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头孢甲肟与头孢磺啶联合治疗难治性复杂性尿路感染(尤其是由铜绿假单胞菌引起的)

[Concomitant therapy with cefmenoxime and cefsulodin for refractory complicated urinary tract infection (especially caused by Pseudomonas aeruginosa)].

作者信息

Ishigami J, Fujii A, Harada M, Arakawa S, Umezu K, Kawabata G, Kataoka N, Kamidono S, Miyazaki S, Takasaki N

出版信息

Hinyokika Kiyo. 1986 May;32(5):779-88.

PMID:3463188
Abstract

Cefmenoxime (2 g) and cefsulodin (1 g) were given twice daily for 5 days by concomitant intravenous drip infusion (mixed infusion) to 135 patients with complicated urinary tract infection (c-UTI) probably caused by Pseudomonas aeruginosa. The clinical efficacy was evaluated according to the criteria proposed by the UTI committee in Japan. Ninety one subjects met the criteria for c-UTI and were evaluable for drug efficacy. P. aeruginosa was detected in 44 cases (including mixed infection with other organisms). The overall efficacy rate was 73% of the 91 cases; 75% of the 44 cases with P. aeruginosa and 70% in the 47 cases without P. aeruginosa infection. As to bacteriological response, the eradication rate was 91% (105/116) for all cases. By organism, the eradication rate for P. aeruginosa, Serratia spp. and Citrobacter spp. were 82 (36/44), 100 (12/12) and 100% (10/10), respectively. The eradication rate for gram-negative rods was 93% (99/107). Twenty-three strains appeared after treatment, and the majority of them (13) were yeast-like organisms. There was only one strain of P. aeruginosa. As for side effects, eruption was found in 2 cases. Cefmenoxime and cefsulodin were administered concomitantly to patients with c-UTI which was suspected to be caused by P. aeruginosa. The high overall efficacy rate of about 70% on the average was obtained regardless of the causative organism and disease state. The eradication rate of as high as about 90% was obtained excluding Enterococcus faecalis. Neither severe side effects nor abnormal laboratory values were found. It appeared, therefore, that this dosage regimen was useful for the treatment of refractory complicated urinary tract infection.

摘要

对135例可能由铜绿假单胞菌引起的复杂性尿路感染(c-UTI)患者,每日两次静脉滴注(混合输注)头孢甲肟(2g)和磺苄西林(1g),共5天。根据日本UTI委员会提出的标准评估临床疗效。91名受试者符合c-UTI标准,可评估药物疗效。44例(包括与其他微生物的混合感染)检测到铜绿假单胞菌。91例患者的总有效率为73%;44例铜绿假单胞菌感染患者的有效率为75%,47例无铜绿假单胞菌感染患者的有效率为70%。在细菌学反应方面,所有病例的根除率为91%(105/116)。按微生物种类,铜绿假单胞菌、沙雷菌属和柠檬酸杆菌属的根除率分别为82%(36/44)、100%(12/12)和100%(10/10)。革兰氏阴性杆菌的根除率为93%(99/107)。治疗后出现23株菌株,其中大多数(13株)为酵母样微生物。仅发现1株铜绿假单胞菌。在副作用方面,2例出现皮疹。对疑似由铜绿假单胞菌引起的c-UTI患者联合使用头孢甲肟和磺苄西林。无论病原体和疾病状态如何,平均总有效率约为70%。除粪肠球菌外,根除率高达约90%。未发现严重副作用和实验室值异常。因此,该给药方案似乎对难治性复杂性尿路感染的治疗有效。

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