Clinical study of cefpirome in treating complicated urinary tract infection caused by Enterococcus faecalis
We studied the bacteriological effect and resistances to cefpirome (CPR) in the treatment of complicated urinary tract infection caused by Enterococcus faecalis over the 5 years from 1994 to 1998. E. faecalis was isolated in 68 of 129 subjects (52.7%) in whom clinical efficacy was analyzable. Monomi...
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| Published in | Japanese Journal of Chemotherapy Vol. 48; no. 9; pp. 737 - 746 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society of Chemotherapy
2000
公益社団法人 日本化学療法学会 |
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| Online Access | Get full text |
| ISSN | 1340-7007 1884-5886 |
| DOI | 10.11250/chemotherapy1995.48.737 |
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| Abstract | We studied the bacteriological effect and resistances to cefpirome (CPR) in the treatment of complicated urinary tract infection caused by Enterococcus faecalis over the 5 years from 1994 to 1998. E. faecalis was isolated in 68 of 129 subjects (52.7%) in whom clinical efficacy was analyzable. Monomicrobial infection accounted for 33.8%(23/68) and polymicrobial infection for 66.2%(45/68). In terms of clinical efficacy in E. faecalis-isolated subjects, cefpirome was markedly effective in 21 subjects, effective in 36, and no response or ineffective in 11. Efficacy was 83.8%. Efficacy in monomicrobial infection was 87.0% and that in polymicrobial infection was 82.2%. Efficacy related catheter was 73.7% with use and 87.8% without, indicating a favorable outcome in either case. The efficacy of CPR in subjects in whom E. faecalis was not detected was 82.0%, comparable to E. faecalis-isolated subjects. No particular problem was seen in adverse subjective or objective adverse effects. In the MIC distribution of CPR against E. faecalis by isolation chronology, MIC50was 6.25 or 12.5μg/mL whereas MIC90 was 25 or 50μg/mL findings similar to those for strains isolated during from 1985 to 1988. For MIC100, 200μg/mL was the highest recorded before 1990, indicating no trend toward resistance. CPR is the first cephem medicinal product approval for use against E. faecalis, which has thus far shown no problem such as decreased efficacy or the development of resistance, demonstrating its usefulness. |
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| AbstractList | We studied the bacteriological effect and resistances to cefpirome (CPR) in the treatment of complicated urinary tract infection caused by Enterococcus faecalis over the 5 years from 1994 to 1998. E. faecalis was isolated in 68 of 129 subjects (52.7%) in whom clinical efficacy was analyzable. Monomicrobial infection accounted for 33.8%(23/68) and polymicrobial infection for 66.2%(45/68). In terms of clinical efficacy in E. faecalis-isolated subjects, cefpirome was markedly effective in 21 subjects, effective in 36, and no response or ineffective in 11. Efficacy was 83.8%. Efficacy in monomicrobial infection was 87.0% and that in polymicrobial infection was 82.2%. Efficacy related catheter was 73.7% with use and 87.8% without, indicating a favorable outcome in either case. The efficacy of CPR in subjects in whom E. faecalis was not detected was 82.0%, comparable to E. faecalis-isolated subjects. No particular problem was seen in adverse subjective or objective adverse effects. In the MIC distribution of CPR against E. faecalis by isolation chronology, MIC50was 6.25 or 12.5μg/mL whereas MIC90 was 25 or 50μg/mL findings similar to those for strains isolated during from 1985 to 1988. For MIC100, 200μg/mL was the highest recorded before 1990, indicating no trend toward resistance. CPR is the first cephem medicinal product approval for use against E. faecalis, which has thus far shown no problem such as decreased efficacy or the development of resistance, demonstrating its usefulness.
