淋菌性感染症の疫学的治療学的研究 --Aztreonamによるone shot療法の検討--

Abstract

淋菌性感染症244例(男子尿道炎212例, 女子子宮頸管炎32例)に対し, Aztreonam one shot (1～2 g)治療を試みた.1)症例より分離した淋菌244株中42株(17.2%)がPPNGであった.2) Aztreonamの淋菌に対する106 CFU/mlでのMICはβ-lactamase産生に関係なく, 0.025 μg/mlにpeakをもち, 0.0125 μg/ml以下から0.2 μg/mlに分布していた.3) Aztreonam 1 gおよび2 g投与による淋菌の消失時間は1～8時間, 平均4～4.5時間の間に消失をみており, 1 gと2 gの間にほとんど差は認められなかった.4) Aztreonam 1 g one shot, 2 g one shotによる臨床効果を男女244例について検討したが, 3日所見で判定するとPPNGでも治療効果は変らず, 有効率は男子尿道炎では1 g 90.7%, 2 g 97.1%, 女子子宮頸管炎では1 g, 2 gとも100%であった.5) Aztreonamの副作用は244例中しびれ, 両手に発赤, 腫脹1例, 倦怠感1例の計2例(0.8%)にみられたがいずれも軽度であった

A clinical study of a new monocyclic beta-lactam antibiotic, AZTREONAM (hereafter referred to as AZT) for gonorrheal infections as well as epidemiologic study of gonorrheal infections were made Epidemiology: There was a reflection of the increasing sexual activity of the younger generation; both male and female patients in their twenties were most frequent (male 49.5%, female 43.7%) and the percent of teen age patients was 15.1% (male) and 34.4% (female). Forty two strains (17.2%) out of 244 clinically isolated gonococci were PPNG. Residue of serious secretion was observed in a little less than 20% suggesting a complication by Chlamydia trachomatis. Clinical Result: One shot (1-2 g) therapy by AZT was given to 244 gonorrheal infection cases (212 urethritis cases of males. 32 cervicitis cases of females) with the following highly effective rate. Although beta-lactamase producing MIC of AZT at 10(6) CFU/ml showed a peak of 0.025 microgram/ml and ranged between less than 0.0125 microgram/ml to 0.2 microgram/ml. The time required for the elimination of gonococci was studied by the administration of 1 g and 2 g AZT. Gonococci became extinct in 1-8 hours or 4-4.5 hours on average. The difference between n 1 g and 2 g was scarcely observed. Clinical effect of 1 g one shot and 2 g one shot AZT was examined on the 3rd treatment day for 244 male and females cases. The effective rate was high; 90.7% by 1 g, 97.1% by 2 g for male urethritis, 100% by 1 g also by 2 g for female cervicitis. This therapeutic efficacy was kept even in PPNG, isolated cases. There were two side effects (0.8%), one case each of numbness and, redness and swelling of both hands, out of 244 cases, but both of them were minor ones without clinical complication.