[Chemotherapy in the treatment of infections--basis and proper use of antibiotics].
There have been changes of pathogenic microorganisms (pathogens) and conditions of diseases in the field of obstetrics-and-gynecologic infections. Infections caused by weak-bacteria, i.e., opportunistic infections, have increased in the bacterial infections of genital organs. Increase of compromised hosts is one of the contributing factors to such increase. On the other hand, advance of chemotherapy plays a major role in the treatment of infections and many antibiotics including beta-lactam antibiotics (penicillins and cephalosporins), new quinolones and others have been introduced in the recent few years. When history of development of antibiotics and changes of pathogens in obstetrics-and-gynecologic infections are reviewed, it is noticeable that significance of gram negative bacilli (including anaerobic bacilli) has increased, and complicated infections (aerobes plus anaerobes) account for two thirds of the infections. Consequently, emphasis has been placed on the development of antibiotics which should be effective for these pathogens, and beta-lactam antibiotics such as penicillins and cephalosporins are the main flow of the recent antibiotics. However, in consideration of potentiated antibacterial activity and pharmacokinetics, new antibiotics of a little different usage and selection from the prevailing ones are in demand. Thus, the contents of chemotherapy have been changed as well as the changes of pathogens. Antibiotics have specific mode of action and point of action respectively and they show respective characteristics in their pharmacokinetics (serum concentration, urinary excretion and transfer into genital tissues).(ABSTRACT TRUNCATED AT 250 WORDS)
Matsuda
S
S
Kotoh Hospital, Tokyo.
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000378:metabolism; D002511:Cephalosporins / Q000493:pharmacokinetics / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005831:Genital Diseases, Female / Q000188:drug therapy; D005836:Genitalia, Female / Q000378:metabolism; D006090:Gram-Negative Bacteria; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D014018:Tissue Distribution
D000900:Anti-Bacterial Agents; D002511:Cephalosporins