[beta-lactamase activity in sputum of patients with community-acquired lower respiratory tract infections]

beta-Lactamase production and activities in sputa of patients with community-acquired lower respiratory tract infections (LRTI) were determined and following results were obtained: 1) Suspected causative organisms frequently isolated were H. influenzae and Streptococcus pneumoniae. Similar results were previously reported. 2) Various beta-lactamase producing indigenous bacteria were detected. In many cases these indigenous beta-lactamase producing strains were isolated even when suspected causative bacteria were not beta-lactamase producers. 3) beta-Lactamase activities were detected from 61.5% of the sputa tested. Remaining activities of antibiotics added to the sputa were highly correlated with detection of beta-lactamases produced by suspectedly causative and indigenous strains and with presence of beta-lactamase activities in the sputa. Sulbactam/cefoperazone was stable in sputa than other antibiotics tested. 4) We concluded that the beta-lactamase produced by indigenous strains can be one of the factors of indirect pathogenicity in the community-acquired LRTI.

Symptoms and social adjustment of schizophrenic patients as evaluated by family members

The purpose of this study is to reveal the relationship between family expressed emotion (EE) and family evaluation for symptoms and social adjustment of schizophrenic patients. Chronic schizophrenic outpatients in offshore islands under stationary therapeutic conditions were studied. For evaluation, the Five Minute Speech Sample (FMSS) for EE and the Katz Adjustment Scale (KAS) for family evaluation of patients were used. EE level was high among relatives who thought the patient was belligerent, negativistic, unstable or helpless. High-EE relatives tended to evaluate their patients' performance of social activities rather low and showed strong dissatisfaction with the patient's leisure activities. Moreover, a high emotional overinvolvement (EOI) value is more common in Japan than in other countries. A subgroup of the FMSS-EOI, the emotional display, was seen where many mothers began to cry while speaking.

[Evaluation of surgical treatment of gastric cancer in the aged]

Patients with gastric cancer aged 70 years or over were divided into 3 age groups (70-74, 75-79, 80 years or over) and were compared with patients aged 60-69 years, (which is the age group with the highest incidence of stomach cancer) with regard to the incidence of postoperative complications. In addition, factors which might be associated with increased mortality were investigated. There were no significant differences with regard to the incidence of postoperative complications (16-21%) or the mortality rate (0-3%, within 30 days after surgery) between the various age groups. However, the incidence of those complications which later proved fatal was higher in those aged 75 years or over. Factors associated with the development of complications in each age group were the type of surgical technique used, the operation time, and the severity of hemorrhage during surgery. The prognosis for gastric resection was poor in patients aged 80 years or over. Our findings indicated that curative resections should be performed for gastric cancers in the elderly if the general physical condition of the patients permits. A more conservative approach is desirable when the general condition is not favorable.

[Antimicrobial activities of polymyxin B against clinically isolated microbial strains. Results of MIC determination including high concentrations]

Minimum inhibitory concentrations (MICs) were determined for polymyxin B (PL-B), gentamicin, ofloxacin and norfloxacin against clinically isolated microbial strains collected since November 1992, and the following conclusions were obtained: 1. Judging from the MIC distribution of PL-B against the studied strains including multi-drug resistant organisms of major strains of family Enterobacteriaceae, such as Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., and Pseudomonas aeruginosa, it appeared that no PL-B resistant strains were detected among those Gram-negative organisms within the antimicrobial spectrum of PL-B. 2. MICs of PL-B against most strains including methicillin resistant Staphylococcus aureus and coagulase-negative staphylococci were distributed between 100 and 800 micrograms/ml. These results supported reports of other investigators that the eradication of Staphylococcus spp. including MRSA (methicillin-resistant S. aureus) was possible by the use of PL-B at 1 mg/ml. 3. MIC distribution of PL-B against organisms of the Bacteroides fragilis group was almost the same as the results described above.

