複雑性尿路感染症に対するメリシンの治療効果にかんするopen study

Abstract

An open study was performed in order to evaluate usefulness of pivmecillinam in treatment for chronic complicated urinary tract infections. Pivmecillinam was orally given to 108 patients for 5 consecutive days in daily dosage of 300 to 400 mg a day. Thirty-eight of the 108 patients were excluded from the evaluation analysis by either of the following reasons: 1) Bacterial count less than 10[3] cells/ml. 2) Pyuria of less than 5 white blood cells/hpf. 3) Pseudomonas aeruginosa is considered causa tive. 4) Not fully documented protocols. Percentage of response ('excellent' and 'good') in the 68 pivemecillinam-treated patients was 55.9% as to overall clinical response, 48.5% as to improvement or elimination of bacteriuria, and 54.1% as to pyuria. Improvement of the infection was observed in 29.496 of patients in whom a catheter was left indwelled, while in 64.796 of patients without inlying catheter. Bacteriologically, pivmecillinam was effective in 65.4% of patients with E. coli infection and 47.1% of patients with Klebsiella infection. Disc sensitivity test using Mast one-concentration disc (Mast Laboratories Ltd., Liverpool, England) showed that 70.7% of E. coli and 41.7% of Klebsiella were sensitive to pivmecillinam. Adverse reactions were not encountered at all during a period of the study. All pivmecillinamadministered patients but 4 showed normal levels of laboratory examinations after the treatment. Slight decrease of red blood cell count in 1 patient, slight decrease of white blood cell count in 2, and slightly increased levels of GOT and GPT in 1 were noted.