慢性前立腺炎と前立腺炎様症候群の臨床的研究 第3報: 薬効評価基準を用いた慢性細菌性前立腺炎の臨床的再検討昭和大学藤が丘病院泌尿器科(主任:甲斐祥生教授)

Abstract

1981年9月～1988年12月に経験した慢性細菌性前立腺炎65例(適合症例43例)を対象に, UTI研究会・前立腺炎小委員会が設定した薬効評価基準に準拠してretrospectiveに臨床的再検討を行い, 得られた臨床成績を背景因子・分離菌種・使用抗菌剤別に分析した.また本基準の総合臨床効果と自覚症状との関係, 本基準判定症例(14日目判定)と長期治療症例(28日目判定)での成績の比較による投薬期間と効果判定時期の検討, GNR+E. faecalis群とGPC-E. faecalis群での成績の比較によるGram陽性菌群における病原性の有無の検討を行い, 本基準の臨床的有用性についての評価を試みた

In accordance with the criteria for clinical evaluation, established by the UTI research group, 43 cases of chronic bacterial prostatitis were retrospectively analyzed. The subjective symptoms were "resolved" in 18.5%, "improved" in 46.5%, and "persisted" in 34.9%. The white blood cells were "cleared" in 34.9%, "decreased" in 37.2%, and "unchanged" in 27.9%. The bacteria were "eliminated" in 51.2%, "decreased" in 16.2%, "replaced" in 11.6%, and "unchanged" in 21.0%. Overall clinical efficacy was "excellent" in 51.2%, "moderate" in 39.5%, and "poor" in 27.9%, with an overall effectiveness rate of 72.1%. Bacteria (isolated bacteria: 8 species, 52 strains) were "eradicated" in 69.2% (GNR 71.4%, GPC 66.7%), and "persisted" in 30.8%. The bacterial eradication rate was 87.5% for E. coli, 58.3% for S. epidermidis, and 75.0% for E. faecalis. The analytical results of the clinical effects, classified by characteristic factor, showed significantly better results, in the excellence rate (p less than 0.05) and the overall effectiveness rate (p less than 0.01) of primary cases as compared with relapse cases. Among the isolated bacterial species, GNR showed more favorable results in comparison with GPC but without any significant difference. Further, the results of 81.3% for E. coli, 66.7% for S. epidermidis, and 62.5% for E. faecalis, indicates no significant difference between respective bacterial species. The new quinolones showed a favorable rate of 92%, followed by 80% of ST (sulfamethoxazole-trimethoprim), and 78% of tetracyclines, with a significant difference (p less than 0.01) in comparison with the mean overall effectiveness rates of cephems, penicillins, and old quinolones.(ABSTRACT TRUNCATED AT 250 WORDS)