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Transcription:

Table 1 Sensitivity distribution of clinical isolates 1. Escherichia coli Inoculum size: 106cells/ml 2. Klebsiella pneumoniae 3. Enterobacter cloacae 4. Serratia marcescens Inoculum size: 106cells/nil

5. Proteus mirabilis Table 1 6. Proteus vulgaris Inoculum size: 106cells/ml 7. Proteus rettgeri 8. Proteus inconstans B

9. Haernophilus influenzae Table 1 10. Pseudomonas aeruginosa

Table 2 Serum and sputum level 56y, M cefotaxime 2g I.V. Table 3 Serum and sputum level 31y. F cefotaxime 2g D.I.

Table 4 Clinical result of cefotaxime

CHEMOTHERAPY 1) NEU, H. C.; N. ASWAPOKEE, P. ASWAPO- KEE & K. P. Fu : HR 756, a new cephalosporin active against gram-positive and gram -negative aerobic and anaerobic bacteria. Ant. imicrob. Agents Chemother. 15: 273-281, 1979 2) WISE, R.; T. ROLLASON, M. LOGAN, J. M. ANDREWS & K. A. BEDFORD: HR 756, a highly active cephalosporin : Comparison with cefazolin and carbenicillin. Antimicrob. Agents Chemother. 14: 807-811, 1978

LABORATORY AND CLINICAL TRIALS WITH CEFOTAXIME KEIICHI NAKAGAWA, KENTARO WATANABE, Ko FUKUI, MASARU KOYAMA and KOSUKE NAKAZAWA Department of Internal Medicine, Tokyo Kyosai Hospital MITSUHIRO YOKOZAWA Inspection Department, Tokyo Kyosai Hospital MIC of cefotaxime (HR 756, CTX), a new cephalosporin preparation, for various clinically isolated gram-negative rod was examined. The concentrations in blood and in sputum after the administration of cefotaxime were determined with two patients. Cefotaxime was also administered to 16 patients with various infections. The results are described hereunder : 1. MIC of cefotaxime (to be referred to as CTX) for gram-negative rod was compared with those of cefazolin (CEZ), cefmetazole (CMZ), cefuroxime (CXM), and piperacillin (PIPC). It was observed that cefotaxime showed a sensitivity by far superior to other antibiotics for E. coli, K. pneumoniae, E. cloacae and S. marcescens. It showed an outstanding MIC in comparison with ampicillin (ABPC), CXM and CMD for H. influenzae. However, for P. aeruginosa, it was found inferior in sensitivity to PIPC, T-1551, cefsulodin (CFS) and gentamicin (GM) and slightly better than carbenicillin (CBPC). 2. The concentrations in blood and in sputum after intravenous administration and instillation of 2 g each of CTX in two patients were determined : blood concentrations in the cases of 2 g i. v. were 78 Đg/ml in 30 minutes and 0. 36 Đg/ml in 8 hours, and in the cases of 2g instillation, 90.0 Đg/ml in 2 hours after instillation was finished and 4. 0 Đg/ml in 6 hours. The peak of the concentrations in sputum was 0. 1 Đg/ml in both cases. 3. 16 cases of clinical trials included 10 cases of respiratory tract infection (to be referred to as RTI), 3 cases of urinary tract infection (to be referred to as UTI), and 3 cases of biliary tract infection (to be referred to as BTI). Among 5 cases of pneumonia, it proved effective in 1 case, poor in 4 cases. In 4 cases of poor, 3 cases were old men of 67 years or more, and not good in general conditions, having S. faecalis believably as caused organisms or possibly with viral infection. Among 4 cases of chronic RTI, it proved effective in 1 case, fair in 1 case and poor in 2 cases: 1 of the poor cases was bronchiectasis due to P. aereginosa and the other was allergic bronchitis. CTX was excellent for 1 serious case of acute bronchitis and it was effective for each 3 case of UTI and BTI. As for side effects, no abnormalities were observed both clinically and in various inspections before and after administration. Although the rate to effectiveness of CTX for RTI was low, this preparation is a new useful cephalosporin derivative.

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