急性細菌性前立腺炎におけるCefmenoximeの前立腺液内移行に関する検討

Abstract

急性細菌性前立腺炎(急性炎症群)16例, 非前立腺疾患患者(正常群)19例にCMX 2 gを静注し60分後のEPSへの移行を検討した.1)急性炎症群のEPS内濃度は12.6±9.6 μg/ml, EPS/血清内濃度比は0.31±0.21, 正常群のEPS内濃度は0.7±0.8 μg/ml, EPS/血清内濃度比は0.015±0.018で, 急性炎症群の方が有意に高かった.2)急性炎症群のEPS/血清内濃度比と初診時末梢血白血球数およびCRP値とは有意の相関を認めなかったが, EPS/血清内濃度比と初診時血沈1時間値とは有意の相関を示した.3)急性細菌性前立腺炎ではCMXはある一定の割合で前立腺液内へ移行し, 炎症の程度により移行度に差があることが示唆された

Expressed prostatic fluid (EPS) levels and serum levels of cefmenoxime (CMX) after intravenous administration were examined in 16 patients with acute bacterial prostatitis and 23 patients without prostatic diseases. Blood was drawn at 30, 60, 120 minutes and EPS was taken by prostatic massage at 60 minutes after the intravenous administration of 2 g CMX to evaluate the concentration of CMX. The concentration of CMX was determined by the bioassay using the E. coli NIHJ JC strain. The relationships between the EPS/serum ratio and peripheral WBC counts, CRP value and ESR 1h value were also analyzed. The serum levels of CMX at 60 minutes ranged between 20.3 micrograms/ml and 73.5 micrograms/ml (mean +/- S.D.: 41.8 +/- 14.2 micrograms/ml) in 16 patients with acute prostatitis, and between 21.5 micrograms/ml and 89.5 micrograms/ml (mean +/- S.D.: 49.5 +/- 18.7 micrograms/ml) in 23 patients without prostatic diseases. The EPS levels ranged between 0.4 micrograms/ml and 30.8 micrograms/ml (mean +/- S.D.: 12.6 +/- 9.6 micrograms/ml) in 16 patients with acute prostatitis, and between 0 and 2.3 micrograms/ml (mean +/- S.D.: 0.7 +/- 0.8 microgram/ml) in 19 patients without prostatic diseases. In 4 patients without prostatic diseases, the EPS amount was not large enough to evaluate the concentration of CMX. The EPS/serum ratio ranged between 0.006 and 0.697 (mean +/- S.D.: 0.31 +/- 0.21) in patients with acute prostatitis and between 0 and 0.058 (mean +/- S.D.: 0.015 +/- 0.018) in patients without prostatic diseases. The diffusion of CMX into the prostatic fluid in patients with acute prostatitis was strikingly higher than that in patients without prostatic diseases (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)