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[小诺米星对造血系统疾病患者严重感染的治疗效果。阪神感染研究组]

[Therapeutic effects of micronomicin against severe infections in patients with hematopoietic disorders. Hanshin Infection Study Group].

作者信息

Hasegawa H, Horiuchi A, Nagai K, Kanamaru A, Masaoka T, Shibata H, Kitani T, Taniguchi N, Yasunaga K, Okamoto Y

出版信息

Jpn J Antibiot. 1985 Aug;38(8):2129-38.

PMID:3908733
Abstract

Micronomicin (MCR) at a daily dose of 120 to 360 mg was administered to patients with severe infections who had hematopoietic disorders as underlying diseases. Efficacy and safety of the drug were evaluated. The underlying diseases in the 56 patients included in the evaluation of efficacy were acute myelocytic leukemia (24 cases), acute lymphocytic leukemia (8), acute promyelocytic leukemia (6), acute monomyelocytic leukemia (4), acute monocytic leukemia (1), erythroleukemia (1), chronic myelocytic leukemia-blastic crisis (4), malignant lymphoma (3), aplastic anemia (2), and others (3). The infections were septicemia in 9 patients, suspected septicemia in 48, respiratory tract infection in 7, and perianal abscess in 2. The clinical efficacy of MCR was 'excellent' in 12 patients, 'good' in 17, 'fair' in 7, 'poor' in 30 for an efficacy rate of 43.9%. The efficacy rate classified according to infections was 22.2% in septicemia, 56.3% in suspected septicemia. The organisms isolated from the patients with septicemia were Escherichia coli in 2, Klebsiella pneumoniae in 2, Pseudomonas aeruginosa in 1, alpha-Streptococcus in 1, Serratia marcescens in 1, and Acinetobacter sp. in 1. The efficacy rate was 15.4% in the 13 patients whose causative organisms were identified. The efficacy rate for patients who had failed to respond to prior antibiotic therapy was 43.9%. The efficacy rate in patients (34 cases) with an initial neutrophil count less than 100/microliter was 44.1%. Side effect which might have been caused by MCR was skin eruption in only one episode among 83 episodes those were evaluated for safety.

摘要

对以造血系统疾病为基础疾病的严重感染患者,每日给予120至360毫克小诺米星(MCR),评估该药的疗效和安全性。纳入疗效评估的56例患者的基础疾病包括急性髓细胞白血病(24例)、急性淋巴细胞白血病(8例)、急性早幼粒细胞白血病(6例)、急性单核细胞白血病(4例)、急性单核细胞白血病(1例)、红白血病(1例)、慢性粒细胞白血病急变期(4例)、恶性淋巴瘤(3例)、再生障碍性贫血(2例)及其他(3例)。感染类型为败血症9例、疑似败血症48例、呼吸道感染7例、肛周脓肿2例。MCR的临床疗效为“优”12例、“良”17例、“中”7例、“差”30例,有效率为43.9%。按感染类型分类的有效率为败血症22.2%、疑似败血症56.3%。从败血症患者中分离出的病原菌为大肠埃希菌2例、肺炎克雷伯菌2例、铜绿假单胞菌1例、α-链球菌1例、粘质沙雷菌1例、不动杆菌属1例。13例病原菌明确的患者有效率为15.4%。对先前抗生素治疗无效的患者有效率为43.9%。初始中性粒细胞计数低于100/微升的患者(34例)有效率为44.1%。在83例评估安全性的病例中,仅1例出现可能由MCR引起的副作用,表现为皮疹。

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