Antimicrobial and beta-lactamase inhibitory activities of carpetimycins A and B, new carbapenem antibiotics

Carpetimycins A and B showed widely broad spectra and potent activity against gram-positive and gram-negative bacteria, including various species of anaerobic bacteria. The antimicrobial activity of carpetimycin A was 8 to 64 times greater than that of carpetimycin B and 4 to 128 times greater than that of cefoxitin. The inhibitory concentration of carpetimycin A required to inhibit more than 90% of clinical isolates was 0.39 micrograms/ml for Escherichia coli and klebsiella and 1.56 microgram/ml for Proteus and Staphylococcus aureus. At a concentration of 3.13 micrograms/ml, carpetimycin A inhibited almost all clinical isolates of Enterobacter and Citrobacter, which showed resistance to many clinically used beta-lactam antibiotics. Carpetimycins A and B furthermore were shown to have potent inhibitory activities against several kinds of beta-lactamases produced by beta-lactam-resistant strains; they inhibited not only penicillinase-type beta-lactamases but also cephalosporinase-type beta-lactamases, which were insensitive to clavulanic acid. In combination with beta-lactam antibiotics such as ampicillin, carbenicillin, and cefazolin, carpetimycins A and B showed synergistic activities against beta-lactam-resistant bacteria.

A new broad-spectrum aminoglycoside antibiotic complex, sporaricin. IV. Sporaricins C and D

Two new aminoglycoside antibiotics, sporaricins C and D have been isolated from the culture broth of Saccharopolyspora hirsuta subsp. kobensis, which produced sporaricins A and B. The structures of sporaricins C and D have been determined to be 4-N-carbamoyl-glycylsporaricin B and 4-N-formylglycylsporaricin B, respectively. Sporaricins C and D are active against Gram-negative and Gram-negative bacteria including aminoglycoside-resistant strains.

[Studies on a new cephalosporin, cefotiam, in the pediatric field (author's transl)]

The studies on cefotiam (CTM) administered by intravenous drip infusion in pediatric field made the following results: 1. The serum levels after administration of cefotiam 25 mg/kg, 63 mg/kg by intravenous was maintained high until 2 hours after and kept to be able to measure after 5 hours, and the half life was 0.9-1.7 hours. 2. The drug transferred actively about 1/5 of serum level into the intrathoracic pus. The excretion rate in urine was about 80% of the drug administered. 3. The clinical effective rate after the administration of CTM 50-70 mg/kg for 4 to 29 days was 95% in 21 patients with different five diseases. 4. No side effect and abnormality in laboratory findings were observed.

[Fundamental and clinical studies in pediatric field on 6059-S (author's transl)]

Fundamental and clinical studies in the pediatric field on 6059-S, a newly synthesized oxacephem antibiotics, were carried out, and following results were obtained. 1) MIC of 6059-S for K. oxytoca (40 strains), recently isolated from patients, were mostly more less than 0.2 mcg/ml, and that for H. influenzae was 0.05 mcg/ml, but that for non-group A-beta-Streptococcus (2 strains) were 12.5 mcg/ml. 2) In 9 infants, the serum concentration of 6059-S in a dose of 10 approximately 37.5 mg/kg/day with intravenous drip infusion method was measured. The peak serum concentration were 32.8 approximately 241 mcg/ml at end of injection, and serum concentration were 0.6 approximately 3.19 mcg/ml 7 hours after administration. The excretion rates in urine for 12 hours after administration were distributed between 55.8 approximately 89.6%. 3) Clinical evaluation of 6059-S was performed in evaluated 29 cases: 24 cases of respiratory tract infection, 2 cases of cervical lymphadenitis, 2 cases of urinary tract infection, 1 case of enteritis. The overall efficacy rate was 96.6%. 4) Side effects observed during this therapy were 1 case of diarrhea, 2 cases of adverse effect (eosinophilia, elevation of GOT, GPT).

[Some experiences in the field of pediatrics with cefoxitin treatment by intravenous injections (author's transl)]

Following are the results obtained from studies made with cefoxitin in the field of pediatrics: (1) The peak serum level observed upon completion of the one hour drip infusion in a dose of 20-25 mg/kg of cefoxitin varied from 66.4 to 93.0 mcg/ml. This fell to a remarkably low level after 2 hours. The serum half-life varied from 18.84 to 27.86 minutes. (2) The cumulative quantity of cefoxitin excreted in the active form in the urine by the end of 6 hours after completion of the drip infusion was 92.9-93.8%. (3) All of the 42 patients with acute pediatric infection (such as various kinds of acute upper or lower respiratory tract infection, urinary tract infection were treated with either cefoxitin by a single shot (23 patients), or by drip infusion (19 patients). The dosage employed was approximately 50-100 mg/kg/day divided into two to three treatments. There was no major difference in the clinical efficacy between administering two times or three times, the efficacy rates being 96% and 89% respectively. The overall efficacy rate was 93%. (4) In either case of intravenous injections by either a single shot or drip infusion, excellent clinical responses were obtained in most patients. These people had a variety of infections, which were considered to be caused by various kinds of Gram-positive cocci, E. coli (including ABPC resistance), P. mirabilis, Kl. oxytoca and Haemophilus. (5) Out of the 42 patients who received cefoxitin in a daily dose of 5-100 mg/kg divided into two or three times either by a single shot or drip infusion, no hepatic or renal function abnormality was observed except for 2 cases of temporary eosinophilia. (6) On the basis of these results, cefoxitin was found to be a highly useful antibiotic in the treatment of acute pediatric infection caused by microorganisms which are sensitive to cefoxitin.

