Norfloxacinの慢性前立腺炎に対する治療効果

Abstract

慢性前立腺炎74例に対しnorfloxacin (NFLX) 600 mg/日を原則として4週間投与し検討した.総合臨床効果を前立腺分泌液(EPS)中細菌, 白血球, 自覚症状の3つの要因で判定してみると, グラム陰性桿菌(GNR)群の総合有効率は2週目71.4%, 4週目100%, グラム陽性球菌(GPC)群のそれはそれぞれ79.3%, 88.0%と良好であった.治療前のEPS分離細菌数103CFU/ml未満であった症例の総合臨床効果をEPS中白血球, 自覚症状の2つの要因で判定してみると, その総合有効率は2週目89

The clinical efficacy of norfloxacin (NFLX) was evaluated in 74 patients having chronic prostatitis with the subjective symptoms suggesting the inflammations of prostate and more than five white bloodcells (WBCs)/hpf in their prostatic secretions (EPS). Of these, gram negative rods with greater than or equal to 10(3)CFU/ml (GNR group) were isolated from the EPS in 10 patients (13.6%) and gram positive cocci with greater than or equal to 10(3) CFU/ml (GPC group) were obtained in 46 patients (62.2%). E. coli (70.0%) was the most frequent strain isolated among GNR group and S. epidermidis (40.4%), S. aureus (19.1%), E. faecalis (17.0%) and S. haemolyticus (14.9%) were frequently isolated among the GPC group. The overall clinical efficacy of NFLX was determined at the second and fourth week by the three factors, (1) the effect on bacteria, (2) WBCs in the EPS and (3) the subjective symptoms in the patients with bacteria of greater than or equal to 10(3) CFU/ml being isolated. The overall clinical effectiveness rate was 71.4% and 100%, respectively, in the GNR group. In the GPC group, its rate was 79.3% and 88.0%, respectively. The patients with no bacteria or less than 10(3) CFU/ml isolated from the EPS had an overall clinical effectiveness rate of 89.8% at the second week and 90.0% at the fourth, when it was evaluated by the effect on WBCs and subjective symptoms. In the effect of NFLX on bacteria in the EPS, it eliminated them in 75.0% and 83.9% at the second and fourth week, respectively, of all patients with GNR or GPC of greater than or equal to 10(3) CFU/ml isolated from the EPS. The minimum inhibitory concentrations (MIC) of NFLX against E. coli isolated from the EPS was distributed from 0.025 microgram/ml to 3.13 micrograms/ml with most below 0.1 microgram/ml. Those against all other GNR were below 0.78 microgram/ml. NFLX showed good antimicrobial activities against GPC with most of MIC being distributed from 0.78 microgram/ml to 1.56 micrograms/ml. NFLX produced the highest eradication rate in bacteriological response not only against GNR such as 100% at the first, the second and fourth week but GPC as 89.2%, 93.8% and 96.0%, respectively. In the effect of NFLX on WBCs in EPS, 40-50% of patients got free from the inflammation of prostate by NFLX treatment. This became prominent in the GNR group as the treatment was continued although not in the GPC group. The subjective symptoms were improved by NFLX treatment in most of the patients.