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Biomedical subjects

K Sunakawa

Publications and source records attributed to K Sunakawa.

At least 127 records · Page 7Linked to original sources

[Experimental investigation on various administration methods of gentamicin. Comparison of the effect of gentamicin on phagocytosis].

We compared the efficacy of intravenously, intramuscularly administered or intravenously infused over 45 minutes gentamicin (GM) by the experimental system in rabbits using diffusion chambers. Serum concentrations of GM obtained with 3 administration methods were different, while the peak values after intramuscular injection and intravenous drip infusion were similar. Similar concentration time curves of GM in the chambers were revealed after intramuscular injection and intravenous infusion. No marked difference in 3 administration methods was showed in the effects on the growth of P. aeruginosa in the chamber. Viable bacterial number in the chambers decreased when the GM concentration in the chamber was 4--5 times of MIC, and thereafter regrowth was observed after the decrease of GM concentration in the chambers to 2--3 times of MIC. About 8 hours were required for growth to the base line value. In the leucocyte containing chambers, viable bacterial number similarly decreased, but the rate of regrowth was slow. About 12 hours were required for growth to the base line value. The regrowth rate in the GM containing chamber was similar to that in the antibiotic free chamber. From this result, it is suggested that, when the antibiotic concentration in the chamber is 1--2 times of MIC, antibiotic does not show the growth suppressive effect and the activating effect on phagocytosis of leucocytes in the environment closed to the practical pathological condition such as this model. For the patients with qualitative or quantitative abnormal changes of phagocyte, short interval of drug administration might be needed. For this purpose, intravenous drip infusion under monitoring of serum concentration is more suitable than intramuscular injection, which might be accompanied with severe pain and contracture of injected muscle.

Animals↗

[Experimental and clinical evaluation of cefotetan in pediatrics].

Preclinical studies were carried out on cefotetan (CTT), together with clinical studies in the field of pediatrics. The following results were obtained. A total of 114 clinical isolates that have been stored in the authors' department was employed to determine the minimum inhibitory concentrations (MICs) of CTT against various bacterial species. Against E. coli, Salmonella, K. pneumoniae and P. mirabilis, the MICs of CTT showed a peak at 0.78 micrograms/ml, and most of the strains were inhibited by a CTT concentration of 6.25 micrograms/ml or less. The MICs for S. marcescens strains showed a peak at 25 micrograms/ml, with 25% of the strains having MICs of 3.13 micrograms/ml or less, and 67% having MICs of 25 micrograms/ml or more. All of the P. aeruginosa strains had MICs of over 100 micrograms/ml. Against all of the tested strains of S. aureus, a Gram-positive bacterium, CTT showed MICs of 12.5 micrograms/ml or more, while all of the strains of S. faecalis were found to have MICs of over 100 micrograms/ml. CTT was administered intravenously to pediatric patients as a bolus injection, and then the concentration of the antibiotic in the serum was determined as a function of time. When the dosage rate was 10 mg/kg, the mean serum levels were as follows; 58.2 micrograms/ml at 30 minutes, 45.5 micrograms/ml at 1 hour, 33.6 micrograms/ml at 2 hours, 18.0 micrograms/ml at 4 hours and 11.7 micrograms/ml at 6 hours after the injection. The half-life of CTT in the serum at this dosage was thus 2.40 hours. Similarly, at a dosage rate of 20 mg/kg, the mean values at the various times were; 98.6 micrograms/ml at 30 minutes, 75.6 micrograms/ml at 1 hour, 57.8 micrograms/ml at 2 hours, 35.5 micrograms/ml at 4 hours and 23.2 micrograms/ml at 6 hours subsequent to the injection. The half-life of CTT in the serum in these cases was 2.73 hours. CTT was drip-infused intravenously over a period of 1 hour, and then the serum concentration of the drug was monitored with the passage of time. Subsequent to the administration of 10 mg/kg, the mean serum concentrations were as follows; 48.8 micrograms/ml at 30 minutes, 81.5 micrograms/ml at 1 hour, 42.2 micrograms/ml at 2 hours, 23.6 micrograms/ml at 4 hours and 14.8 micrograms/ml at 6 hours subsequent to the injection. The half-life of CTT in the serum after this intravenous drip infusion was thus 2.13 hours.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

[Experimental and clinical evaluation of cefpiramide in pediatrics].

