[Staggered intensive chemotherapy using arbekacin, fosfomycin and ceftazidime on polymicrobial infections involving MRSA].
Bacteriological and clinical studies were carried out on staggered intensive chemotherapy regimen for methicillin-resistant Staphylococcus aureus (MRSA) infections combined with Gram-negative opportunistic pathogens as polymicrobial infections. The regimen consisted of administering ceftazidime (CAZ) 30 minutes after infusion of arbekacin (ABK) and a bolus injection of fosfomycin (FOM). The combination of these drugs strongly inhibited the growth of MRSA and Pseudomonas aeruginosa. By this combination treatment, both of MRSA and P. aeruginosa in mixed culture became more susceptible to killing by macrophages. We evaluated the clinical efficacy and safety of combination of ABK, FOM and CAZ in the treatment of 15 patients with MRSA infections. The total efficacy rate was 80.0% and the bacterial eradication rate of MRSA was 60.0%. It is considered that staggered intensive chemotherapy with ABK, FOM and CAZ is useful for such polymicrobial infections involving MRSA.
Tanaka
T
T
1st Department of Internal Medicine, Kagawa Medical School.
Iida-Tanaka
K
K
Takahara
J
J
Fujioka
Y
Y
Tamura
T
T
Yamanoi
Y
Y
Houjou
S
S
Takahashi
T
T
Miki
S
S
Nakamura
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D002442:Ceftazidime / Q000008:administration & dosage / Q000494:pharmacology; D003982:Dibekacin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000494:pharmacology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D005578:Fosfomycin / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D005578:Fosfomycin; D003982:Dibekacin; D002442:Ceftazidime; C031986:arbekacin