dibekacin and Urinary-Tract-Infections

A clinical investigation was carried out to evaluate arbekacin, an aminoglycoside, in the treatment of MRSA infections (pneumonia, septicemia, etc.) of pediatric patients. The obtained results are summarized as follows. 1.. Excluding those patients who met the present exclusion criteria and withdrawal cases from a total of 18 patients, 10 patients (3, 6, and 1 cases of septicemia, pneumonia, and urinary tract infection, respectively) were subjected to clinical evaluation. These were composed of 1, 1, 6, and 2 cases of neonate, infants, pre- and school age children, respectively. Excellent, good and fair results were obtained in 5, 2, and 3 patients, respectively; thus, the efficacy rate was 70.0%. The efficacy rate by disease was 100%, 50.0% and 100% in septicemia, pneumonia, and urinary tract infection, respectively. The bacteriological eradication were obtained in 70.0% of the total patients; by disease, these rates were 100% and 50.0% in septicemia/urinary tract infection and in pneumonia, respectively. The MIC50 as well as the MIC80 against MRSA strains isolated from 9 patients were 0.39 microgram/ml and 1.56 micrograms/ml, respectively. No adverse reactions were observed in the 15 patients, while in laboratory test values, one case each out of 12 patients examined showed gamma-GTP elevation, proteinuria, and hematuria. 2. Pharmacokinetics: The pharmacokinetics of the agent was investigated in a total of 9 patients, which included 1 neonate and 4 cases each of pre- and school age children. The Cmax, 4.85-8.83 micrograms/ml, was observed immediately after the termination of the instillation. The T1/2's were 4.96 hours, 1.24-2.54 hours, and 1.78-1.88 hours in the neonate, the pre- and the school age children, respectively; in the neonate the half-life was longer. When 1.92-2.7 mg/kg were administered to 3 each of the pre- and school age children, urinary excretion rates in the first 6-8 hours were 40.1-56.5% of the dosages administered. In all cases, the urinary concentrations were highest in the first 2 hours, after the administration, and then gradually decreased. These results suggest that arbekacin is a useful antibiotic for treating MRSA infections in the pediatric field.

Topics: Adolescent; Aminoglycosides; Anti-Bacterial Agents; Bacteremia; Child; Child, Preschool; Dibekacin; Female; Humans; Infant; Infant, Newborn; Male; Methicillin Resistance; Pneumonia, Staphylococcal; Staphylococcal Infections; Staphylococcus aureus; Urinary Tract Infections

Dibekacin (DKB) was administered to patients with complicated urinary tract infections without any indwelling catheter to evaluate objectively and comparatively the efficacy, safety and usefulness of intravenous drip infusion once daily and twice daily in a well-controlled study. A 50 mg dose of DKB was administered twice a day to group A, and a 100 mg dose was given once a day to group B. In both groups the drug was given by 1-hr i.v. infusion for 5 consecutive days. Drug efficacy was evaluated in 72 (group A: 36, group B: 36) of the 83 patients treated, and the safety was evaluated on 81 patients (group A: 41, group B: 40). There were no significant differences in the background characteristics between the two groups. The overall clinical efficacy judged by the Committee for Evaluation of Clinical Efficacy was "excellent" in 14% and "moderate" in 50% of group A, and "excellent" in 17% and "moderate" in 64% of group B, the efficacy being higher for group B than group A, but the difference was not statistically significant. The overall drug efficacy rate for each type of infection excluding group 2, was slightly higher in group B, but this difference was not significant either. The overall clinical efficacy for each site of infection, was higher for group B but the differences were not significant. The overall clinical efficacy as judged by the attending physicians was "excellent" in 17% and "moderate" in 58% of group A, and "excellent" in 25% and "moderate" in 61% of group B. The intergroup difference was thus smaller than that judged by the Committee. The elimination rates against bacteriuria were 58% for both groups A and B, and the decrease rates including "cleared" were 42% against pyuria for both groups A and B. Bacteriological evaluation, showed that there was no significant difference in the eradication rates, between group A (65%) and group B (70%). But the eradication rate for gram-positive bacteria was 40% in group A and 81% in group B, there being a significant difference (P less than 0.05) between them. The evaluation of usefulness gave 44% and 53% "satisfactory" rates, respectively, for groups A and B. The results for the "average score" were also the same in both groups. There were no side effects in any of the 81 patients examined. Abnormal laboratory test values attributed to the drug were seen only in 3 and 2 patients in groups A and B, respectively, there being no difference between the groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Bacteria; Clinical Trials as Topic; Dibekacin; Drug Administration Schedule; Drug Resistance, Microbial; Female; Humans; Infusions, Parenteral; Kanamycin; Male; Middle Aged; Urinary Tract Infections