[Some investigations on cefadroxil dry syrup (author's transl)]

MIC of cefadroxil (CDX) against A group beta-Streptococcus was distributed between 0.05-0.2 microgram/ml, that is, more susceptible than cephalexin (CEX) an cefaclor (CCL), and susceptible to tetracycline (TC), erythromycin (EM), lincomycin (LCM) resistant strains. Serum level was higher than CCL administered orally at the same dose, and urinary excretion ratio after oral administration was good similarly to CEX and CCL. Patients treated were mostly scarlet fever and upper respiratory tract infections as acute tonsillitis and lacunar tonsillitis. They responded well to CDX at a daily dose of 30 mg/kg divided into 3-4 times. All cases of scarlet fever became normal temperature within 2 days. Among 14 cases in which A group beta-hemolytic Streptococcus was detected by pharyngeal sputum culture at admission, 11 cases became negative on the 1st day. This result was superior to CEX, when this drug was administered orally at a daily dose of 40-60 mg/kg, bacteria became negative at the ratio of 73.3% on the 2nd day. CDX was effective for acute tonsillitis, lacunar tonsillitis, acute bronchitis, impetigo and maxillary lymphadenitis in which numerous A group beta-Streptococcus, Staphylococcus aureus and Haemophilus influenzae were proven, as well as for acute urinary tract infection due to Escherichia coli. Clinical results of CDX in totalling 69 cases were excellent in 63 cases, good in 6 cases, efficacy ratio being 100%. No local nor systemic side effects were observed in 69 cases including maximum 11 days' treatment, as well as no effect was noticed on hepatic and renal functions. From the above results, it was concluded that satisfactory treatment results may be obtained with CDX dry syrup for children at a daily dose of 20-50 mg/kg divided into 3-4 times in acute infections due to CDX susceptible pathogens.

A new aminoglycoside antibiotic, sannamycin C and its 4-N-glycyl derivative

Streptomyces sannanensis KC-7038 used for the production of sannamycins A and B has also produced another antibiotic sannamycin C, in the culture broth. Physico-chemical characterization revealed that sannamycin C is a new aminoglycoside antibiotic having 6-N-methylpurpurosamine C and 2-deoxy-3-epi-fortamine. Its 4-N-glycyl derivative indicated inhibitory activity against Gram-positive and Gram-negative bacteria containing aminoglycoside resistant strains.

[Treatment of pertussis with cefoperazone (author's transl)]

Clinical trial of cefoperazone (CPZ) for the treatment of 15 cases suffering from pertussis was performed and the results were as follows. The method of administration, as a rule intravenous infusion was performed at 100 approximately 200 mg/kg/day. (1) Seventeen strains of Bordetella pertussis showed under 0.006 mcg/ml of MIC. It was similar to PIPC. (2) Any effect to hepatic or renal function was not observed. (3) Clinical response obtained in these cases was excellent in 13 cases (86.7%), good in 2 cases (13.3%) and none of poor case.

[Fundamental and clinical studies in pediatric field on cefoperazone, a cephalosporin derivative having broad spectrum newly developed in Japan (author's transl)]

Studies in the pediatric field on cefoperazone (CPZ), a newly synthesized broad spectrum cephalosporin, were carried out, and the following results were obtained. 1) In 3 infants, the concentration of CPZ was measured after intravenous instillation. The blood concentrations were maintained at the high level for a long time and the measurable amount of blood levels were detected for 8 hours after the end of injection. The excretion rates in urine for 12 hours after the end of drip infusion were distributed between 34.2 approximately 56.1%. 2) Twenty-three patients with respiratory tract infections, 8 patients with enteritis, 4 patients with urinary tract infections, 3 patients with meningitis, 1 patient with sepsis and 4 patients with other infections were administered CPZ mainly by intravenous instillation. 3) Any effect on hepatic or renal function was not observed. 4) Clinical response obtained in these cases was excellent in 33 cases (82.5%), good in 7 cases (17.5%), and none of poor case.

Comparison of the cobalt-60 photon beam dose distributions corrected by three shift-factors for oblique incidence

A new factor for shifting isodoes curves for oblique Co-60 photon beams has been deduced. Like the two other known factors, this shift factor depends on the source-to-surface distance (SSD), the depth dose (D) and the derivative of D with depth. A comparison of corrected dose distributions has been made by using the three shift factors for the 15 X 15-cm2 field incident on a surface at 45 degrees. In general, the corrected dose distributions given by the new shift factor show the best agreement with the measured depth dose data.

