Hayashi I, Sakurai M, Karato A, Ichiki M, Sekine I, Ishikawa T, Shiotani J, Yoshida T, Niida M, Ogawa M
Pharmaceutical Research Center, Meiji Seika Kaisha Ltd.
Jpn J Antibiot. 1994 Aug;47(8):991-1005.
The time-lag/sequential/step by step chemotherapy by fosfomycin plus sulbactam/cefoperazone including a short time small dose of steroid was done for 27 severely infected patients suffered from various cancer or other severe basal diseases. And the staggered "intensive" chemotherapy with added arbekacin or vancomycin to the previous staggered chemotherapy was done against 13 severely infected patients having MRSAs among their infecting pathogens. 1. Bacteriological effects Pseudomonas aeruginosa 6/8, Staphylococcus epidermidis 5/5, Enterococcus faecalis 3/6, Acinetobacter calcoaceticus 2/2, Klebsiella pneumoniae 2/2, MRSA 2/2, Xanthomonas maltophilia 2/3 and other 10/10 were eradicated (84.2%) by the staggered chemotherapy and MRSA 7/13, P. aeruginosa 3/4, E. faecalis 3/5, A. calcoaceticus 2/2, X. maltophilia 1/1 and others 2/2 were eradicated (53.8% in MRSA, 78.6% in others and 66.7% in total) and 3 of MRSAs were colonized. 2. Clinical effects 1) Staggered chemotherapy: Excellent 18/27, good 8/27, fair 1/27, poor 0/27 (96.3%). 2) Staggered "intensive" chemotherapy: Excellent 6/13, good 4/13, fair 2/13, poor 1/13 (76.9%) in total: excellent 60.0%, efficacy rate 90.0%.
对27例患有各种癌症或其他严重基础疾病的严重感染患者，采用磷霉素加舒巴坦/头孢哌酮进行时间延迟/序贯/逐步化疗，包括短时间小剂量使用类固醇。对13例感染病原体中含有耐甲氧西林金黄色葡萄球菌（MRSA）的严重感染患者，在前述序贯化疗基础上加用阿贝卡星或万古霉素进行交错“强化”化疗。1. 细菌学疗效 序贯化疗使铜绿假单胞菌6/8、表皮葡萄球菌5/5、粪肠球菌3/6、醋酸钙不动杆菌2/2、肺炎克雷伯菌2/2、MRSA 2/2、嗜麦芽窄食单胞菌2/3及其他10/10被清除（84.2%）；MRSA 7/13、铜绿假单胞菌3/4、粪肠球菌3/5、醋酸钙不动杆菌2/2、嗜麦芽窄食单胞菌1/1及其他2/2被清除（MRSA为53.8%，其他为78.6%，总体为66.7%），3例MRSA出现定植。2. 临床疗效 1）序贯化疗：优18/27、良8/27、中1/27、差0/27（96.3%）。2）交错“强化”化疗：总体优6/13、良4/13、中2/13、差1/13（76.9%）：优60.0%，有效率90.0%。
