolated frequently before CMZ treatment were S. epidermidis, E. coli, and Klebsiella sp. in group A and Klebsiella sp. in group B. Pseudomonas sp. was frequently isolated after CMZ treatment in both groups. 4) MIC's of CMZ and cefazolin (CEZ) and Q-lactamase activity were determined for the bacteria isolated from patients with postoperative infections. MIC's indicated that gram-negative and anaero - bic bacteria tended to be more sensitive to CMZ than to CEZ. In addition, CMZ was more resistant than CEZ with respect to Q-lactamase activity. The specific activity was below 1 U/mg protein in all strains. 5) CMZ levels in the serum and peritoneal exudate were determined after an intravenous injection of 1g of the drug in 2 stomach cancer patients who had been operated on 2 days previously. The peak CMZ level in the peritoneal exudate was 20.2 and 26. 7ug/ml, respectively. Its ratio to the serum CMZ level was 52. 2 and 47. 5%, respectively.

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