Fundamental and clinical studies on cefpiramide (CPM), a new semisynthetic cephalosporin, were made and the following results were obtained. The antibacterial activities of CPM against clinical isolates were almost similar to those of conventional cephems except for Pseudomonas aeruginosa. The antibacterial activity of CPM against P. aeruginosa was excellent and superior than those of the others. Ten or twenty mg/kg of CPM was given intravenously at one shot to 11 cases. The mean serum levels of CPM reached 231 micrograms/ml at 15 minutes, 119 micrograms/ml at 30 minutes, 88 micrograms/ml at 1 hour, 65 micrograms/ml at 2 hours and 33 micrograms/ml at 6 hours after administration at a single dose of 10 mg/kg, respectively with the half-life of 3.42 hours. In case of 20 mg/kg, the mean serum levels attained 306 micrograms/ml at 15 minutes, 245 micrograms/ml at 30 minutes, 160 micrograms/ml at 1 hour, 118 micrograms/ml at 2 hours and 66 micrograms/ml at 6 hours respectively after administration with the half-life of 5.20 hours. CPM was given intravenously to 12 patients with various bacterial infections. The clinical effects were excellent in 5 cases, good in 6 cases and poor in 1 case and the effective rate was 92%. No side effect was observed in all cases.

Adolescent↗

[Experimental and clinical evaluation of latamoxef in newborn and premature infants].

Latamoxef (LMOX) was used in the treatment and prophylaxis of infections in neonates and immature infants. The following results were obtained. Mean serum concentrations (bioassay) 30 minutes after a single intravenous injection of about 20 mg/kg of LMOX were 49.9 mcg/ml in neonates and 47.3 mcg/ml in immature infants aged 0--3 days, 54.1 mcg/ml in neonates and 60.6 mcg/ml in immature infants aged 4--7 days, 48.9 mcg/ml in neonates and 46.7 mcg/ml in immature infants aged 8--28 days and 62.1 mcg/ml in immature infants aged over 29 days. Six-hour values were 24.1 mcg/ml, 22.5 mcg/ml, 15.9 mcg/ml, 27.2 mcg/ml, 12.9 mcg/ml, 19.1 mcg/ml and 12.8 mcg/ml, respectively. Mean serum concentration half-lives were 6.70 hours in neonates and 8.16 hours in immature infants aged 0--3 days, 3.68 hours in neonates and 5.83 hours in immature infants aged 4--7 days, 3.06 hours in neonates and 4.47 hours in immature infants aged 8--28 days and 2.59 hours in immature infants aged over 29 days. Adequate clinical efficacy can be expected by the intravenous injection of LMOX in doses of 20 mg/kg 1--2 times daily, in neonates and immature infants aged 0--3 days, 20 mg/kg 2--3 times daily, in neonates and immature infants aged 4--7 days and 20 mg/kg 3 times daily, in neonates and immature infants aged 8--28 days. The clinical efficacy of LMOX was good in 5 cases of sepsis (including suspected cases), 5 cases of urinary tract infection, 2 cases of respiratory tract infection and 6 cases of intrauterine infection (including suspected cases). Only a case of respiratory tract infections due to P. aeruginosa was thought to be ineffective. Bleeding tendency was noted in 3 cases, which results from secondary vitamin K deficiency should be checked carefully during the administration of LMOX.

Bacterial Infections↗

[Pharmacokinetics study on gentamicin intravenous drip infusion in children].

Pharmacokinetics of gentamicin in children after intravenous infusion over 60 minutes were compared with that after intramuscular injection. 1. Mean measured peak serum levels after intravenous infusion of 2.5 mg/kg and intramuscular injection of 2.0 mg/kg were 6.1 micrograms/ml at termination of infusion and 6.5 micrograms/ml at 30 or 60 minutes after injection, respectively. Older children showed higher serum levels. 2. There was no difference in serum half-life between both modes of administration. 3. The AUC after intravenous infusion was slightly larger than that after intramuscular injection. 4. It was suggested that the efficacy and safety of the treatment by intravenous infusion in children are comparable to that by the intramuscular injection, and optimum single dose is 1.5--2.5 mg/kg.

Adolescent↗

[Fundamental and clinical studies of cefotaxime in neonates and immature infants].

Cefotaxime (CTX) was used in the treatment and prophylaxis of infections in neonates and immature infants. The following results were obtained. 1. Mean serum concentrations (bioassay) 30 minutes after a single intravenous injection of about 20 mg/kg of CTX were 44.5 mcg/ml in neonates and 47.2 mcg/ml in immature infants aged 0-3 days, 45.8 mcg/ml in neonates and 56.4 mcg/ml in an immature infant aged 4-7 days and 40.6 mcg/ml in neonates and 38.1 mcg/ml in immature infants aged 8 or more days. Six hour values were respectively 10.9 mcg/ml, 17.0 mcg/ml, 4.6 mcg/ml, 13.4 mcg/ml, 3.8 mcg/ml and 2.7 mcg/ml. 2. Mean serum concentration half-lives were 3.0 hours in neonates and 3.2 hours in immature infants aged 0-3 days, 1.8 hours in neonates and 3.2 hours in an immature infant aged 4-7 days, and 1.5 hours in neonates and 1.6 hours in immature infants aged 8 or more days. 3. Urinary recovery rates were 0.8-78.0% for 0-6 hours after treatment. 4. Adequate clinical efficacy can be expected by the intravenous injection of CTX in doses of 20 mg/kg 2 times daily, every 12 hours, in neonates and immature infants aged 0-3 days, 20 mg/kg 3 times daily, every 8 hours, in neonates and immature infants aged 4-7 days, and 20 mg/kg 3 to 4 times daily, every 6-8 hours, in neonates and immature infants aged 8 or more days. 5. The clinical efficacy of CTX was good in all 4 cases of sepsis (including suspected case), excellent in 1 case of urinary tract infection, and good in all 4 cases of fever of unknown origin for a cure rate of 100%. 6. Adverse reactions were not noted in any cases.

