Motohiro T, Handa S, Yamada S, Oki S, Yoshinaga Y, Oda K, Sakata Y, Kato H, Yamashita F, Imai S
Department of Pediatrics, School of Medicine Kurume University.
Jpn J Antibiot. 1995 Feb;48(2):238-60.
Pharmacokinetic, bacteriological and clinical studies on SY5555, a new oral penem, were carried out, and the following results were obtained. 1. MICs were determined for 6 drugs, SY5555, clavulanic acid/amoxicillin (CVA/AMPC), cefaclor (CCL), cefotiam (CTM), cefpodoxime (CPDX), cefdinir (CFDN) against 20 strains of bacteria isolated from patients who were subsequently treated with SY5555. MICs of SY5555 for Gram-positive cocci ranged from 0.05 to 0.10 microgram/ml against 10 strains of Staphylococcus aureus. The MIC was < or = 0.025 microgram/ml against one strain of Streptococcus pyogenes, and MICs were from < or = 0.025 to 0.39 microgram/ml against Streptococcus pneumoniae. These MIC values were equivalent or superior to those of the other 5 drugs. MICs of SY5555 for Gram-negative bacilli were 0.39 and 6.25 micrograms/ml against Haemophilus influenzae, and these values were equivalent to those of the other drugs, except CPDX. The MIC of SY5555 was 0.39 microgram/ml against 2 strains of Escherichia coli, and this value was equivalent or superior to those of CVA/AMPC and CCL, similar or inferior to those of CPDX and CFDN, and inferior to that of CTM. The MICs of several drugs were determined for 10 strains of Bordetella pertussis and 30 strains of Campylobacter jejuni isolated from patients before this clinical study. The MICs of SY5555 against the 10 strains of B. pertussis were compared with those of 7 drugs, CCL, CTM, CPDX, ampicillin (ABPC), piperacillin (PIPC), imipenem (IPM) and erythromycin (EM). The MIC of SY5555 was 0.78 microgram/ml against all of the strains. This value was superior to those of CCL, CTM and CPDX, similar or inferior to that of IPM and inferior to those of PIPC and EM. The MICs of SY5555 against the 30 strains of C. jejuni were compared with those of 7 drugs. CCL, CTM, CPDX, CFDN, ABPC, IPM and EM, and the MIC of SY5555 was < or = 0.025 microgram/ml or 0.05 microgram/ml and these values were equivalent or superior to those of the 7 reference drugs. 2. SY5555 dry syrup was administered orally at 30 min. after meals, to a total of 5 patients, at doses of 5.0 and 10.0 mg/kg to 2 patients each and at a dose of 15.0 mg/kg to one patient and the plasma concentrations were determined. Peak concentrations were detected 1 to 3 hours after administration in all patients and the peak concentrations were 0.93 and 1.21 micrograms/ml at the 5.0 mg/kg dose, 2.85 and 5.49 micrograms/ml at the 10.0 mg/kg dose and 5.79 micrograms/ml at the 15.0 mg/kg dose.(ABSTRACT TRUNCATED AT 400 WORDS)
对新型口服青霉烯类药物SY5555进行了药代动力学、细菌学及临床研究,结果如下。1. 测定了SY5555、克拉维酸/阿莫西林(CVA/AMPC)、头孢克洛(CCL)、头孢替安(CTM)、头孢泊肟酯(CPDX)、头孢地尼(CFDN)这6种药物对20株从后续接受SY5555治疗的患者中分离出的细菌的最低抑菌浓度(MIC)。SY5555对10株金黄色葡萄球菌的革兰氏阳性球菌的MIC范围为0.05至0.10微克/毫升。对1株化脓性链球菌的MIC≤0.025微克/毫升,对肺炎链球菌的MIC为≤0.025至0.39微克/毫升。这些MIC值与其他5种药物相当或更优。SY5555对革兰氏阴性杆菌中的流感嗜血杆菌的MIC为0.39和6.25微克/毫升,这些值与除CPDX外的其他药物相当。SY5555对2株大肠杆菌的MIC为0.39微克/毫升,该值与CVA/AMPC和CCL相当或更优,与CPDX和CFDN相似或更低,且低于CTM。在本临床研究前,测定了几种药物对从患者中分离出的10株百日咳博德特氏菌和30株空肠弯曲菌的MIC。将SY5555对10株百日咳博德特氏菌的MIC与7种药物CCL、CTM、CPDX、氨苄西林(ABPC)、哌拉西林(PIPC)、亚胺培南(IPM)和红霉素(EM)的MIC进行比较。SY5555对所有菌株的MIC为0.78微克/毫升。该值优于CCL、CTM和CPDX,与IPM相似或更低,且低于PIPC和EM。将SY5555对30株空肠弯曲菌的MIC与7种药物CCL、CTM、CPDX、CFDN、ABPC、IPM和EM的MIC进行比较,SY5555的MIC≤0.025微克/毫升或0.05微克/毫升,这些值与7种对照药物相当或更优。2. 餐后30分钟口服给予5名患者SY5555干糖浆,2名患者剂量为5.0和10.0毫克/千克,1名患者剂量为15.0毫克/千克,并测定血浆浓度。所有患者给药后1至3小时检测到峰值浓度,5.0毫克/千克剂量时峰值浓度为0.93和1.21微克/毫升,10.0毫克/千克剂量时为2.85和5.49微克/毫升,15.0毫克/千克剂量时为5.79微克/毫升。(摘要截短于400字)