학술논문

EFFICACY OF COMBINATION THERAPY AGAINST MRSA IN IBARAKI PREFECTURE / 茨城県におけるMRSA感染症に対する併用療法についての検
Document Type
Journal Article
Source
The Japanese Journal of Antibiotics. 1994, 47(6):781
Subject
Language
Japanese
ISSN
0368-2781
2186-5477
Abstract
Clinical efficacies of fosfomycin (FOM) or arbekacin (ABK) plus β-lactam combination therapies against methicillin-resistant Staphylococcus aureus (MRSA) infections were examined in 15 major hospitals in Ibaraki Prefecture. The subjects were 54 inpatients from January 1991 to April 1993, and most of them showed moderate to severe infections with underlying diseases. MRSA alone was isolated from23patients and the other 31 patients had polymicobes including MRSA Pseudomonas aeruginosa was the most frequent among the co-isolated strains. The number of patients treated with FOM and cefmetazole (CMZ) was22 (Group C) and that with FOM and flomoxef (FMOX) was25 (Group F). CMZ or FMOX was administrated 60minutes after FOM administration. To 8 nonresponding patients in Groups C and F and 7 nonresponders to the other therapies, ABK and ceftazidime (CAZ) or ABK and piperacillin (PIPC) were treated simultaneously (Group A).The clinical efficacies of Groups C and F were63.6%and 64%, respectively. The bacteriological efficacies (eradication rates) of both groups including microbial substitutions were 42.9% in the former and56.5%in the latter. No statistical differences were observed in the clinical and the bacteriological efficacies between Groups C and F. The clinical and bacteriological efficacies in Group A were 66.7%and 46.2%, respectively.No side effects were observed in any cases. Mild disturbances of hepatic functions were observed in2 cases of Groups C and F, and there were no abnormal laboratory test results in Group A.The combination therapy with FOM plus β-lactam may be useful for the treatment of MRSA infections, but the ABK plus CAZ or PIPC combination is more effective to the patients with multi-drug-resistant MRSA infections.