細菌性前立腺炎に対するsparfloxacinの基礎的・臨床的検討

Abstract

1)感受性:EPSから分離した細菌48株のMICを測定した.S. epidermidis (n=12)の8株が≦0.05 μg/ml, E. coli (n=6)のすべてが≦0.025 μg/mlの優れた抗菌活性を示した.2) PFへの移行濃度:200 mg内服1～3時間で0.33～0.49 μg/mlの移行を示し, 対血清比1.15～1.47であった.3)臨床成績:前立腺炎14例(急性5, 慢性9)に対し, 本剤1日200～400 mg, 平均14.1日間投与した効果は, 主治医判定で12例有効.除菌率は15株中14株93.3%であった.グラム陰性桿菌が検出された7例ではすべて除菌された.4)安全性:臨床検査値の変動は, 1例に一過性のGOT, GPT, Al-Pの上昇と血小板数の低下をみた.自覚的副作用は消化器障害1例と日光過敏症と手掌の知覚異常の1例を認め, いずれも治療終了後無処置で正常に復した.5)結論:SPFXはPFへの移行がMICと比べて高く, かつ組織内滞留時間が長いので, 前立腺炎に対して既存の同系剤と比肩する有効性が認められた.安全性については類縁剤と同様に配慮すべきであると考えられた

Sparfloxacin (SPFX), a new oral quinolone antimicrobial, was studied for the bacterial response, pharmacokinetics and clinical efficacy in the treatment of bacterial prostatitis. The minimum inhibitory concentration (MIC) values for 48 strains isolated from expressed prostatic secretion were measured. The values for 8 out of 12 strains of S. epidermidis were below 0.05 microgram/ml and those for all 6 strains of E. coli were below 0.025 microgram/ml. The SPFX concentrations in prostatic fluid (PF) were 0.33 to 0.49 microgram/ml at 1 to 3 hours after oral administration of 200 mg, the PF/serum ratio being 1.15 to 1.47. SPFX was administered at a dose of 200 to 400 mg daily for an average of 14.1 days to 14 patients with prostatitis (5, acute: 9, chronic). The clinical efficacy judged by physician in charge was effective in 12 cases with an efficacy rate of 85.7%. The bacterial eradication rate was 93.3% (14/15 strains), and eradication was complete in all 7 cases infected with gram-negative rods. SPFX-related abnormal laboratory values were observed in one case with transient increase of glutamic-oxalacetic transaminase, glutamic-pyruvic transaminase and alkaliphosphatase activities, and decrease of platelet. As side effects, one case with gastrointestinal symptoms and the other case with photosensitivity skin rash accompanied by sensory abnormality of palms were observed. The abnormal values or side effects in these patients recovered to normal or disappeared after completion of the treatment without any treatments. In view of the higher concentrations in PF than the MIC values with long remaining in the tissues, SPFX is considered to be effective in the treatment of bacterial prostatitis.(ABSTRACT TRUNCATED AT 250 WORDS)