Imipenem/Cilastatin sodium(MK-0787/MK-0791)の泌尿器科領域における長期投与対象の選択と治療成績の検討

Abstract

MK-0787/MK-0791をUTIを主とした感染症や, 感染防止目的で35例36回, 原則として1日0.5 g×2を10日間以上にわたり投与した.1)評価可能26例で有効以上は, 治療初期で88.5%, 終了時で92.3%であった.有用性についても全く同様の成績を得た.P. aeruginasa等を含む分離菌35株の全てが治療後除菌された.投与後出現菌は, 真菌類が多かった.2)長期投与の方が短期投与に比べて, 有用性が高い傾向を認めた.3)副作用として, 嘔吐による中止例が1例あった.臨床検査値異常では, 血小板減少1件, 好酸球増多1件, GOT上昇2件, GPT上昇3件, γ-GTP上昇1件をみたが, 変動幅は小さく, 中止により可逆的であった

MK-0787 (Imipenem)/MK-0791 (Cilastatin sodium), a new compound of Thienamycin, was administered in treatment of 35 patients (36 cases) with chronic complicated UTI or for prevention of serious infections with much complicated factors. The patients were principally treated at a daily dose of 1 g for over 10 days. The efficacy rate of 26 patients who were evaluable in the early phase (4-7 days) was 88.5%, while it became up to 92.3% in the final phase judgment. As for clinical usefulness, the result was obtained to be as high as that of the clinical efficacy. In bacteriological study, 35 strains were clinically isolated including 7 strains of P. aeruginosa from UTI. All the strains disappeared with an eradication rate of 100% after treatment. Strains appearing after Imipenem/Cilastatin sodium treatment mainly consisted of fungi. Usefulness judgements tended to be greater in the final phase than in the early phase. As for side effects, vomiting was recorded in one case, in which the administration was discontinued. In laboratory findings there were 3 cases with elevated GPT, 2 cases with elevated GOT, one case with elevated gamma-GTP, one with thrombocytopenia, and one with eosinophilia each, but these abnormal values were slight and transient. In summary our clinical study showed that Imipenem/Cilastatin sodium was a very effective antibiotic in treatment on moderate or serious UTI or preventive use for infections in compromised hosts. Considering the features of this agent, it might be more effective and useful for clinical use in treatment on polymicrobial infections including stubborn organisms than any other antimicrobial compounds. Furthermore, it was safe and well tolerable in a long term treatment.