Shimada J, Yokota N, Koguchi M, Suzuki Y, Fukayama S, Ishihara R, Oda S, Deguchi K
Refractory Disease Treatment Research Center, St. Marianna University of Medicine.
Jpn J Antibiot. 1995 Jul;48(7):949-59.
We investigated clinical and bacteriological effects of cefetamet pivoxil (CEMT-PI) in community-acquired respiratory tract infections and obtained the following findings. 1. Of the 420 respiratory tract infection cases that were treated with CEMT-PI according to a same protocol at a total of 42 institutions in Tokyo, Kanagawa-ken, Saitama-ken and Chiba-ken from February to the beginning of April 1994, 359 cases in which clinical evaluations were considered possible were selected as the subjects of the clinical study. Regarding genders of patients, slightly more females (56.3%) than males were included. Diagnoses given to these patients included laryngopharygealitis (60.7%), tonsillitis (14.2%) and acute bronchitis (13.6). Outpatients accounted for 94.4% of the subjects. 2. For the bacteriological study, a written material describing the method of collecting specimens, storage and transport in detail was distributed to the above mentioned institutions. The isolation and identification of suspected causative bacteria, determination of minimum inhibitory concentrations (MIC) and investigation of beta-lactamase production were conducted all together. Suspected causative bacteria were detected from 238 (66.3%) out of the 359 cases. They included 85 strains of Haemophilus influenzae, 76 strains of Streptococcus pneumoniae, 20 strains of Streptococcus pyogenes and 17 strains of Moraxella subgenus Branhamella catarrhalis. 3. Clinical efficacy rates (the ratio of those excellent+good) among those who were treated with 1 CEMT-PI tablet (194 mg, titer) twice a day was 76.5% and among those who were given 2 tablets twice a day was 87.4%. The improvement rate of the latter was higher at a significant level of P < 0.05. 4. The clinical efficacies classified by suspected causative bacteria (single bacterium) were 93.3% against M.(B.) catarrhalis, 91.7% against beta-streptococci, 87.1% against H. influenzae and 78.4% against S. pneumoniae, etc. Though 7 (9.2%) of the 76 strains of S. pneumoniae were benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP), the bacteriological efficacy was assessed either excellent or good in all of the 7 patients from whom PISP were detected. The clinical efficacy was assessed 100.0% in those from which a plural number of bacteria were detected. The 13 cases from which small numbers of Staphylococcus aureus was detected with other bacterium were also included in these cases.
我们研究了头孢他美酯（CEMT-PI）对社区获得性呼吸道感染的临床及细菌学疗效，结果如下。1. 1994年2月至4月初，在东京、神奈川县、埼玉县和千叶县的42家机构，按照相同方案对420例呼吸道感染病例使用CEMT-PI进行治疗，其中359例被认为可进行临床评估，被选作临床研究对象。患者性别方面，女性（56.3%）略多于男性。这些患者的诊断包括喉咽炎（60.7%）、扁桃体炎（14.2%）和急性支气管炎（13.6%）。门诊患者占研究对象的94.4%。2. 对于细菌学研究，向上述机构分发了一份详细描述标本采集、保存和运输方法的书面材料。同时进行疑似致病菌的分离鉴定、最低抑菌浓度（MIC）测定以及β-内酰胺酶产生情况的调查。在359例病例中，238例（66.3%）检测到疑似致病菌。其中包括85株流感嗜血杆菌、76株肺炎链球菌、20株化脓性链球菌和17株卡他莫拉布兰汉菌属莫拉菌。3. 每日服用1片CEMT-PI（194mg效价）的患者临床有效率（优 + 良的比例）为76.5%，每日服用2片的患者有效率为87.4%。后者的改善率更高，P < 0.05，具有显著差异。4. 按疑似致病菌（单一细菌）分类的临床疗效为：对卡他莫拉菌属（布兰汉菌属）为93.3%，对β-链球菌为91.7%，对流感嗜血杆菌为87.1%，对肺炎链球菌为78.4%等。在76株肺炎链球菌中，有7株（9.2%）为对苄青霉素（PCG）不敏感的肺炎链球菌（PISP），但在所有检测到PISP的7例患者中，细菌学疗效评估均为优或良。在检测到多种细菌的患者中，临床疗效评估为100.0%。这些病例还包括13例除其他细菌外还检测到少量金黄色葡萄球菌的病例。