Bacterial Infections↗

[Basic and clinical studies on cefmenoxime in pediatric field].

Basic and clinical studies were made on cefmenoxime (CMX) in pediatric field, and the following results were obtained. 1. The antibacterial activity of CMX against clinically isolated and maintained strains was examined. CMX had stronger antibacterial activity than CEZ against Escherichia coli, Salmonella, Klebsiella pneumoniae, Proteus mirabilis, Serratia marcescens and Pseudomonas aeruginosa, but CEZ had stronger antibacterial activity against Staphylococcus aureus. 2. The blood concentrations of CMX, 0.5, 1, 2, 4 and 6 hours after a one-shot intravenous injection of 20 mg/kg of CMX were 33.6, 15.1, 4.5, 2.5 and 0.6 mcg/ml, respectively, with the half-life of 1.04 hours. 3. The blood concentrations of CMX, 0.5, 1, 2, 4 and 6 hours after a 1-hour intravenous drip infusion of 20 mg/kg of CMX were 32.0, 55.2, 8.4, 4.2 and 1.0 mcg/ml, respectively, with the half-lite of 0.96 hour. 4. A complete or partial clinical response to therapy with CMX was obtained in all 10 children with infectious diseases. 5. Bacteriological examination made on 3 patients showed that all bacteria had been eradicated, and that therapy was effective. The bacteria were E. coli in 2 patients and Proteus mirabilis in 1 patient. 6. The side effects produced were neutropenia, eosinophilia and skin eruption in 1 patient, and diarrhea in 1 patient.

Adolescent↗

[Fundamental and clinical evaluation of 9,3"-diacetylmidecamycin in pediatric field (author's transl)].

1. The dry syrup of MOM was administered orally to 17 patients mainly with heart diseases at doses of 10 mg/kg and 20 mg/kg. In 17 cases, the serum level was measured and in 4 cases, the urinary excretion rate including the metabolites of MOM. 2. The mean maximal concentrations were 0.54 mcg/ml at 30 minutes for the group of 10 mg/kg treatment and 0.33 mcg/ml at 1 hour for the group of 20 mg/kg treatment. The dose response was not observed obviously in both groups. 3. In each of the cases, the sum of excretion rates of metabolites in the 24-hour urine was about 1%. 4. MOM was administered clinically to 39 cases with respiratory tract infections and the overall efficacy rate was 85%. 5. In this study, 5 strains of S. pyogenes were isolated and the eradication rate was 60%. 6. Although severe side effects were not observed, gastrointestinal abnormalities like diarrhea and vomiting were seen in 3 cases. 7. Any pediatric patient did not refuse taking.

Administration, Oral↗

[Fundamental and clinical studies of cefotiam in the field of pediatrics (author's transl)].

The fundamental and clinical studies on cefotiam (CTM) were performed in the field of pediatrics, and the following results were obtained: 1. The peak MIC's of CTM against Gram negative rods such as E. coli, Klebsiella, Salmonella, Proteus were 1.56 mcg/ml. The MIC distribution against S. aureus was almost equal to the conventional cephalosporin antibiotics. The MICs against P. pseudomonas and Serratia were over 400 mcg/ml. 2. The mean serum levels of CTM after bolus intravenous injection of 25 mg/kg were 59.9 mcg/ml after 15 min., 30.0 mcg/ml after 30 min., 15.6 mcg/ml after 1 hour. 3. Administration of CTM to 6 pediatric patients produced the clinical responses which were good in all 6 cases and the bacterial effects of eradication in 3 cases and superinfection in the 2 cases in the 5 cases from whom the organism were isolated. No side effect was observed. From the above results, it is considered that a bolus injection of CTM 25 mg/kg t.i.d. to q.i.d. is a safe and useful treatment for pediatric cases.

Age Factors↗

[Basic and clinical examinations of 6059-S in pediatrics (author's transl)].

