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Biomedical subjects

K Deguchi

Publications and source records attributed to K Deguchi.

At least 289 records · Page 16Linked to original sources

[Bacteriological, pharmacokinetic and clinical studies on the use of ceftriaxone in the perinatal period].

Laboratory studies and clinical evaluation of ceftriaxone (CTRX) were carried out with mothers and infants in perinatal period. The presence of synergistic effect between CTRX and amniotic fluid were studied using a broth dilution method. Stronger effects were recognized when both agents were present together compared to each agent alone by the fact that values of MIC and MBC became closer together for Escherichia coli as well as for Streptococcus agalactiae. Against the growth of E. coli, a synergism was observed, but for S. agalactiae, only an additive effect was found. The placental transmission of CTRX upon the administration was rapid, and the blood CTRX level reached its peak shortly after the intravenous administration of the drug. The transport of the drug into the fetus through placenta was excellent and one dose of 1 g of CTRX gave drug concentrations in the umbilical cord serum and amniotic fluid higher than MIC's against main pathogenic organisms. According to these results, it should be possible to treat or prevent perinatal infections by a dose of one gram per day of CTRX, once or twice daily. Cases of perinatal infections were treated with CTRX. An effective treatment without side effects was obtained. No physical abnormalities nor unusual laboratory test results were recognized in neonates delivered from mothers who received CTRX administration. The penetration of CTRX into mothers' milk was low, thus the drug transfer into neonates through the breast-feeding should not be a problem. It appears, from the above study, that CTRX is a clinically useful antibiotic for the prophylaxis and the treatment of perinatal infections.

Adult↗

[The antimicrobial activity of sisomicin against fresh clinical isolates].

Antimicrobial activities of sisomicin (SISO) against clinical isolates obtained in the second half of 1986 were investigated together with other 4 aminoglycosides (AGs) (gentamicin (GM), tobramycin (TOB), dibekacin (DKB), amikacin (AMK] and 2 cephems (cefotiam, cefotaxime), and were compared to the results reported in the period of late 1970's through early 1980's in Japan. 1. The incidence of SISO-resistant Staphylococcus aureus in the present study was 18% and is comparable to that of the other studies suggesting that the incidence of SISO resistant strains remains on the stable level. The incidence of SISO-resistant Pseudomonas aeruginosa showed the tendency of slight increase. 2. SISO-resistant strains of Enterobacter spp., Serratia marcescens and Citrobacter freundii did not show increase from the 1970/1980 levels. 3. Isolation rates of SISO-resistant indole(+) Proteus varied depending on strains. Isolation rates of SISO-resistant P. vulgaris and Morganella morganii were both as low as 4%, but that of Providencia rettgeri was as high as 60%. Refering to an American study reporting that the Genus Providencia including P. rettgeri showed high incidence of resistance to SISO as well as to GM or TOB, we pointed out that the antimicrobial activity of AGs against Genus Providencia should be evaluated separately from those of other indole(+) Proteus strains. 4. No SISO-resistant strains of Escherichia coli, Klebsiella pneumoniae or P. mirabilis were found. 5. SISO had good antimicrobial activity against most of the investigated species and SISO may still be regarded as one of the clinically useful AGs.

Bacterial Infections↗

[Antimicrobial activity of sulbactam/cefoperazone. Comparison with other new cephems].

Antimicrobial activities of sulbactam/cefoperazone (SBT/CPZ) against 50 fresh clinical isolates of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Enterobacter spp., Serratia marcescens, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa were compared to those of CPZ, Cefotiam (CTM), Cefotaxime (CTX) and Latamoxef (LMOX). Minimal inhibitory concentrations (MIC's) of SBT and CPZ mixed in a ratio of 1:1 were determined by the dilution method using Mueller-Hinton agar and expressed by absolute concentrations of CPZ. Antimicrobial activities of SBT/CPZ against principally penicillinase (PCase) producing bacteria, i.e., S. aureus, E. coli, K. pneumoniae, P. mirabilis, were superior to those of CPZ alone. The presence of SBT in concentrations around 0.39 approximately 1.56 micrograms/ml clearly enhanced CPZ's antimicrobial activities against these PCase producing strains. The synergistic antimicrobial effects of SBT in combination with CPZ were less pronounced against principally cephalosporinase (CEPase) producing bacteria, i.e., C. freundii, Enterobacter spp., S. marcescens, P. vulgaris, and P. aeruginosa, and exerted with SBT at concentrations around 3.13 approximately 12.5 micrograms/ml. Comparative antimicrobial activities indicated by MIC80's of tested agents showed that SBT/CPZ had more stable activities against bacteria ranging from Gram-positive to Gram-negative bacteria than CTM, CTX and LMOX. MIC's of SBT/CPZ were higher than 25 micrograms/ml against 8% of S. aureus, 18% of C. freundii, 10% of Enterobacter spp., 26% of S. marcescens, 2% of P. vulgaris, and 18% of P. aeruginosa. These resistant strains against which the addition of SBT showed no synergism, may possess other mechanism of resistance than beta-lactamase production. It is concluded that the presence of CPZ resistant strains is an actual current problem and not an imaginary future problem, and that the number of resistant strains against other new cephems which have different chemical structure from CPZ is increasing. When these present bacteriological environments are considered, the appearance of SBT/CPZ in the clinical practice is timely and meaningful.

