Shimada J, Ishihara R, Suzuki Y, Ishii Y, Nakazawa A, Deguchi K
Refractory Disease Treatment Research Center, St. Marianna University of Medicine.
Jpn J Antibiot. 1997 Sep;50(9):756-67.
We investigated clinical and bacteriological effects of cefetamet pivoxil (CEMT-PI) in community-acquired respiratory tract infections and obtained the following findings. That method was approximately equal to that of investigation in 1994. 1. Of the 431 respiratory tract infection cases that were treated with CEMT-PI according to a same protocol at a total of 41 institutions in Tokyo, Kanagawa-ken, Saitama-ken and Chiba-ken from January to the beginning of March 1996. Outpatients accounted for 98.1% of the subjects. Regarding genders to patients, slightly more females (52.6%) than males were included. Diagnoses given to these patients included pharyngo-laryngitis (53.5%), tonsillitis (20.4%) and acute bronchitis (19.1%). 2. We investigated clinical efficacy rates (the ratio of those excellent + good) classified by diseases. The improvement rates of pharyngo-laryngitis, tonsillitis and acute bronchitis were more than 85.0%. Other cases were small in number. That of chronic bronchitis-acute increasing change for the worse was 66.7%, pneumonia was 50.0% and bronchiectasis infection was 16.7%. It was not studied that clinical efficacy rates among those who were treated with 1 CEMT-PI tablet twice and among those who were given 2 tablets twice were significant level. 3. 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 (MICs) and investigation of beta-lactamase production were conducted all together at section of studies, Tokyo Clinical Research Center. Suspected causative bacteria were detected from 274 (63.6%) cases. They included 88 strains of Haemophilus influenzae, 47 strains of Streptococcus pneumoniae, 42 strains of Streptococcus pyogenes, 20 strains of Moraxella subgenus Branhamella catarrhalis and 17 strains of Klebsiella pneumoniae subsp. pneumoniae. Suspected causative bacteria classified by diseases were S. pyogenes (tonsillitis), S. pneumoniae (acute bronchitis and secondary infection of chronic respiratory infection) and H. influenzae (pharyngo-laryngitis), and the detection frequency of those was high. The clinical efficacies (the ratio of improvement) classified by suspected causative bacteria were 84.4% against organism that was indicating CEMT and were 69.2% against organism that was not indicating CEMT.
我们研究了头孢他美酯（CEMT-PI）在社区获得性呼吸道感染中的临床和细菌学效果，并得到了以下结果。该方法与1994年的调查方法大致相同。1. 1996年1月至3月初，在东京、神奈川县、埼玉县和千叶县的41家机构，按照相同方案对431例呼吸道感染病例使用CEMT-PI进行治疗。门诊患者占受试者的98.1%。患者性别方面，女性（52.6%）略多于男性。这些患者的诊断包括咽喉部炎症（53.5%）、扁桃体炎（20.4%）和急性支气管炎（19.1%）。2. 我们按疾病分类调查了临床有效率（优+良的比例）。咽喉部炎症、扁桃体炎和急性支气管炎的改善率超过85.0%。其他病例数量较少。慢性支气管炎急性加重恶化的改善率为66.7%，肺炎为50.0%，支气管扩张感染为16.7%。未研究每日服用1片CEMT-PI两次的患者与每日服用2片CEMT-PI两次的患者之间的临床有效率是否有显著差异。3. 对于细菌学研究，向上述机构分发了详细描述标本采集、储存和运输方法的书面材料。在东京临床研究中心的研究部门统一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。从274例（63.6%）病例中检测到疑似致病菌。其中包括88株流感嗜血杆菌、47株肺炎链球菌、42株化脓性链球菌、20株卡他莫拉菌莫拉克斯氏菌属亚种和17株肺炎克雷伯菌肺炎亚种。按疾病分类的疑似致病菌为化脓性链球菌（扁桃体炎）、肺炎链球菌（急性支气管炎和慢性呼吸道感染的继发感染）和流感嗜血杆菌（咽喉部炎症），且这些菌的检出频率较高。按疑似致病菌分类的临床有效率（改善比例），针对对CEMT敏感的菌株为84.4%，针对对CEMT不敏感的菌株为69.2%。