1. MIC of 6059-S against 92 strains of clinically isolated bacteria were measured. The compound was active against most of Gram-negative rods, but was not active against Staphylococcus aureus. 2. 20 mg/kg of 6059-S (newly synthesized oxacephem antibiotics) was administered to the pediatric patients and its blood concentration was measured by agar well method using E. coli 7437 as a test organism. 3. The mean blood concentrations were maximum at 15 minutes after intravenous one-bolus injection. Maximum levels were 94.5 mcg/ml in the patients of below 5 years old and 98.7 mcg/ml above 6 years old. Their half-life of the blood levels were 95.4 and 110.6 minutes respectively. 4. The mean blood concentrations were highest at the end of the infusion in the cases of 60 minutes drip injection. Maximum levels were 85.0 mcg/ml in the patients of below 5 years old and 64.8 mcg/ml above 6 years old. 5. Clinical efficacy of 6059-S in 6 cases pyelonephritis, 2 cases of sepsis, 1 case of meningitis, 1 case of intraperitoneal abscess, 9 cases pneumonia and 2 case of tonsillitis was 100%. In the case of urinary tract infection, 4 patients were treated successfully by the administration of 20 mg/kg/day of 6059-S. Other bacterial infections were treated with 55 to 200 mg/kg/day. 6. 100% of the causative organisms were eliminated by 6059-S. They were E. coli, Klebsiella pneumoniae, Serratia marcescens, H. influenzae and beta-Streptococcus. 7. No remarkable side effect was noticed during administration.

Adolescent↗

[Examination of blood levels and urinary excretion of cefmetazole in the mature and immature neonates (author's transl)].

1. Cefmetazole was administered to mature and immature neonates for the purpose of treatment and prophylaxis of infections, and the blood level was examined. The mean blood level (moni-trol I standard) of cefmetazole after a single administration, 20 mg/kg intravenously, were 63.9 mcg/ml in 0 to 3 days old neonates and 57.4 mcg/ml in 4 to 7 days old neonates after 30 minutes, and 24.2 mcg/ml and 12.4 mcg/ml, respectively, after 6 hours. 2. The mean half-life of the blood level was 5.42 hours in 0 to 3 days old neonates and 2.55 hours in 4 to 7 old neonates. 3. The urinary excretion was varied, but approximately 80% of the administered dose seemed to be excreted during 0 to 12 hours. 4. Cefmetazole is seemed to be clinically effective by a single dose of 20 mg/kg giving twice daily in every 12 hours in 0 to 3 days old neonates, a dose of 20 mg/kg giving three times daily in every 8 hours in 4 to 7 days old infants, and a single dose of 20 mg/kg giving 3 to 4 times in every 6 to 8 hours in older than 8 days old neonates.

Anti-Bacterial Agents↗

[Clinical investigation of cefadroxil in pediatric field (author's transl)].

(1) Cefadroxil powder for syrup was administered in 24 cases of respiratory tract infection and urinary tract infection, and the efficacy was obtained in 21 cases, effective ratio being 87.5%. (2) Clinical effect could be obtained satisfactorily at a daily dose of 10-15 mg/kg divided into 3 times after each meal. (3) As to the side effect, GOT and GPT rose in 1 case, and stomatitis in 1 case, though the patients returned to normal after discontinuation of the drug. (4) Haemophilus appeared by pharyngeal culture after administration of the drug, and attention should be paid on an alteration of pharyngeal flora.

Cefadroxil↗

[Study of cefroxadine in pediatrics regarding clinical efficacy and serum levels (author's transl)].

Basic and clinical evaluations of cefroxadine were carried out in children, and the following results were obtained. 1. Cefroxadine 20 mg/kg was administered to 9 children with heart disease for the prophylaxis against infections before undergoing cardiocatheterization and cardioangiography, and serum levels were determined. Peak levels reached after 30 minutes in 4 of the 9 cases, with a mean peak level of 22.5 mcg/ml and after 1 hour in 5 cases, with a mean peak level of 16.2 mcg/ml. Half life was 3.1 hours in the former group in a 6-hour blood sampling (1.04 hours in a 2-hour sampling) while in the latter group it was 1.37 hours. 2. Clinical responses were evaluated in 56 children comprising 23 cases of pharyngitis, 8 of tonsillitis, 13 of scarlet fever, 10 of urinary tract infections and 2 of impetigo. Fifty of these cases had excellent and good responses showing a efficacy rate of 89.3%. 3. From 42 of the cases, 43 strains were isolated as causative organisms. Major organisms included 27 strains of S. pyogenes, 9 of E. coli and 3 of S. aureus. As for bacteriological responses, all strains were eradicated. 4. No severe side effects were observed except for diarrhea of 1 cases and eosinophilia of 2 cases. Furthermore, no children refused to take cefroxadine dry syrup.

Cephalosporins↗