Cefmetazole sodiumによる尿路感染予防および治療効果の臨床的検討

Abstract

The in vitro antibacterial activity of cefmetazole sodium on four kinds of clinically isolated bacterial species was determined, and the clinical effect of the drug in 20 cases of postoperative or chroniccomplicated urinary tract infection was studied. l) The maximum sensitivity distribution rate was under 1.56 µg/ml of MIC either on 10[6]cells/ml or 10[8]cells/ml of inoculum size in 25 strains of E. coli, 25 strains of Klebsiella pneumoniae, 25 strains of Genus proteus and 20 strains of Staphylococcus aureus. This indicates that the antibacterial activity of cefmetazole sodium was little influenced by the inoculum size of any of the bacterial species. 2) The patients were 13 males and 7 females with a mean age of 56.7 years. The cause of urinary tract infection was urological tumors in 6 cases, urolithiasis in 4 cases, neurogenic bladder in 3 cases, trauma in 2 cases, inflammation in 2 cases and others in 3 cases. Various operations were performed on 15 patients, and the other 5 patients were not operated on. Catheters were inserted into the urethra or renal pelvis, or ureterocutaneostomy was done in 13 cases; 7 patients did not have catheters inserted. 3) Two to 4 g of cefmetazo1e sodium per day was administered intravenously. The mean duration of chemotherapy was 9.3 days and mean total dose of administration was 25.5 g. 4) The clinical effect of the drug was judged good, unchanged or poor chiefly based on the change of urinalyses. Depending on these criteria, 4 cases which were determined unchanged, were finally judged good as all of them had had catheters inserted. Overall results were good in 12 cases and poor in 8 cases. Effective rate, therefore, was 60%. 5) Comparison of the effectiveness of the drug for the patients who had had catheters inserted to those who had not, showed that the administration of cefmetazo1e sodium was also effective in treating chronic urinary tract infection even when catheters were used. A good effect was seen in 6 of the 7 cases (86%) in which catheters were not used, and in 6 of the 13 cases (46%) in which catheters were used.