[Laboratory and clinical study of cefamandole by intravenous injection in the pediatric field (author's transl)]

Cefamandole sodium (CMD) was intravenously administered and following laboratoric and clinical results were obtained. (1) The peak blood concentration was 32 approximately 44 micrograms/ml when the drip infusion was finished. At 1 hour after the end of the drip infusion the blood concentration was 7.6 approximately 8.1 micrograms/ml. Half life was approximately 0.64 hours. (2) Urinary recovery rate was 84.5 approximately 95% in active state within 6 hours. (3) Penetration of cerebrospinal fluid was found in 2 cases. (4) In most of 170 strains of Streptococcus haemolyticus MICs of cefamandole were 0.05 microgram/ml. They were less susceptible to cefazoline, cefmetazole and ceftezole. (5) CMD was administered to 35 pediatric patients (upper or lower RTI, lymphadenitis, enteritis or UTI) at 100 mg/kg/day for 3 approximately 9 days, the efficacy rate was 97.1%. (6) Side effect: Rash occurred in one case, and eosinophilia was observed in 4 cases. No abnormal finding of renal and liver function was observed.

[Fundamental and clinical studies of cefuroxime, a new cephalosporin antibiotic, in pediatric field (author's transl)]

A series of studies on cefuroxime (CXM) were carried out and the following results were obtained. 1) Most of MICs to recent clinical isolates of Group A hemolytic Streptococcus were less than 0.0125 micrograms/ml. 2) A single intravenous bolus dose of 36.5 mg/kg of CXM was given to two children, and the peak blood levels of 30 and 40 micrograms/ml were obtained at 30 minutres after injection; mean half-life in blood was 1.02 hours. The doses of 25 approximately 50 mg/kg were given over 1 hour by intravenous instillation to six children. The peak blood level appeared at the end of instillation, and half-life in blood was distributed between 0.56 and 0.81 hour. With both of these administrations, measurable blood levels were maintained up to 6 hours, and urinary excretion rate in active form up to 6 hours was distributed between 40.5 and 96%. 3) Serious upper respiratory tract inflammations, low respiratory tract inflammations (acute bronchitis and bronchopneumonia), staphylococcal exanthema and acute urinary tract infections mostly responded well to CXM intravenous administration (one shot injection, or instillation at dose of 50 approximately mg/kg/day in 2 approximately 3 daily divided doses. 4) Staphylococcal pyothorax was completely cured by 17 day-long CXM intravenous instillation at dose of about 150 mg/kg/day. 5) No difference in CXM therapy result was seen between the two administration forms used, i.e., one shot injection and instillation. 6) Clinical efficacy rate in 48 patients was 100% (excluding 1 unassessable case). As for side effect, transitory elevation of GPT and Al-P were seen in only 1 case each. The summary of this paper was reported on June 9, 1979 at 27th General Meeting of Japan Society of Chemotherapy (Fukuoka).

Continuous intercostal nerve block for pain relief after lumbar incision

To relieve postoperative pain along a lumbar incision in 9 patients the intercostal nerves were blocked with catheters for continuous epidural anesthesia. The catheters were inserted near the intercostal nerves, above and beneath the incision, just before the wound was closed and 0.25% bupivacaine hydrochloride solution was infused periodically through the catheters. With this technique 5 of 9 patients had a satisfactory analgesic effect and could breathe deeply or cough without pain. The other 4 patients did not have satisfactory results and this was believed to be owing to inadequate insertion of the catheters. None of the patients had any complications. The technique is simple and can produce an analgesic effect repeatedly without causing pain for the patient.

A new broad-spectrum aminoglycoside antibiotic complex, sporaricin. I. Fermentation, isolation and characterization

Two new aminoglycoside antibiotics, sporaricins A (C17H35N5O5) and B (C15H32N4O4) produced by a rare actinomycetales, Saccharopolyspora hirsuta subsp. kobensis have been isolated by column chromatography on a cation-exchange resin. Sporaricin A is highly active against Gram-positive and Gram-negative bacteria including aminoglycoside-resistant strains.

A new broad-spectrum aminoglycoside antibiotic complex, sporaricin. II. Taxonomic studies on the sporaricin producing strain Saccharopolyspora hirsuta subsp. Kobensis nov. subsp

Morphological, cultural and physiological characteristics of a new nocardioform actinomycete are reported. The microorganism which produces the antibiotic complex sporaricin has been selectively isolated from a sample of soil obtained from Kobe City, Hyogo Prefecture, Japan. By whole-cell analysis of the actinomycete, meso-diaminopimelic acid, arabinose and galactose were identified. But lipid LCN-A (lipid characteristic of Nocardia) and nocardomycolic acid were not detected. The taxonomic characteristics of this strain is closely related to the genus of Saccharopolyspora, described by LACEY and GOODFELLOW. Based on the taxonomic comparison with Saccharopolyspora hirsuta ATCC 27875, the strain was considered to be a subspecies of Saccharopolyspora hirsuta. Therefore, the proposed subspecies is named Saccharopolyspora hirsuta subsp. kobensis.