Enteroccus faecalisによる複雑性尿路感染症に対するcefpirome (CPR) の有効性, 細菌学的効果および耐性化傾向の有無を検討する目的で, 1994～1998年の5年間にわたり臨床試験を行った。臨床効果解析可能129例中68例 (52.7%) においてE. faecalisが分離され, その内訳は単独菌感染33.8%(23/68), 複数菌感染66.2%(45/68) であった。E. faecalis分離例における臨床効果は, 著効21例, 有効36例, 無効11例で有効率は83.8%であった。単独菌感染例および複数菌感染例における有効率はそれぞれ87.0%および82.2%, カテーテル留置の有無別有効率は留置例73.7%, 非留置例87.8%であり, いずれも良好な成績であった。E. faecalisが検出されなかった症例におけるCPRの有効率は82.0%であり, E. faeoalis分離例と同等であった。また自他覚的副作用に関しても特に問題となるものは認められなかった。分離年代別のE. faecalisに対するCPRのMIC分布は, MIC50は6.25または12.5μg/mL, MIC90は25または50μg/mLであり, 1985～1988年に分離された株の値と同様であった。MIC100についても, 1990年以前の200μg/mLがもっとも高い値であり, 耐性化傾向は認められなかった。CPRはcephem系でははじめてのE. faecalisを適応菌種として取得した薬剤であるが, 現在のところ有効率の低下や耐性化などの問題はなく, 有用な薬剤であると考えられた。 We studied the bacteriological effect and resistances to cefpirome (CPR) in the treatment of complicated urinary tract infection caused by Enterococcus faecalis over the 5 years from 1994 to 1998. E. faecalis was isolated in 68 of 129 subjects (52.7%) in whom clinical efficacy was analyzable. Monomicrobial infection accounted for 33.8%(23/68) and polymicrobial infection for 66.2%(45/68). In terms of clinical efficacy in E. faecalis-isolated subjects, cefpirome was markedly effective in 21 subjects, effective in 36, and no response or ineffective in 11. Efficacy was 83.8%. Efficacy in monomicrobial infection was 87.0% and that in polymicrobial infection was 82.2%. Efficacy related catheter was 73.7% with use and 87.8% without, indicating a favorable outcome in either case. The efficacy of CPR in subjects in whom E. faecalis was not detected was 82.0%, comparable to E. faecalis-isolated subjects. No particular problem was seen in adverse subjective or objective adverse effects. In the MIC distribution of CPR against E. faecalis by isolation chronology, MIC50was 6.25 or 12.5μg/mL whereas MIC90 was 25 or 50μg/mL findings similar to those for strains isolated during from 1985 to 1988. For MIC100, 200μg/mL was the highest recorded before 1990, indicating no trend toward resistance. CPR is the first cephem medicinal product approval for use against E. faecalis, which has thus far shown no problem such as decreased efficacy or the development of resistance, demonstrating its usefulness. |
| Author | Matsumoto, Tetsuro |
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| References | 18) 河田幸道, 出口隆, 塚本泰司, 他: 複雑性尿路感染症に対するbiapenemとimipenem/cilastatinの比較検討. 日本化学療法学会雑誌48: 218-231, 2000 10) 山田大介, 宇埜智, 西谷嘉夫, 他: 複雑性尿路感染症に対するCefpiromeの基礎的・臨床的検討. Chemotherapy 39 (S-1): 282-291, 1991 6) UTI研究会 (代表大越正秋): UTI薬効評価基準 (第3版). Chemotherapy 34: 408-441, 1986 11) 川原元司, 後藤俊弘, 川原和也, 他: 尿路感染症におけるCefpiromeの基礎的・臨床的検討. Chemotherapy 39 (S-1): 305-310, 1991 15) 松本哲朗, 田中正利, 屠形僧雄, 他: 泌尿器科領域におけるCofpiromeの使用経験. Chemotherapy 39 (8-1): 299-304, 1991 5) 村谷哲郎, 松本哲朗: 経口セフェム薬の有効性と限界3) 泌尿器科領域. 感染と抗菌薬vol.2 (1): 79-83, 1999 3) Nakayama I, Akieda Y, Yamaji Y, et al.: Single and Multiple dose Pharmacokinetics of Intravenous Cefpirome (HR-810) to healthy volunteers.J.Clinical pharmacology 32: 256-266, 1992 7) 日本化学療法学会: 最小発育阻止濃度 (MIC) 測定法再改訂について. Chemotherapy 29: 76-79, 1981 13) 鈴木裕志, 清水保夫, 岡田謙一郎: 複雑性尿路感染症に対するCefpiromeの臨床的検討. Chemotherapy 39 (S-1): 581-584, 1991 8) 吉岡琢, 広瀬崇興, 熊本悦明, 他: 尿路感染症に対するCofpiromeの基礎的・臨床的検討. Chemotherapy 39 (S-1): 243-252, 1991 14) 植田省吾, 江藤耕作: 慢性複雑性尿略感染症に対するCefpiromeの臨床的検討. Chemotherapy 39 (8-1): 589-592, 1991 20) 木村美司, 吉田勇, 東山伊佐夫, 他: 種々の臨床分離株の各種抗菌薬に対する感受性サーペイランス-その1 1996年分離グラム陽性球菌について-. 