尿路感染症に対するCefixime(CFIX)の臨床的検討

Abstract

1988年2月から同年7月の間に大阪大学泌尿器科ならびにその関連病院16施設において, 238例の尿路感染症に対してCFIXを投与し, その臨床効果と安全性について検討した.1)評価基準に基づいて効果の判定を行いえた症例は135例であり, そのうち女子急性単純性膀胱炎の92例では93%, 複雑性尿路感染症の42例では57%の総合有効率を得た.単純性腎盂腎炎の1例でも著効を示した.2)自覚的副作用は236例について検討され, 3例に軽い消化管症状と, 服薬を中止した全身掻痒感の1例, 合計4例に副作用を認めた.臨床検査値の異常変動は141例中6例に認め, 肝機能値の変動を主とした.総じて重篤な副作用は認めなかった

Cefixime (CFIX, Cefspan), a new oral cephem, was used in the treatment of urinary tract infections, and was evaluated for its therapeutic effectiveness and safety at the Department of Urology, Osaka University Hospital and 16 affiliated hospitals. A total of 238 patients were administered daily doses of 200 or 400 mg. Clinical efficacy was assessed on 92 female patients with acute uncomplicated cystitis and 42 patients with complicated UTI according to the Criteria for Clinical Evaluation of Antimicrobial Agents in UTI (3rd ed.) recommended by the Japan UTI Committee, to which we added our own minimum modification. Clinical efficacy was evaluated as excellent in 57 of the acute uncomplicated cystitis cases, moderate in 33 and poor in 2, with an overall clinical effectiveness rate of 98%. Clinical efficacy was evaluated as excellent in 12 of the complicated UTI cases moderate in 12 and poor in 18, with an overall clinical effectiveness rate of 57%. In one case of uncomplicated pyelonephritis, CFIX showed an excellent efficacy. Of the total of 102 bacterial strains isolated from uncomplicated UTIs, 95 (93%) were eradicated by CFIX, while 36 (72%) eradicated in 50 strains isolated from complicated UTIs. Subjective adverse reactions were seen in 4 cases (1.7%) of the 236 patients, as generalized pruritus and upper gastrointestinal discomforts. Abnormal laboratory findings were recorded in 6 out of 141 cases. They were increases in serum GPT, GOT, alkaline phosphatases, total bilirubin, as well as increases in peripheral leukocytes. These adverse symptoms and abnormal laboratory findings disappeared after the termination of CFIX administration. CFIX might therefore be considered as a clinically useful oral antibiotic in the treatment of UTI.