[Antimicrobial activity of cefodizime against fresh clinical isolates]

In order evaluate antimicrobial activities of cefodizime (CDZM), minimum inhibitory concentrations (MIC's) of CDZM and other control drugs were determined against various clinical isolates, that were sent to our center from nation-wide medical institutions or were isolated and identified in our laboratory from various specimens of infected patients. The followings are a summary of the results: 1. Bacterial species with no or few strains resistant to cephems including CDZM included Streptococcus pyogenes, Haemophilus influenzae, Citrobacter diversus, most of Klebsiella pneumoniae and Proteus mirabilis. Some strains of Klebsiella oxytoca were resistant to cephems increases in beta-lactams resistant Streptococcus pneumoniae and cephem resistant Escherichia coli seemed likely. Among Citrobacter freundii, Enterobacter spp., Serratia marcescens, Proteus vulgaris, Morganella morganii and Providencia spp. belonging to a category of so-called "mildly toxic bacteria", high portions of the strains examined were resistant to cephems including CDZM and these strains were also resistant to new quinolones, thus they showed multiple drug resistance. 2. MIC90's of CDZM against Streptococcus spp., H. infleunzae, Moraxella subgenus Branhamella catarrhalis, E. coli, Klebsiella spp. and P. mirabilis, frequently found in daily treatment of infections, were less than < or = 0.025 to 1.56 micrograms/ml. This indicates that CDZM would be expected to have enough antibiotic activity in infections caused by above mentioned bacteria. However, cautions are needed in the treatment of infections by beta-lactam resistant S. pneumoniae, cephem resistant E. coli and cephem resistant K. oxytoca with CDZM. 3. Among the above mentioned "mildly toxic bacteria", many multiple drug resistant strains exist. Therefore, we evaluated an usefulness of concomitant use of CDZM with aminoglycosides in the treatment of infections by these bacteria, using other reports which indicates the usefulness in vitro and in vivo. 4. Antibacterial activities of CDZM we observed in this study seem to indicate that CDZM concentrations in infected areas are maintained at above MIC levels for relatively long periods of time.

[The antimicrobial activity of cefteram against recently clinically detected and isolated strains]

In order to examine antibiotic activities of cefteram (CFTM), its minimum inhibitory concentrations (MIC's) and those of other cephem drugs were determined against clinically isolated strains received from July 1990 to June 1991 and from July 1992 to February 1993 from medical facilities throughout the country and against clinically isolated strains detected in our laboratory in samples from patients with various infectious diseases. The obtained results are summarized below. 1. No CFTM-resistant strains were found among beta-streptococci, Klebsiella spp., Proteus mirabilis, Haemophilus influenzae, and Neisseria gonorrhoeae or even when found, they were present in extremely low proportions. 2. It appeared that Streptococcus pneumoniae insensitive or resistant to beta-lactams, as well as cephems-resistant strains of Escherichia coli were increasing. The former included benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP) of PCG-resistant S. pneumoniae (PRSP), and the presence of the latter suggests the possibility of the existence of "Extended broad-spectrum beta-lactamase" producing strains. The MIC's of beta-lactams against the above PISP or PRSP, and against cephems-resistant E. coli tended to be high, but those of CFTM were relatively low (in most cases). 3. Proportions of strains resistant to cephems, including CFTM among Citrobacter spp., Enterobacter spp., Serratia marcescens, Proteus vulgaris, Morganella morganii, and Providencia rettgeri were high, and in addition, the existence of these cephem resistant species suggests an increase in multiple drug resistant strains that show resistance to new quinolone drugs. 4. As mentioned above, CFTM is by no means a perfect drug or utility drug and its antimicrobial activities do not cover some recent isolates with multiple drug resistance. Except problems encountered with so-called "attenuated" strains of bacteria, increases in resistance can only be observed at a level of MIC90's, and as far as MIC80's are concerned, CFTM still is as active as before and may be used in the treatment of most infections we encounter in normal medical practices.

Prognostic differences of adenocarcinoma arising from the cardia and the upper third of the stomach

Of 1,012 patients who underwent gastrectomy for carcinoma of the stomach from 1980 to 1990, 33 with adenocarcinoma arising from the gastroesophageal junction (group C) and 55 with adenocarcinoma of the upper third of the stomach (group U) were compared with regard to their clinicopathologic features. Twenty-five patients (76%) in group C and 49 patients (89%) in group U underwent curative resection. The 5-year survival rates following curative resection were 32 and 70 per cent, respectively (P < 0.001). The poor prognosis of group C was ascribed to a greater propensity for esophageal invasion and nodal involvement, as well as to more advanced disease at diagnosis. The rich lymphatic drainage around the cardia may account for the wide spread of such tumors. Most patients presented with an advanced disease, so earlier detection of carcinoma of the cardia is mandatory to improve the results of surgery. At operation, it is important to dissect all the involved lymph nodes from the mediastinum to the abdominal paraaortic nodes and to ensure a tumor-free esophageal margin.

