Fosfomycin Dry Syrupの臨床治験ならびにFosfomycinの抗菌力および髄液内濃度

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  • CLINICAL AND LABORATORY STUDIES OF FOSFOMYCIN IN PEDIATRIC FIELD
  • Fosfomycin Dry Syrup ノ リンショウ チケン ナラビニ F

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1) Clinical studies of fosfomycin dry syrup were carried out on 18 patients with various pediatric infections, consisting of 5 tonsillitis, 2 bronchitis, 3 pneumonia, 3 pyothorax and each one of rhinitis, bacterial cystitis, urethritis, otitis media and purulent meningitis. The drug was administered orally at the daily doses of 65-200mg per kg for 3-32 days. In 2 cases of them, pyothorax and purulent meningitis, fosfomycin for injection was given intravenously or intrapleurally at the same time of or after oral administration of dry syrup. The sufficient effect of the drug was revealed clinically in 83. 3% and bacteriologically in 77.7% of the patients. Each one patient of pyothorax and purulent meningitis were found to be effective for the first time after starting intrapleural or intravenous administration. Regarding to the kind of bacteria isolated Staph. aureus was most responsive, while Strept. hemolyticus and Klebsiella pneumoniae were poorly. As for the side effect there found diarrhea in 2 cases and slight increasing of S-GOT level in 1 case.<BR>2) The antimicrobial activities (MIC) were measured on 90 strains of 7 different bacteria isolated from patients with various pediatric infections. The main distributions of MIC were as follows;1.56-6.25μgml in 14 of 21 strains of Staph. aureus, 6.25-100μg/ml in 37 of 38 strains of Strept. hemolyticus, 50-100, ug/ml in all of 5 strains of Klebsiella pneumoniae, 6.25-25μg/ml in 7 of 10 strains of E. coli.<BR>3) CSF concentration of f osf omycin after oral and intravenous administration of each single dose of 0.3 g of the drug were measured on a 5-month-old male infant weighing 6.5 kg who had a continuous ventricular drain for hydrocephalus and purulent meningitis. The measurement was performed at theintervals of 2 hours by the techinique of cup method using Proteus sp. (MB 838), and following results were obtained. After oral adminstration the concentration became measurable-0.88μg/ml-at 4 hours after the dose and gradually increased to the level of 1.44μg/m1 at 8 hours, whereas it reached more rapidly after intravenous injection to the high level of 10.1-11. 8μg/ml at 2-4 hours and maintained still the relative high level of 4.8μg/ml at 10 hours later. From these results, f osf omycin may be used intravenously for the treatment of purulent meningitis.

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