[Laboratory and clinical evaluation of cefmetazole in the newborn infants (author's transl)].

1. Medium to large amount of CMZ (100-270 mg/kg/day) was administered to 4 cases of neonatal infants having severe infections due to pathogenic E. coli and sepsis due to E. coli CMZ was remarkably effective in all cases, and the causative bacteria disappeared in 100%. 2. Among 10 cases which administered CMZ, 5 cases showed side effect. Eruption, diarrhea and increase of GOT, GPT and LDH activities were observed but no case suggested interruption of administration. 3. Blood level of CMZ was determined in 4 cases of 0-1 day old, premature infants. The half life of CMZ was 8.55-15.3 hours, prolonged considerably, and 12 hours after one shot (20 mg/kg) of intravenous CMZ administration, 20.2 microgram/ml of blood level was maintained. 4. Intraspinal CMZ level was determined in aseptic meningitis. When one shot 50 mg/kg CMZ was given intravenously, intraspinal CMZ levels after 30 minutes and 1 hour were 20.3 microgram/ml and 34.5 microgram/ml, respectively, and distribution of CMZ in the cerebrospinal fluid was shown to be excellent. 5. Exchange blood infusion (amount of exchange, 170 ml/Kg) was performed in a small premature newborn baby, and blood transformation of CMZ was examined. It was found as the result that the blood level of CMZ was decreased to 53% of the pretreated level. 6. MIC of CMZ was examined in 3 strains of E. coli isolated from blood and cerebrospinal fluid. MICs were 0.39-0.78 microgram/ml when 10(6)/ml was inoculated and 0.78-1.56 when 10(8)/ml was inoculated.

[Clinical evaluation of cefotiam therapy in children (author's transl)].

Cefotiam (CTM) was evaluated for its safety and efficacy in children. Twenty-six patients were treated with 40 to 200 mg/kg per day of CTM by intravenous administrations. The diagnosis of the patients were acute pharyngitis (2), acute bronchitis (1), pneumonia (4), empyema (2), urinary tract infection (2), typhoid fever (1), acute enterocolitis (2), partially-treated purulent meningitis (1), and suspected septicemia in neuroblastoma (1); and the remaining ten patients were considered to have nonbacterial infections. The pathogens recovered were Streptococcus pyogenes (1), Streptococcus pneumoniae (1), Staphylococcus aureus (4), Haemophilus influenzae (4), Escherichia coli (1), enteropathogenic Escherichia coli (1), Salmonella typhi (1), and Campylobacter jejuni (1). All but two patients of bacterial infections were cured after the CTM therapy, and the rate of efficacy was 87.5%. Diarrhea (3), urticaria (1), transient elevation of GOT and GPT (1), and transient eosinophilia (3) were found to be associated with the CTM therapy. However, no severe adverse reactions were encountered. Half life of the serum CTM level was 0.93 +/- 0.13 hours, and excretion into the urine was rapid. CSF concentration obtained 1 hour after an intravenous injection of 21 mg/kg of CTM in a case with inflamed meninges was 1.5 mcg/ml, and the CSF/serum ratio was 9.0%. From these data, CTM appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections.

[Clinical evaluation of 6059-S therapy in children (author's transl)].