日本化学療法学会雑誌44: 324-341, 1998 1) Arai S, Kobayashi S, Hayashi S. et al.: In vitro antimicrobial activity of cefpirome, a new cephalosporin with abroad antimicrobial spectrum. Jpn J Antibiot 40: 969-981, 1987 12) 西沢理, 土田正義, 佐々木秀平, 他: 複雑性尿路感染症に対するCefpiroeの臨床的検討. Chemotherapy 39 (S-1): 564-567, 1991 17) 藤田和彦, 藤目真, 川地義雄, 他: 複雑性尿路感染症に対するlevonoxacinの臨床効果. 日本化学療法学会雑誌48: 68-74, 2000 19) 日本化学療法学会抗菌薬感受性測定法検討委員会: 尿路感染症における抗菌薬のブレイクポイント. 日本化学療法学会雑誌43: 711-728, 1997 16) 河田幸道, 坂義人, 熊本悦明, 他; 複雑性尿路感染症に対するgatifloxacinとlevofloxacinの比較検討. 日本化学療法学会雑誌47: 662-679, 1999 4) 名出頼男, 守殿貞夫, 荒川創一, 他: 複雑性尿路感染症に対するCefpiromeとCeftazidimeの比較検討. 泌尿器科紀要37: 447-464, 1991 9) 荒川創一, 今井敏夫, 高木伸介, 他: 泌尿器科領域におけるCefpiromeの基礎的および臨床的検討. Chemotherapy 39 (S-1): 271-281, 1991 2) Kobayashi S, Arai S, Hayashi 5, et al.:β-lactamase stability of cefpirome (HR 810), a new cephalosporin with a broad antimicrobial spectrum. Antimicrob Agents Chemother 30: 713-718, 1986 |
| References_xml | – reference: 6) UTI研究会 (代表大越正秋): UTI薬効評価基準 (第3版). Chemotherapy 34: 408-441, 1986 – reference: 12) 西沢理, 土田正義, 佐々木秀平, 他: 複雑性尿路感染症に対するCefpiroeの臨床的検討. Chemotherapy 39 (S-1): 564-567, 1991 – reference: 5) 村谷哲郎, 松本哲朗: 経口セフェム薬の有効性と限界3) 泌尿器科領域. 感染と抗菌薬vol.2 (1): 79-83, 1999 – reference: 16) 河田幸道, 坂義人, 熊本悦明, 他; 複雑性尿路感染症に対するgatifloxacinとlevofloxacinの比較検討. 日本化学療法学会雑誌47: 662-679, 1999 – reference: 7) 日本化学療法学会: 最小発育阻止濃度 (MIC) 測定法再改訂について. Chemotherapy 29: 76-79, 1981 – reference: 2) Kobayashi S, Arai S, Hayashi 5, et al.:β-lactamase stability of cefpirome (HR 810), a new cephalosporin with a broad antimicrobial spectrum. Antimicrob Agents Chemother 30: 713-718, 1986 – reference: 9) 荒川創一, 今井敏夫, 高木伸介, 他: 泌尿器科領域におけるCefpiromeの基礎的および臨床的検討. Chemotherapy 39 (S-1): 271-281, 1991 – reference: 17) 藤田和彦, 藤目真, 川地義雄, 他: 複雑性尿路感染症に対するlevonoxacinの臨床効果. 日本化学療法学会雑誌48: 68-74, 2000 – reference: 11) 川原元司, 後藤俊弘, 川原和也, 他: 尿路感染症におけるCefpiromeの基礎的・臨床的検討. Chemotherapy 39 (S-1): 305-310, 1991 – reference: 1) Arai S, Kobayashi S, Hayashi S. et al.: In vitro antimicrobial activity of cefpirome, a new cephalosporin with abroad antimicrobial spectrum. Jpn J Antibiot 40: 969-981, 1987 – reference: 15) 松本哲朗, 田中正利, 屠形僧雄, 他: 泌尿器科領域におけるCofpiromeの使用経験. Chemotherapy 39 (8-1): 299-304, 1991 – reference: 20) 木村美司, 吉田勇, 東山伊佐夫, 他: 種々の臨床分離株の各種抗菌薬に対する感受性サーペイランス-その1 1996年分離グラム陽性球菌について-. 日本化学療法学会雑誌44: 324-341, 1998 – reference: 3) Nakayama I, Akieda Y, Yamaji Y, et al.: Single and Multiple dose Pharmacokinetics of Intravenous Cefpirome (HR-810) to healthy volunteers.J.Clinical pharmacology 32: 256-266, 1992 – reference: 4) 名出頼男, 守殿貞夫, 荒川創一, 他: 複雑性尿路感染症に対するCefpiromeとCeftazidimeの比較検討. 泌尿器科紀要37: 447-464, 1991 – reference: 10) 山田大介, 宇埜智, 西谷嘉夫, 他: 複雑性尿路感染症に対するCefpiromeの基礎的・臨床的検討. Chemotherapy 39 (S-1): 282-291, 1991 – reference: 13) 鈴木裕志, 清水保夫, 岡田謙一郎: 複雑性尿路感染症に対するCefpiromeの臨床的検討. Chemotherapy 39 (S-1): 581-584, 1991 – reference: 18) 河田幸道, 出口隆, 塚本泰司, 他: 複雑性尿路感染症に対するbiapenemとimipenem/cilastatinの比較検討. 日本化学療法学会雑誌48: 218-231, 2000 – reference: 14) 植田省吾, 江藤耕作: 慢性複雑性尿略感染症に対するCefpiromeの臨床的検討. Chemotherapy 39 (8-1): 589-592, 1991 – reference: 19) 日本化学療法学会抗菌薬感受性測定法検討委員会: 尿路感染症における抗菌薬のブレイクポイント. 日本化学療法学会雑誌43: 711-728, 1997 – reference: 8) 吉岡琢, 広瀬崇興, 熊本悦明, 他: 尿路感染症に対するCofpiromeの基礎的・臨床的検討. Chemotherapy 39 (S-1): 243-252, 1991 |
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| Title | Clinical study of cefpirome in treating complicated urinary tract infection caused by Enterococcus faecalis |
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