(特集：PIVMECILLINAMによる尿路感染症の治療) 複雑性尿路感染症に対するPivmecillinamの臨床評価 - Nalidixic acidとの比較成績 -

Abstract

To 156 complicated urinary tract infection cases (all no cathterindwelt cases) daily 300 mg of pivmecillinam or 1, 500 mg of nalidixic acid were administered for 14 days at random, and the efficacy and safety were compared. (1) Regarding overall clinical efficacy rate according to ‘Criteria for Clinical Evaluation in Complicated Urinary Tract Infection’ recommended by the Japan Society of Chemotherapy, it was 58.8% in the pivmecillinam group and 28.9% in the nalidixic acid group after one week administration, and it was 64% and 44% respectively after 2 week administration. (2) In case of clinical efficacy by doctor's judgement, the efficacy rate of the pivmecillinam group was 60 % and that of the nalidixic acid group 41.2% after one week administration. It was 57.1% and 38.0% respectively in case of the judgement after 2-week administration. (3) As for the anti-bacteriological effect, E. coli was eradicated in 83.3% of the pivmecillinam group and in 52.9 % of the nalidixic acid group after one week administration, which was 79.2% and 69.2% respectively after 2-week administration. Though high bacteriological eradication rate was observed also in case of Klebsiella, Citrobacter and Proteus, statistical analysis was impossible because of the lack of number of strains. (4) Side effects, such as mild gastrointestinal trouble, were observed in 4 cases of the pivmecillinam group and 3 cases of the nalidixic acid group. Abnormal change of laboratory findings was not observed in the pivmecillinam group and one case of mild elevation of GOT and GPT values as well as one case of mild elevation of BUN and creatinine values in the nalidixic acid group. Thus, pivmecillinam seems to be the quite useful drug for the treatment of complicated urinary tract infection (no cathter in dwelt cases).