TREATMENT OF E. COLI MENINGITIS WITH CEFMETAZOLE

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  • KOBAYASHI YUTAKA
    Department of Pediatrics, Kobe Central Municipal Hospital, Kobe, Japan
  • MORIKAWA YOSHIRO
    Department of Pediatrics, Kobe Central Municipal Hospital, Kobe, Japan
  • HARUTA TSUNEKAZU
    Department of Pediatrics, Kobe Central Municipal Hospital, Kobe, Japan
  • FUJIWARA TORU
    Department of Pediatrics, Kobe Central Municipal Hospital, Kobe, Japan
  • KUROKI SHIGEKAZU
    Department of Pediatrics, Kobe Central Municipal Hospital, Kobe, Japan

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Other Title
  • 大腸菌性髄膜炎に対するCefmetazoleの使用について
  • 大腸菌性髄膜炎に対するCefmetazoleの使用について--有効2症例とその髄液中濃度
  • ダイチョウキンセイ ズイマクエン ニ タイスル Cefmetazole ノ シ
  • REPORT OF TWO CASES WITH FAVORABLE RESPONSE AND DETERMINATION OF THE CONCENTRATIONS IN CSF
  • 有効2症例とその髄液中濃度

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Abstract

Two patients with purulent meningitis, of which causative organism was presumed to be E.coli, were treated with intravenous administration of cefmetazole, 300-400mg/kg/day in 4-6 divided doses, and the following conclusions were obtained.<BR>1) Clinical response was favorable and a complete cure was obtained without sequelae in both patients. There were no adverse reactions noted except for a mild and transient eosinophilia (12%) in one case.2) Of two strains of E. coli recovered from CSF, one was sensitive to ampicillin, cefazolin and cefmetazole, among which ceflnetazole had the highest bacterial activity. Although another strain was sensitive to ceftnetazole, it showed resistance to cefazolin (>12.5μg/ml) and to ampicillin (>100μ9/ml).<BR>3) Concentrations of ceftnetazole in CSF following 1-2 hours of its intravenous administration were either equal to or higher than those of ampiciloin, which was given to the same patient for a short period of time. The concentrations in CSF were higher than 3.1μg/ml on each occasion except fbr in some specimems during the convalescent phase and exceeded well the MIC of the causative organlsm.<BR>4) Based on the above results, cefmetazole is considered to be a potent antibiotic in the treatment of E. coli meningitis. Although further studies are needed as to the dosage, an intravenous administration at 4-hour interval appears to be warranted based on the studies that the half-life of the drug is short in CSF in animal experiments.

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