title: [Clinical evaluation of the combination of carumonam and fosfomycin in the treatment of complicated urinary tract infection].
abstract: Carumonam (CRMN), the first monobactam antibiotic in Japan, has excellent activity against gram-negative bacteria and is useful in the treatment of urinary tract infections. However, it may be insufficient in the treatment of complicated urinary tract infections because of the increase in isolation of gram-positive bacteria, and it may be necessary to co-administer antibiotics active against gram-positive organisms to achieve a broader spectrum of coverage in connection with severe infections. The combination of CRMN and fosfomycin (FOM) was evaluated for its effectiveness and safety at the Department of Urology, Yamagata University Hospital and 7 affiliated hospitals. Clinical efficacy was assessed on 64 patients with complicated urinary tract infection according to the Criteria for Clinical Evaluation of Antimicrobial Agents in UTI (3rd. ed.) recommended by the Japan UTI Committee. Clinical efficacy was evaluated as excellent in 16, moderate in 32, poor in 16, with an overall clinical effectiveness rate of 75.0%, which is superior compared with CRMN alone. Of the total of 92 bacterial strains isolated, 66 (71.7%) were eradicated. Subjective adverse reaction was seen in 1 patient (1.4%), as nausea and anorexia. Slight increases in serum GOT and GPT ware recorded in 5 patients (7.1%). These findings disappeared after the termination of administration without treatment. The combination of CRMN and FOM might therefore be useful in the treatment of complicated urinary tract infections.
authors.affiliation: Department of Urology, Yamagata University School of Medicine.
authors.forename: H
authors.initials: H
authors.lastname: Kakizaki
authors.forename: N
authors.initials: N
authors.lastname: Ishii
authors.forename: S
authors.initials: S
authors.lastname: Murakami
authors.forename: K
authors.initials: K
authors.lastname: Suzuki
authors.forename: A
authors.initials: A
authors.lastname: Takamizawa
authors.forename: J
authors.initials: J
authors.lastname: Hirano
authors.forename: K
authors.initials: K
authors.lastname: Mitobe
authors.forename: M
authors.initials: M
authors.lastname: Saito
authors.forename: K
authors.initials: K
authors.lastname: Hirano
authors.forename: A
authors.initials: A
authors.lastname: Imamura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001398:Aztreonam / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002908:Chronic Disease; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005578:Fosfomycin / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D005578:Fosfomycin; C044145:carumonam; D001398:Aztreonam