[Clinical studies and morphological response on ST-95 (fosfomycin)].
Clinical effects of ST-95 (fosfomycin) on infections of the urinary tract were studied on the basis of morphological changes of the urinary bacteria. The subjects were 22 inpatients with complex infections of the urinary tract. ST-95 was dissolved in physiologic saline (2 g/100 ml) and administered intravenously by drip infusion over a 1-hour period twice daily for 5 days. According to the UTI criteria, the treatment was effective in 13 (81%) of the 16 evaluable cases. The present effectiveness in 8 patients with chronic catheterization was 75%. No side effects were observed in any patient. Among the laboratory data, GOT and GPT were slightly increased in 1 patient, but their relations with the treatment were unknown. In one patient (P. vulgaris; MIC: 12.5 micrograms/ml), changes in the urinary ST-95 concentration, viable bacterial count, and morphology of the bacteria were studied after the initial administration. The urinary viable cell count was 1.5 x 10(7) cells/ml before administration, but it was reduced to 1.6 x 10(4) cells/ml at the end of the 1-hour infusion, and decreased progressively thereafter to complete disappearance after 12 hours. Under differential interference microscopy, filamentous debris of bacteria and spherical bacteria with irregular surface were observed from immediately after the end of the administration. By transmission electron microscopy, the cell wall showed a number of projections with formation of vacuolar structures in the space between the cell wall and the irregularly-shaped cytoplasms. In conclusion, the results of administration of ST-95 in complex infections of the urinary tract were satisfactory. The morphological changes of the bacteria suggested that this agent acts at an early stage of cell wall synthesis.
Washida
H
H
Department of Urology, Anjo Kosei Hospital.
Watanabe
H
H
Noguchi
Y
Y
Kato
M
M
Tozawa
K
K
Inuzuka
K
K
D001419:Bacteria / Q000187:drug effects* / Q000648:ultrastructure; D015169:Colony Count, Microbial; D005578:Fosfomycin / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008855:Microscopy, Electron, Scanning; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology* / Q000652:urine; D014556:Urine / Q000382:microbiology*
D005578:Fosfomycin