The bacterial strains isolated from 490 patients diagnosed as having urinary tract infections (UTIs) in 14 institutions in Japan were collected between August 2004 and July 2005. The susceptibilities of them to many kinds of antimicrobial agents were measured. Of them, 577 strains were estimated as causative bacteria and used for the measurement. The strains consisted of 156 gram-positive bacterial strains (27.0%) and 421 gram-negative bacterial strains (73.0%). Against Staphylococcus aureus, arbekacin (ABK), vancomycin (VCM) showed the strongest activity and prevented the growth of all strains with 2 microg/mL. Against Enterococcus faecalis, ampicillin (ABPC) and VCM showed a strong antibacterial activity. The antibacterial activity of cephems to Escherichia coli was generally good, and especially cefozopran (CZOP) and cefpirome (CPR) showed the strongest activity (MIC90: < or = 125 microg/mL). Quinolone resistant E. coli [MIC of ciprofloxacin (CPFX): > or = 4 microg/mL] was detected at frequency of 18.8%, which was higher than that in the last year. Against Klebsiella pneumoniae, CZOP, meropenem (MEPM), and carumonam (CRMN) showed the strongest activity and prevented the growth of all strains with 0.125 microg/mL or less. The antibacterial activity of the other cephems was relatively good, and decrease in their activity observed in the last year study was not recognized. Against Serratia marcescens, imipenem (IPM) and gentamicin (GM) had the strongest antibacterial activity. Against Proteus mirabilis, CRMN showed the strongest activity and prevented the growth of all strains with 0.125 microg/mL or less. MEPM prevented the growth of all strains with 0.25 microg/mL. Next, cefmenoxime (CMX), ceftazidime (CAZ), CZOP, cefixime (CFIX), cefpodoxime (CPDX), and cefditoren (CDTR) showed a strong activity. The antibacterial activity of the drugs to Pseudomonas aeruginosa was generally low, and MIC90 of all the drugs was ranged from 32 to > 128 microg/mL except IPM and MEPM having 16 microg/mL. The antibacterial activities of CZOP and CAZ were considered to be relatively good on MIC50 comparison (MIC50: 2 microg/mL).

Topics: Aminoglycosides; Ampicillin; Anti-Infective Agents; Aztreonam; Cefixime; Cefozopran; Cefpirome; Cefpodoxime; Ceftizoxime; Cephalosporins; Dibekacin; Drug Resistance, Bacterial; Enterococcus faecalis; Escherichia coli; Gentamicins; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Imipenem; Klebsiella pneumoniae; Meropenem; Microbial Sensitivity Tests; Proteus mirabilis; Pseudomonas aeruginosa; Quinolones; Serratia marcescens; Staphylococcus aureus; Thienamycins; Urinary Tract Infections; Vancomycin

In vitro interactions between carumonam (CRMN) and 8 other antibiotics were studied using the agar dilution checkerboard technique against 88 clinical isolates of Escherichia coli, Proteus vulgaris, Serratia marcescens and Pseudomonas aeruginosa. Combinations of CRMN with 8 other antibiotics were generally additive or indifferent. Synergism was found against S. marcescens or P. aeruginosa with CRMN plus fosfomycin, gentamicin (GM) or dibekacin. Antagonism was not observed with CRMN plus any of the 8 other antibiotics tested. In a phase-contrast microscopic study, the synergism of CRMN in combination with GM were confirmed against P. aeruginosa 15846. CRMN in combination with GM demonstrated a in vivo synergy against experimental urinary tract infection caused by P. aeruginosa 15846 in mice. We think that combinations of several antibiotics with CRMN should be appropriate for initial therapy of infections because no antagonism appeared to occur with other antibiotic agents.

