sultamicillin and Bronchitis

Clinical efficacy and safety of sultamicillin (SBTPC) in patients with lower respiratory tract infections, mainly pneumonia and bronchitis, have been evaluated in a multicenter trial by 19 institutions in the Kyushu area during a period of 12 months from December 1988 to November 1989. 1. Clinical evaluation was made in 132 patients and efficacy rates of SBTPC were 80.0% (28/35) for pneumonia, 78.5% (73/93) for bronchitis and 100% for the remaining 1 patient with other respiratory tract infections. The overall efficacy rate was 79.1% (102/129). 2. Clinical efficacy rate of SBTPC for respiratory tract infections in patients with underlying diseases such as chronic bronchitis, old pulmonary tuberculosis etc., was 75.0% (60/80) which was not significantly different from the efficacy rate of 85.7% (42/49) in patients without underlying diseases. 3. Of 13 patients who failed to respond to previous antibiotic treatments, 8 (61.5%) were effectively treated with SBTPC. 4. Clinical efficacy rates against infections caused by single species of organisms were 90.9% (10/11) for Haemophilus influenzae, 100% (8/8) for Streptococcus viridans and 100% (3/3) for Staphylococcus aureus. The overall clinical efficacy rate in all cases of monomicrobial infections was 88.6% (31/35), in polymicrobial infection 45.5% (5/11) and the overall efficacy rate in cases in which causative bacteria were identified was 78.3% (35/46). 5. Adverse reactions occurred in 6.8% (9/132) of the patients. The symptoms included allergic reaction in 1 patient, gastrointestinal system disorders in 7 patients and general fatigability in 1 patient. As abnormalities in laboratory test values, elevations of A1-P, GOT, and GPT were observed in 3 patients during the study, but returned to normal after discontinuation of SBTPC administration. 6. SBTPC is a useful antibiotic in the treatment of lower respiratory tract infections under the current medical environment where resistant organisms which produce beta-lactamases have been increasing.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ampicillin; Bacterial Infections; Bronchitis; Drug Therapy, Combination; Female; Humans; Japan; Male; Middle Aged; Pneumonia; Respiratory Tract Infections; Sulbactam

Thirty hospitalised patients with acute purulent exacerbations of chronic bronchitis were treated orally with either 750 or 1000 mg of sultamicillin (a mutual prodrug of ampicillin and sulbactam) twice daily for ten days. Twenty-eight of these patients were evaluated for clinical response at end-of-treatment (day 11) and at one week post-treatment (day 17). The overall clinical cure rates at these times were 73% (22/30) and 60% (18/30) respectively. Five beta-lactamase-producing organisms were identified in the pre-treatment sputum specimens, but all were eliminated by day 17. The means of the peak serum concentrations of ampicillin achieved after the first 750 and 1000 mg doses were 9.1 and 14.4 mg/l respectively, the corresponding values for sulbactam being 6.4 and 7.9 mg/l. Both the ampicillin and the sulbactam peaks occurred approximately one hour after dosage. Mean peak sputum concentrations of ampicillin of 0.7 and 1.2 mg/l were achieved following the 750 and 1000 mg doses. Concentrations of sulbactam in sputum were above the limit of detection (0.5 mg/l) in only four patients. Although both clinical and bacteriological responses at follow-up (day 17) appeared to be somewhat more favourable at the higher dose, the small number of patients in each group did not permit a statistically valid comparison to be made. One patient in each dosage group discontinued the medication because of severe diarrhoea.

Topics: Adult; Aged; Ampicillin; Bacterial Infections; Bronchitis; Clinical Trials as Topic; Diarrhea; Drug Combinations; Female; Humans; Kinetics; Male; Middle Aged; Penicillanic Acid; Sputum; Sulbactam; Time Factors

Topics: Adult; Ampicillin; Bronchitis; Cefuroxime; Chronic Disease; Drug Therapy, Combination; Female; Humans; Male; Prodrugs; Sulbactam; Treatment Outcome

Oral tablets containing 375 mg sultamicillin were used to treat 30 adult patients of either sex suffering from lower respiratory tract infections. The dose used was one tablet every 12 h for 22 cases and one tablet every 8 h for eight cases. The duration of therapy varied between 5 and 14 days (mean 8.6 days). The therapeutic response was rated as cure in 23 (76.6%) patients, with complete disappearance of pretreatment signs and symptoms, and as improvement in seven (23.3%) patients, with amelioration of the pretreatment manifestations. All 52 microorganisms isolated before treatment were eradicated. No adverse effects were reported in 25 (83.3%) patients, whereas the remaining five (16.7%) patients reported mild loose stools with normal bowel motion. There were no abnormal changes in blood count and liver and renal functions following sultamicillin treatment.

Topics: Acute Disease; Administration, Oral; Adult; Ampicillin; Bacterial Infections; Bronchitis; Chronic Disease; Drug Therapy, Combination; Female; Humans; Male; Pneumonia; Respiratory Tract Infections; Sulbactam; Tablets