A new semisynthetic 1-oxa-beta-lactam derivative, 6059-S, was evaluated for its safety and efficacy in children. Twenty-five patients were treated with 10 to 274 mg/kg per day of 6059-S by intravenous administrations. The diagnosis of the patients were acute pharyngitis (2), acute bronchitis (2), pneumonia (4), pertussis (4), acute enterocolitis (2), recurrent urinary tract infection (2), suspected septicemia (3), and acute purulent meningitis (1); and the remaining 5 patients were considered to have nonbacterial infections. The pathogens recovered were Streptococcus pneumoniae (1), Haemophilus influenzae (4), Haemophilus parainfluenzae (1), Enterobacter cloacae (1), Enterobacter aerogenes (1), Proteus morganii (1), Psuedomonas aeruginosa (2) and Salmonella typhimurium (1). All the patients of bacterial infections were cured after the 6059-S therapy. However, Pseudomonas aeruginosa and Salmonella typhimurium were not eradicated after the 6059-S therapy, and the rate of bacterial disappearance was 75%. Diarrhea (3), precordial pain (2, only in cases with high-dose therapy), transient elevation of GOT and GPT (2), and transient eosinophilia (2) were found to be associated with the 6059-S therapy. However, no severe adverse reactions were encountered. Half life of the serum 6059-S level was 1.34 +/- 0.16 hours. CSF concentrations in a case with Haemophilus influenzae meningitis ranged 4.0 to 9.7 mcg/ml after an intravenous injection of 34.3 to 75 mg/kg of 6059-S. From the present study, 6059-S appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections. It remains to be further determined whether 6059-S is superior to ABPC in the treatment of Haemophilus influenzae meningitis.

[Clinical evaluation of cefoxitin in children (author's transl)].

Cefoxitin (CFX) was evaluated for its safety and efficacy in children. Fifteen patients were treated with 73-125 mg/kg per day of CFX by intravenous administrations. The diagnosis of the patients were acute pharyngitis (4), pneumonia (2), pertussis and pneumonia (1), urinary tract infection (3); and the remaining 5 patients were esteemed to have nonbacterial infections. All the 10 patients of bacterial infections were cured after the CFX therapy. The pathogens recovered were Streptococcus pyogenes (1), Streptococcus pneumoniae (3), Haemophilus influenzae (2), Escherichia coli (2), enteropathogenic Escherichia coli (1), and Klebsiella pneumoniae (1). All the strains isolated were susceptible to CFX, but the 2 isolates of Haemophilus influenzae had relatively high MIC values (12.5 mcg/ml). Diarrhea (3 cases) and transient neutropenia (1 case) were found to be associated with the CFX therapy. However, no severe adverse reactions were encountered. Half-life of the serum level was short (24.1 minutes) and excretion into the urine was rapid. CSF concentration obtained 30 minutes after an intravenous injection of 50 mg/kg of CFX in 1 case with inflamed meninges was considerably high (8.3 mcg/ml). CFX appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections.

[Clinical studies on cefoperazone in the pediatric field (author's transl)].

Cefoperazone (CPZ) at dose levels of 80 approximately 100 mg/kg/day, divided 3 approximately 4 times, was drip-infused or intravenously injected for a period of 2 approximately 6 days to 10 patients. All 10 cases, 4 cases of bronchopneumonia from which H. influenzae was detected (Group A S. pyogenes and S. pneumoniae were also detected in each 1 case). 2 cases of coli urinary tract infection, 1 case of acute colitis from which pathogenic E. coli was detected, 1 case of E. coli carrier, 1 case of acute bronchitis (bacteria were not detected), and 1 case of urinary tract infection (bacteria were not detected) showed rapid improvement of clinical symptoms with rapid eradication of the pathogenic bacteria. In one case of urinary tract infection where S. epidermidis and S. faecalis were simultaneously detected, S. epidermidis was removed but S. faecalis was merely decreased. The effective antibacterial concentration after intravenous injection of CPZ in the feces was determined and found to be present in sufficient concentrations to prevent colon infection. No particular side effects were observed during CPZ therapy.

[Clinical experience with cefuroxime in pediatric field (author's transl)].

Cefuroxime (CXM) was administered to 11 patients with pediatric bacterial infections, and clinical effective results were obtained in all these cases. Causative organisms detected in 5 cases with respiratory tract infection, and with urinary tract infections were all eliminated, and the bacterial count decreased in patients with colitis. As for side effect, 1 case developed eosinophilia, and another case with impaired liver function as underlying disease showed transitory exacerbated examination values. Time-course determinations of blood levels and urinary excretions were performed in 1 case. Fecal levels were determined in 2 cases but could not be detected; inactivation action of CXM was observed from the same fecal filtrate.