Topics: Animals; Aztreonam; Dibekacin; Drug Resistance, Microbial; Drug Synergism; Escherichia coli; Female; Fosfomycin; Gentamicins; Mice; Piperacillin; Proteus vulgaris; Pseudomonas aeruginosa; Serratia marcescens; Urinary Tract Infections

Dibekacin (DKB), an antibiotic of aminoglycoside group, was administered at 4 different dosages of 0.5, 1.0, 1.5 and 2.0 mg/kg as intravenous drip infusion taking 30 minutes or 1 hour. For each dose level, 3 cases each were used out of 24 boys from 1 year and 1 month to 14 years and 7 months of age, and serum concentrations as well as urinary concentrations and recovery rate were determined. After removed of 4 cases unassessable of therapeutic efficacy, 7 cases consisting of 1 case of chronic bronchitis, 1 case of lung abscess and 5 cases of urinary tract infections were treated with DKB at a mean daily dosage of 3.3 mg/kg in 2 or 3 divided doses as intravenous drip infusion taking 30 minutes or 1 hour. The mean treatment period was 7 days. The clinical and bacteriological results were analyzed in these cases and for analysis of side effects drop out cases were also included. The following results were obtained. Following 30 minutes intravenous drip infusion of DKB at 0.5, 1.0, 1.5 and 2.0 mg/kg, the serum concentration peaked at the end of infusion for all dose levels. The highest peak concentration of 9.17 mcg/ml was obtained for the dose level of 2.0 mg/kg. The highest dosage with which serum concentration does not exceed concentrations of 10 to 12 mcg/ml was found to be 2.0 mg/kg. The mean highest serum concentrations obtained were 1.65, 3.49, 5.40 and 8.67 mcg/ml for the dosages of 0.5, 1.0, 1.5 and 2.0 mg/kg, respectively, and the mean AUCs determined by the two-compartment model were 2.99, 6.04, 10.5 and 14.2 mcg X hr/ml, respectively, showing dose response relation in terms of peak concentration and AUC among groups. The mean T1/2 values for each dosage were 1.55, 1.54, 1.77 and 2.03 hours, respectively, with a longer tendency in T1/2 for the dose level of 2.0 mg/kg with unknown cause. When 0.5, 1.0, 1.5 and 2.0 mg/kg of DKB were infused taking 1 hour, the peak of serum concentration appeared also at the end of the infusion. The highest concentration was obtained with 2.0 mg/kg and it was 7.02 mcg/ml. Considering from the concentrations obtained for 0.5 mg/kg and 1.0 mg/kg groups the highest dosage at which the serum concentration does not exceed 10 to 12 mcg/ml was estimated to be 2.5 mg/kg.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Adolescent; Bronchitis; Child; Child, Preschool; Dibekacin; Drug Administration Schedule; Female; Humans; Infant; Infusions, Parenteral; Kanamycin; Kinetics; Lung Abscess; Male; Pneumonia; Urinary Tract Infections

Urinary tract infections in the elderly are severe and intractable, often justifying the use of aminoglycosides. We studied the effects of dibekacin in 28 patients, with no vesical catheter, whose average age was 78 +/- 6.1 years. The drug was given for ten days, in an average dose of 2.1 mg/kg/day divided into two injections. Serum concentration was measured after one hour on day 1 and after eight hours on days 1 and 10. Causative pathogens, all susceptible to dibekacin, were: 18 E. coli, 3 Proteus mirabilis, 3 Klebsiella, 1 Enterobacter cloacae, 1 Citrobacter and 2 Staphylococci. MIC and MBC of dibekacin were determined for each microorganism. Dibekacin was discontinued in four cases on day three because of persistent bacteriuria. Ten days after treatment end, 19 patients were cured, 4 had a relapse and 1 was reinfected. Average serum concentration of dibekacin, measured after eight hours, increased from 0.77 +/- 0.48 micrograms/ml on day 1 to 1.78 +/- 1.22 microgram/ml on day 10 (t = 4.42; p less than 0.0005), while, over the same period, there was no significant change in serum creatinine.

