[Efficacy of combination therapy against MRSA in Ibaraki Prefecture].
Clinical efficacies of fosfomycin (FOM) or arbekacin (ABK) plus beta-lactam combination therapies against methicillin-resistant Staphylococcus aureus (MRSA) infections were examined in 15 major hospitals in Ibaraki Prefecture. The subjects were 54 inpatients from January 1991 to April 1993, and most of them showed moderate to severe infections with underlying diseases. MRSA alone was isolated from 23 patients and the other 31 patients had polymicobes including MRSA. Pseudomonas aeruginosa was the most frequent among the co-isolated strains. The number of patients treated with FOM and cefmetazole (CMZ) was 22 (Group C) and that with FOM and flomoxef (FMOX) was 25 (Group F). CMZ or FMOX was administrated 60 minutes after FOM administration. To 8 nonresponding patients in Groups C and F and 7 nonresponders to the other therapies, ABK and ceftazidime (CAZ) or ABK and piperacillin (PIPC) were treated simultaneously (Group A). The clinical efficacies of Groups C and F were 63.6% and 64%, respectively. The bacteriological efficacies (eradication rates) of both groups including microbial substitutions were 42.9% in the former and 56.5% in the latter. No statistical differences were observed in the clinical and the bacteriological efficacies between Groups C and F. The clinical and bacteriological efficacies in Group A were 66.7% and 46.2%, respectively. No side effects were observed in any cases. Mild disturbances of hepatic functions were observed in 2 cases of Groups C and F, and there were no abnormal laboratory test results in Group A.(ABSTRACT TRUNCATED AT 250 WORDS)
Otsuka
M
M
University of Tsukuba.
Sawahata
T
T
Nakai
T
T
Hasegawa
S
S
Iwata
S
S
Yoshizawa
Y
Y
Ishida
H
H
Irokawa
M
M
Goto
A
A
Shinohara
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003982:Dibekacin / Q000031:analogs & derivatives / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005578:Fosfomycin / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007564:Japan; D007769:Lactams; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D007769:Lactams; D005578:Fosfomycin; D003982:Dibekacin; C031986:arbekacin