title: [Clinical effect of the combined therapy of arbekacin and imipenem/cilastatin against methicillin-resistant Staphylococcus aureus].
abstract: We evaluated the efficacy of combined therapy of arbekacin (ABK) and imipenem/cilastatin (IPM/CS) against infections by methicillin-resistant Staphylococcus aureus (MRSA). The MICs of ampicillin, cefmetazole, cefotiam, cefuzonam, flomoxef, fosfomycin, ofloxacin, minocycline, ABK and IPM/CS against clinically isolated strains of MRSA were examined. Almost all strains of MRSA were resistant to these antibiotics except ABK. Furthermore, combination of ABK and IPM/CS showed smaller MICs than that of ABK or IPM/CS alone. All fractional inhibitory concentration indices (FIC indices) of ABK plus IPM/CS were lower than 0.75. The efficacy rate of combined therapy of ABK and IPM/CS in 22 patients with MRSA infections (15 patients with pneumonia, 3 patients with chronic bronchitis, 2 patients with sepsis, a patient with subcutaneous abscess and a patient with DPB) was 68%. And no patients had adverse reactions. Six (27%) of 22 strains of MRSA were eradicated. Significant correlations were found between bacteriological effect and severity of disease, and between serum albumin level and clinical effect.
authors.affiliation: Second Department of Internal Medicine, School of Medicine, Nagasaki University.
authors.forename: A
authors.initials: A
authors.lastname: Hashimoto
authors.forename: T
authors.initials: T
authors.lastname: Ohtsubo
authors.forename: K
authors.initials: K
authors.lastname: Tomono
authors.forename: M
authors.initials: M
authors.lastname: Kaku
authors.forename: H
authors.initials: H
authors.lastname: Koga
authors.forename: S
authors.initials: S
authors.lastname: Kohno
authors.forename: K
authors.initials: K
authors.lastname: Hara
authors.forename: H
authors.initials: H
authors.lastname: Sugiyama
authors.forename: K
authors.initials: K
authors.lastname: Taira
authors.forename: Y
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D015377:Cilastatin / Q000494:pharmacology / Q000627:therapeutic use; D003982:Dibekacin / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015378:Imipenem / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects*
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D015377:Cilastatin; D003982:Dibekacin; D015378:Imipenem; C031986:arbekacin