Topics: Aged; Blood Bactericidal Activity; Dibekacin; Female; Humans; Injections, Intramuscular; Kanamycin; Male; Microbial Sensitivity Tests; Urinary Tract Infections

Clinical studies were performed on combination chemotherapy with Fosfomycin and Dibekacin. Sixteen patients with complicated urinary tract infections were treated with a combination of Fosfomycin (4 g/day, d.i.v.) and Dibekacin (200 mg/day, i.m.) for 5 days; and, 15 of them were clinically evaluated by criteria of UTI committee. The clinical effects proved excellent in 3 patients, good in 8 patients, and poor in 4 patients overall effective rate was 73.3%. Out of 19 strains isolated from the patients, 12 strains disappeared after the therapy. No side effect was observed in 16 cases. Clinical use of the combination chemotherapy with Fosfomycin and Dibekacin was thought to be effective and safe for patients with complicated urinary tract infections, because the combination acts not only synergistically, but also because Fosfomycin acts to protect against the nephrotoxicity induced by Dibekacin.

Topics: Adult; Aged; Anti-Bacterial Agents; Dibekacin; Drug Therapy, Combination; Female; Fosfomycin; Humans; Kanamycin; Male; Middle Aged; Urinary Tract Infections

The use of a new aminoglycosid antibiotic (dibekacin = Orbicin) in the treatment of severe urinary tract infections in a urological clinic is presented. After having given their written informed consent, 50 patients were treated with a dosage of 150-225 mg dibekacin, administered in three single daily doses. From a total of 41 mono-infections, asepsis could be attained in 70,7%, in 17,1% no effect could be observed and in 12,2% it came to a change of bacteria. From a total of 9 mixed infections, asepsis was observed only twice after the end of therapy. 87,5% of the patients reported about a far-reaching improvement or complete disappearance of clinical symptoms. In 2 cases allergic exanthema was observed. The local toleration was good. Disturbances of the otovestibular function were not registered.

Topics: Adult; Aged; Dibekacin; Humans; Kanamycin; Middle Aged; Proteus Infections; Staphylococcal Infections; Streptococcal Infections; Urinary Tract Infections

Topics: Dibekacin; Drug Resistance, Microbial; Drug Synergism; Ear, Inner; Enterobacteriaceae; Humans; Kanamycin; Kidney; Lactams; Mouth Diseases; Respiratory Tract Infections; Urinary Tract Infections

In this cooperative trial, 181 patients with various urinary tract infections were treated by dibekacin, a new hemi-synthetic aminoglycoside. Clinical and bacteriological results confirm the efficacy of dibekacin in this indication. Local and systemic tolerance, and thus renal and cochleo-vestibular, were very satisfactory.

Topics: Dibekacin; Humans; Kanamycin; Urinary Tract Infections

The aminoglycoside dibekacin, developed in Japan and now on the market in Germany, has been tested for its clinical and microbiological effectiveness on 45 patients with highly resistant germs. 41 of the 55 primary sensitive germs could be thus eliminated from the urine, 6 of the 11 being pseudomonas germs. The clinical results of 33 of the 45 patients were very good, only 4 of them were not convincing. The nephrotoxic side effects were noticeably slight. No evidence of damage to the VIIIth brain nerve was observed in these patients. The results were satisfactory considering the selection of problem patients in the test group. Dibekacin can be regarded with gentamicin as a first choice aminoglycoside.

Topics: Adult; Aged; Dibekacin; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Kanamycin; Male; Middle Aged; Pseudomonas Infections; Urinary Tract Infections