淋菌感染症の疫学的・治療学的研究 - Enoxacinによる検討 -

Abstract

札幌STD研究グループにおいて1982年6月より1年間に男子淋菌性尿道炎131例を対象としてAT-2266 1日600 mgを7日間投与し, 治療効果, その他を検討した.1日1回投与, 2分割投与, 3分割投与の3日間治療成績は著効率がそれぞれ7.7%, 50%, 57%となった.3分割投与群の成績は3日間治療で著効57.0%, 有効39.8%, やゝ有効3.2%であり, 7日間治療では著効74.6%, 有効23.9%, やゝ有効1.5%であったが, 7日間治療でも分泌物や尿中白血球は残存しChlamydiaなど混合感染によると思われた.77株中8株(10.4%)にβ-lactamase産生を認めた.MICは接種菌量でほとんど変化なく, 106 CFU/mlで0.05～0.2 μg/mlと3.16～12.5 μg/mlに二峰性分布を示した.AT-2266の副作用は128例中2例(1.6%)に軽度のものが認められた

From August of 1982 through February of 1983, the Sapporo Clinical Research Group for STD treated 131 cases of male gonorrheal urethritis at its affiliated clinical facilities in Sapporo City. The therapeutic efficacy of AT-2266 was investigated, together with an epidemiological study on the cases and bacteriological studies on the isolated strains of gonococcus. In addition, a few cases of female gonorrheal cervicitis were treated, and the therapeutic results for 3 of these cases evaluated. AT-2266 was administered at a daily dosage of 600 mg in one dose to 14 patients, 2 doses to 10 patients and 3 doses to 98 patients. At the end of 3 days of this therapy, the gonococci had been eliminated in all of the cases, but there was variation in the status of disappearance of the secretion. The "excellent" efficacy rates for these three regimens were thus 7.7%, 50% and 57%, respectively. These results showed that administration of the total dosage in two or more divided doses maintained higher minimum concentrations of the antibiotic in the blood and the urine, and were thus more clinically beneficial than when the dosage was given as one daily dose. Of the patients who were treated with 600 mg/day of AT-2266 in 3 divided doses, 93 were evaluated for the therapeutic efficacy. At the end of 3 days 57.0% were "excellent" cases, 39.8% were "good" cases and 3.2% were "fair" cases, and at the end of 7 days of therapy, 67 patients were 74.6% "excellent" cases, 23.9% were "good" cases and 1.5% were "fair" cases. The clinical efficacy rate was thus quite high. Those cases in which the secretion and leukocytes had not disappeared from the urine even at the end of the 7 days of therapy were probably cases of mixed infection involving Chlamydia, etc. Eight of the 77 gonococcal isolates (10.4%) were beta-lactamase producers. The MIC of AT-2266 hardly differed with the size of the bacterial inoculum. With an inoculum of 10(6)CFU/ml, the MIC distribution showed two peaks, i.e., at 0.05-0.2 micrograms/ml and 3.16-12.5 micrograms/ml. Only 11.7% of the strains were found to have high MICs. The distribution of these high MICs was found to be unrelated to the ability to produce beta-lactamase. Mild side effects of AT-2266 were seen in 2 out of 128 patients. (1.6%), an extremely low incidence.