尿路感染症におけるアミノグリコシド系抗生剤の抗菌力と臨床効果との関係について　ＩＩ　　感性，耐性の境界に関する臨床的考察

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タイトル別名
  • RELATION BETWEEN ANTIMICROBIAL ACTIVITY AND CLINICAL EFFICACY OF AMINOGLYCOSIDES (II)
  • ニョウロ カンセンショウ ニ オケル Aminoglycosideケイ コウセ
  • 感性, 耐性の境界に関する臨床的考察

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Because of the fact that the conventional sensitive-resistant boundary concentration of aminoglycosides is not always fit for the clinical efficicacy, we tried to seek for the fittest one by analyzing the clinical efficacy obtained from well controlled studies. 312 patients with complicated urinary tract infections were treated with usual dosage of gentamicin (GM), tobramycin (TOB), amikacin (AMK) or KW-1062 for five days, and the relations between the efficacies of each drug group and the MICs of the drug for pathogens were observed statistically.<BR>The patients were separated into two groups, so called sensitive and/or resistant group, at various levels of MIC for their pathogens, and the efficacies of both groups were compared statistically. The boundary concentration was determined from the level of MIC showing the most significant difference. The sensitive-resistant boundary concentrations were 1.56-3.13μg/ml (GM 40mg), 3.13-6.25μg/ml (GM 60mg), 3.13-6.25μg/ml (TOB 60mg), 6.25-12.5μg/ml (KW-1062 120mg) and 12.5-25μg/ml (AMK 200mg). Another method was to determine it from the cross point of the curve indicating effectiveness rate and the line indicating a certain expected effectiveness rate (for example 50%) for the patients group with sensitive pathogens. The cut off points for effectiveness rate above 50% revealed to be 3.13-6.25μg/ml (GM), 6.25-12.5μg/ml (TOB), 25-50μg/ml (AMK) and 6.25-12.5μg/ml (KW-1062).<BR>In the present study, the following facts were observed. The most fittest boundary concentration was not always fixed but also changeable according to dosages, drugs and characteristics of subjects.

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