術後尿路内カテーテル留置例におけるSB-PC大量投与およびSB-PC,DKB併用投与による尿路感染の予防的効果

Abstract

Twenty-two postoperative patients carrying indwelling catheter in the lower urinary tract were treated with "massive doses" of sulbenicillin (SB-PC) and by concomitant administration of SB-PC and 3’, 4’-dideoxykanamycin (DKB) for prevention of urinary tract infections. The infections were prevented well in 9 out of the 15 cases given 10 g/day of SB-PG The 7 cases which failed to respond to the preventative therapy were all those carrying the catheter for 7 days or longer. Good prophylactic effect was recognized in all the 7 cases treated with concomitant administration of 4 g/day of SB-PC and 100 mg/day of DKB. As side effect was noted a rise of transaminase value in 3 of the 15 cases given 10g/day of SB-PC, which returned to normal value after discontinuation of medication. Excretion pattern of SB-PC and DKB was also investigated. SB-PC was found to be rapidly excreted in the urine after administration, and duration of the effective SB-PC concentrations in the urine was also satisfactory when judged from the values measured for 6 hours. Urinary excretion of DKB was also good and clinically sufficient DKB concentrations were obtained. Thus, it was found that urinary tract infections were successfully prevented by concomitant administration of SB-PC and DKB in postoperative patients carrying indwelling catheter, though the number of cases employed is as small as 7. It is, however, hard to think of prevention of urinary tract infections in patients carrying indwelling catheter ignoring care of the urinary tract and, therefore, it would be necessary to employ the sterile closed catheterization.