ポリミキシンBによる術後洗浄の経験

Abstract

In twelve cases in which the operation of the lower urinary tract had been performed, a catheter was retained in the urethra and a cystostomy was temporarily placed after operation for draining out urine. The equipments as shown in Fig. 1 and 2 were employed. The equipments were set in such a way as 0.01 % Polymyxin solution may intermittently irrigate the bladder. 1) The amount of the solution was set at 500~2, 000ml per day, and the amount of infusion was determined in accordance with the capacity of the bladder of the patient. Frequency of irrigation was once every 30 minutes or every two hours. 2) As the control, the bladder of a postprostatectomy patient was irrigated with normal saline. This irrigation helped removing such factors responsible for prolonging urinary infection as mentioned by Boyce et al. 3) Nine cases showed good results, two of the bladder and seven of the prostatic operations. The effectiveness was also apparent in one patient with diabetes in view of uneventful course with primary closure of the operative wound. Thus, only in one case, it was judged ineffective. 4) Except for a case in which a three way catheter was blocked causing trouble in urinary drainage, no untoward effect was experienced in the series of the treatment. 5) 124 strains from positive urine culture during 1968-1969 were tested for their sensitivity to Polymyxin B by the three concentration disc method. The over-all positive sensitivity rate was 62.1%. Of these bacteria, E.coli gave 96.8 %, Klebsiella 86.7 %, Pseudomonas 90 %, Proteus 11.1 % and Citrobacter 40 %. The gram negative group thus showed high susceptibility.