Sonoda T, Nakano E, Seguchi T, Yano H, Kuroda H, Ihara Y, Kishimoto T, Takatera H, Mizutani S, Iwao N
Department of Urology, Osaka University Hospital.
Hinyokika Kiyo. 1991 Feb;37(2):203-9.
The combination of carumonam (CRMN) and cefotiam (CTM), expected to have a broader spectrum of coverage in connection with urinary tract infections, was evaluated for its effectiveness and safety at the Department of Urology, Osaka University Hospital and 17 affiliated hospitals. CRMN and CTM were given together to 109 patients with complicated urinary tract infections (UTI), of whom 65 cases satisfied the "Criteria of UTI Committee for the Evaluation of Drug Efficacy in the UTI (3rd Ed.)", which was modified by adopting the midstream urine data for women. CRMN and CTM were administered by drip or one-shot infusion at a total daily dose of 4 g (equally mixed 1 g plus 1 g each, twice a day) for 5 consecutive days or longer. The overall clinical efficacy rate in the 65 cases of complicated UTI was 72%, estimated by the criteria cited above. The efficacy rate according to the infection type groupings was 72% for the 29 patients in the 1st group, 100% for the 1 patient in the 2nd group, 100% for the 7 patients in the 3rd group, 83% for the 6 patients in the 4th group, 50% for the 14 patients in the 5th group and 75% for the 8 patients in the 6th group. The disappearance rate of both urinary Gram positive cocci and Gram negative bacilli was 83.3%. Fifteen strains appeared after the treatment, only 4 of which were Gram positive cocci. Among the 109 patients treated with CRMN+CTM, no subjective side effects were recorded and the abnormalized laboratory findings observed were: eosinophilia in one patient, increases in both GPT and GOT in one patient, and lowered creatinine clearance in one patient. With a broader spectrum and safe regimen, the combination of CRMN/CTM is recommended as the first choice against complicated UTI.
卡芦莫南(CRMN)与头孢替安(CTM)联合使用有望对尿路感染具有更广泛的覆盖范围,大阪大学医院泌尿外科及17家附属医院对其有效性和安全性进行了评估。109例复杂性尿路感染(UTI)患者接受了CRMN和CTM联合治疗,其中65例符合“UTI药物疗效评估UTI委员会标准(第3版)”,该标准通过采用女性中段尿数据进行了修订。CRMN和CTM通过静脉滴注或单次输注给药,每日总剂量为4g(各1g均匀混合,每日两次),连续给药5天或更长时间。根据上述标准估计,65例复杂性UTI患者的总体临床有效率为72%。按感染类型分组的有效率为:第1组29例患者为72%,第2组1例患者为100%,第3组7例患者为100%,第4组6例患者为83%,第5组14例患者为50%,第6组8例患者为75%。尿中革兰氏阳性球菌和革兰氏阴性杆菌的清除率均为83.3%。治疗后出现15株菌株,其中仅4株为革兰氏阳性球菌。在接受CRMN + CTM治疗的109例患者中,未记录到主观副作用,观察到的实验室检查异常结果为:1例患者嗜酸性粒细胞增多,1例患者谷丙转氨酶和谷草转氨酶均升高,1例患者肌酐清除率降低。鉴于CRMN/CTM联合用药具有更广泛的抗菌谱且治疗方案安全,推荐将其作为治疗复杂性UTI的首选药物。