Bacteria↗

[Antibacterial activities of various aminoglycosides against clinically isolated methicillin-resistant Staphylococcus aureus].

Methicillin-resistant Staphylococcus aureus (MRSA) were isolated from samples collected from various patients during 1986, and antibacterial activities of 6 aminoglycosides (AGs) (netilmicin (NTL), gentamicin (GM), sisomicin (SISO), dibekacin (DKB), tobramycin (TOB) and amikacin (AMK] and 4 beta-lactam antibiotics (cefazolin (CEZ), cefmetazole (CMZ), cloxacillin (MCIPC) and methicillin (DMPPC) against these MRSA were evaluated. Among these 6 AGs, NTL was the most potent, and its MIC50 and MIC80 were 1.56 and 3.13 micrograms/ml, respectively. Antibacterial activities of GM, SISO, DKB and TOB were weak, and MIC50's of GM and DKB were both 100 micrograms/ml, while those of SISO and TOB were 50 and greater than 100 micrograms/ml, respectively. Frequency of highly resistant specimens to AMK was rather low and its MIC50 and MIC80 were 12.5 and 25 micrograms/ml, respectively. As for antibacterial activities of the above 4 beta-lactam antibiotics, the MIC50 and MIC80 of CMZ were 6.25 and 12.5 micrograms/ml, respectively, and therefore, its antibacterial activity to MRSA is relatively good. However, MIC50's of CEZ, MCIPC and DMPPC were all greater than 100 micrograms/ml, showing poor antibacterial activities. Recently, MRSA became a problem in various fields of clinical practice, and a number of literatures reporting refractory infections caused by MRSA have been published. Since MRSA is featured as multiply resistant bacteria, it is known that MRSA is resistant to the majority of existing antibiotics (penicillins, cephems, macrolides, AGs, etc.). In 1985, we reported results of our study concerning the antibacterial activities of a number of CEPs and some of AGs against multiply resistant S. aureus including MRSA.(ABSTRACT TRUNCATED AT 250 WORDS)

Amikacin↗

Combination of cefmenoxime and cefsulodin in the treatment of complicated urinary tract infections caused by Pseudomonas aeruginosa.

The clinical efficacy of the combination therapy with cefmenoxime plus cefsulodin was studied in patients with complicated urinary tract infections caused by Pseudomonas aeruginosa. Patients received 1 g of CMX and 1 g of CFS concomitantly twice a day by 1-hour intravenous drip infusion. Of a total of 127 patients who received medication, 82 patients were evaluated on the 5th day. The overall clinical efficacy of treatment was evaluated by the criteria proposed by the UTI Committee, Japan, as excellent, moderate or poor. It was excellent in 15%, moderate in 55% and poor in 30%. Of the 143 strains isolated from 82 patients, 115 strains (80%) were eradicated. The eradication rate of P. aeruginosa was 83%. Subjective side effects were observed in 3 (2.4%) of the patients. Drug-related aggravations in laboratory test results were observed in 8 (7.5%), but most of them were minimal and reversible. The results of this study suggest that a combination of cefmenoxime and cefsulodin might be useful in the treatment of complicated urinary tract infections caused by P. aeruginosa.

Candidiasis↗

[A clinical bacteriological efficacy study on a fosfomycin otic solution].

Fosfomycin (FOM) otic solution was administered to 587 patients with suppurative otitis media infections including 190 patients in the dose-establishment test, 126 patients in the open clinical trial and 271 patients in the double blind test. Various bacteria were detected in the 549 cases in which bacteriological investigation was possible. Main bacteria detected from the above cases were S. aureus (261 strains, 47.5%), P. aeruginosa (93 strains, 16.9%), coagulase negative Staphylococci (CNS) (89 strains, 16.2%), Providencia spp. (35 strains, 6.4%) and Proteus spp. (28 strains, 5.1%). Twenty-seven strains of anaerobic bacteria (4.9%) were also detected. The MIC of FOM, and the reference drug, chloramphenicol (CP), fradiomycin (FRM), cefmenoxime (CMX) and cephalexin (CEX), were determined up to a concentration of 800 micrograms/ml with inoculum sizes of 10(6) and 10(8) CFU/ml. About 30% of S. aureus was multi-drug resistant, including methicillin and cephems, but FOM showed excellent antibacterial activity against it. The FOM had superior antibacterial activity against P. aeruginosa to CP, FRM and CMX, and was also active against other bacteria. The antibacterial activity of FOM was inferior to other drugs against CNS, Enterobacter spp., P. putida and P. cepacia. The detection rate of these bacteria, however, was low and since their role as causative organisms is not well defined, the inferior activity of FOM has no effect on the bacteriological evaluation of FOM. Since the concentration in the tympanic cavity about 1 hour after the administration of 3% FOM solution was estimated to be 2,000 to 3,000 micrograms/ml, it could be presumed that bacteria inhibited by 800 micrograms/ml of FOM at an inoculum size of 10(8) CFU/ml would be eradicable. The low ototoxicity of FOM is likely due to its characteristic as an inhibitor of bacterial cell wall synthesis. From these results, 3% FOM otic solution may be considered as a remarkably useful topical preparation for the treatment of suppurative otitis media.

