[Clinical efficacy of arbekacin in deep MRSA infection. Including follow-up study after the termination of chemotherapy].
We analyzed the efficacy of arbekacin (ABK) using monotherapy or combined therapy on deep MRSA infection to find the most adequate usage of the drug. We also followed-up the isolation incidence of MRSA after the end of chemotherapy. The results are summarized as follows: 1. Clinical efficacy of ABK on 29 pneumonia and 3 septicemia due to MRSA was 42.9% in ABK monotherapy (9 patients), 62.5% in combined therapy with ABK and minocycline (9 patients), 100% with ABK and imipenem/cilastatin (IPM/CS) (7 patients), and 100% with ABK and other drugs (7 patients). 2. As for microbiological efficacy, combined therapy with ABK and IPM/CS or other drug was superior to other methods. Among patients from whom two or more species of bacteria were isolated, causative bacteria persisted in many cases, and some replacements occurred. 3. Kidney functions deteriorated in two patients that underwent monotherapy or combined therapy with ABK and IPM/CS, but they recovered when therapy was completed the completion. 4. In the three month follow-up study after ABK therapy, we found four cases of renewed infections after disappearance of MRSA. When just decreases in the number of MRSA resulted upon the chemotherapy, the relapse occurred in all cases. 5. Above results indicate that ABK is effective in MRSA infection, and combined therapy with beta-lactams is superior to other methods in serious MRSA infections. We also suggest that chemotherapy should be continued until the complete disappearance of MRSA is achieved.
Kuwabara
M
M
Department of Internal Medicine, Hiroshima Prefectural Hospital.
Konishi
F
F
Yokoyama
T
T
Kodama
T
T
Santoh
T
T
Nakai
S
S
Miyoshi
N
N
Kurimura
T
T
Miyazawa
T
T
Arita
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015377:Cilastatin / Q000627:therapeutic use; D003982:Dibekacin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007668:Kidney / Q000187:drug effects; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D012008:Recurrence; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D015377:Cilastatin; D003982:Dibekacin; D015378:Imipenem; D008911:Minocycline; C031986:arbekacin