Administration, Topical↗

[In vitro susceptibilities of BRL 25000 (clavulanic acid-amoxicillin) against causative organisms in the field of obstetrics and gynecology].

The in vitro susceptibilities of various causative organisms recently isolated from patients with genital infections to BRL 25000 (a formulation with 2 parts of amoxicillin and 1 part of potassium clavulanate), amoxicillin (AMPC), cefaclor (CCL), cephalexin (CEX), cefadroxil (CDX) and cefroxadine (CXD) were determined. beta-Lactamase-producing strains were detected by the nitrocefin disc method. Frequencies of isolation of beta-lactamase producing strains of E. coli, K. pneumoniae and B. fragilis were 36%, 96% and 100%, respectively. The activity of BRL 25000 against S. agalactiae and anaerobic GPC (anaerobic Streptococci, Peptostreptococcus spp.) was slightly less than that of AMPC but was 2- to 4-fold higher than CCL and 8- to 16-fold higher than CEX, CDX and CXD. Against E. coli and K. pneumoniae, the activity of BRL 25000 was superior to that of AMPC and approximately equal to CEX, CDX and CXD but 2-fold less than CCL. Against the B. fragilis group, BRL 25000 was much more active than AMPC or any of the cephalosporins tested, clearly demonstrating the beta-lactamase inhibitory properties of the clavulanic acid in BRL 25000. At inocula of 10(6) CFU/ml, MIC values of BRL 25000 were 12.5-50 micrograms/ml against some strains of E. coli, K. pneumoniae and B. fragilis. A mechanism of resistance other than beta-lactamase production is obviously prevalent in these strains. It is speculated that the resistance may be due to a low affinity of the drug to target proteins. Mixed infections of B. fragilis and E. coli or K. pneumoniae are commonly found in the obstetric and gynecological patients. BRL 25000 shows activity against these strains and also against both aerobic and anaerobic GPC. Therefore, BRL 25000 is considered useful for the treatment of genital infections.

Amoxicillin↗

[Midecamycin acetate-susceptibility of clinical isolates from dental and oral surgical infections].

To investigate the clinical and bacteriological usefulness of orally administered midecamycin acetate (MOM), the susceptibility of clinical isolates to MOM, Mb-12 (the main metabolite of MOM), josamycin (JM), ampicillin (ABPC) and cephalexin (CEX) was determined. The results are summarized as follows. Antibacterial activities of MOM against aerobic Gram-positive cocci, B. catarrhalis, and anaerobic bacteria were inferior to those of JM by 2-fold, but superior to those of CEX. Activities of MOM against S. aureus, Bacteroides spp., Fusobacterium spp., Veillonella spp. were superior to those of ABPC and CEX. Since serum and tissue concentrations of Mb-12 after 200 mg administration in humans have been reported to be 1-2 micrograms/ml, it can be presumed that the causative bacteria would be eradicated by a usual dosage of MOM used in the present study. From these considerations, it is speculated that MOM may be successfully used in the treatment of dental and oral surgical infections.

Ampicillin↗

[Study of concentrations of clindamycin phosphate in bone marrow blood and tissue].

Clindamycin phosphate (CLDM) was administered to 33 surgical cases in orthopedics to treat or prevent infection (600 mg in 15 cases and 1,200 mg in 18 cases by intravenous drip infusion over 60 minutes) and the concentrations of CLDM in the bone marrow blood and tissue of the operative field as well as in venous blood were determined with the cup plate method of bioassay by collecting specimens immediately after completion of infusion or 30 or 60 minutes later. The concentration of CLDM in bone marrow blood averaged 104.3 approximately 105.5% of the corresponding concentration in venous blood in the cases receiving 600 mg and 101.3% in those receiving 1,200 mg. The concentration of CLDM in bone marrow tissue averaged 154.0 approximately 163.7% of the corresponding concentration in venous blood in the group receiving 600 mg but 78.8 approximately 86.2% in the group receiving 1,200 mg. This difference between the 2 groups was considered to reflect largely the difference in specimens collected. Thus, the concentration of CLDM in bone marrow tissue was interpreted as the amount of drug penetrating and remaining in bone marrow tissue and its adjacent area. The MIC75 of CLDM for clinical isolates were 0.20 micrograms/ml for S. aureus, 0.78 micrograms/ml for B. fragilis and 0.20 micrograms/ml for Peptostreptococcus spp. The concentrations of CLDM attained in bone marrow blood and tissue and its adjacent area after administration of 600 mg or 1,200 mg were thus sufficient to eliminate these organisms. The above results indicate that CLDM is a useful antibiotic for treatment and prevention of infection in orthopedics.

Adolescent↗