Allelism of panda and dotted white plumage genes in Japanese quail

Panda and dotted white mutant plumage colors of Japanese quail (Coturnix japonica) were found to be controlled by the autosomal alleles. Both mutants showed white plumage with colored spots or patches, but they were easily distinguishable by size and location of the colored areas and the color and markings of the pigmented feathers. At hatching also they were easily distinguishable by the position, size, and colors of the spots or patches. The panda chicks possessed large blackish patches on the head, back, tail, cheek, and wing, whereas the dotted white chicks had small light brown spots on the head and/or back. Some dotted white chicks (12%) did not have any brown spots. In a testcross experiment, panda type and dotted white type progeny segregated in 1:0, 3:1, 1:0, and 1:1 ratios in the F1 and F2 generations and in back-crosses to the panda and dotted white parents, respectively, suggesting allelism and dominance of panda over dotted white. The new gene symbol sdw is proposed for the allele controlling the dotted white plumage.

[Studies on development of evaluation method for wood-based floors. Part 1. Evaluating the attenuational capacity of human locomotor system due to the acceleration at several parts of the human body]

Experiments were conducted to compare the impact on several parts of the body caused by the striking of the heel during human gait. In these experiments, five kinds of wood flooring that have differing levels of light weight-impact sound insulating efficiency were used. The obtained results were as follows: 1) The generated acceleration of calcaneus varied with the difference of flooring. According to the regression analysis, the open polygonal relationship between bound back coefficient of floor and acceleration of calcaneus was determined. 2) The impact force given to the calcaneus propagated from the heel to the forehead after most of the force being absorbed at the ankle and the knee. We found direct correlation between the subjective feeling of floor pliabilty and the force to the leg. Therefore, it was suggested that the measurement of the force to the ankle and the knee was important in evaluating the efficiency of floors.

[Antimicrobial activity of cefetamet against clinically isolated microbial strains collected from urban RTI patients]

The authors studied antimicrobial activities of cefetamet (CFMT) and other leading oral antimicrobials of beta-lactam class against clinically isolated strains from urban respiratory tract infection (RTI) patients from January to March, 1992. 1. CFMT showed potent antimicrobial activities against "3 primary pathogens" of RTIs i.e., Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae, but the drug had a slightly higher MIC than those of a few oxime-type cephems already on the market. 2. CFMT was as stable as cefixime to beta-lactamase, generated by Moraxella subgenus Branhamella catarrhalis, which reduces the antimicrobial activity of cephems. 3. Blood concentrations of CFMT after administering cefetamet pivoxil (CFMT-PI), an oral form of the drug, exceeded the MIC80 against the "3 primary pathogens" as well as M. (B) catarrhalis and Klebsiella pneumoniae, for a duration of approximately 9 and 11 hours, respectively, after single doses of 250 and 500 mg. This suggests that CFMT could remain above the MICs for a sufficient time period with twice daily dosages of normal dose levels. 4. It is concluded that CFMT-PI will be useful for treating urban RTIs.

[Combined effects of arbekacin with other antibiotics against methicillin-resistant Staphylococcus aureus. IV. Combined effects of arbekacin with cefmetazole or flomoxef]

Antibacterial effects of combination use of arbekacin (ABK) with cefmetazole (CMZ) or flomoxef (FMOX) were evaluated against methicillin-resistant Staphylococcus aureus (MRSA) and the following results were obtained. 1. Antibacterial effects of combinations of ABK with CMZ and with FMOX were equally potent against MRSA at clinically expected 1 MIC of ABK in blood. However, at a sub MIC of ABK different effects were observed between the 2 combinations. The former combination was slightly less effective than the latter. 2. In either combination the potency of the antibacterial activity was less dependent on the concentration of CMZ or FMOX, but was strongly dependent on ABK concentrations. These results suggest that antibacterial effects of the combinations were highly dependent on antibacterial potency and concentration of ABK as previously reported for combinations of ABK with other drugs. 3. It appears that the antibacterial activity of the combination of the sub MIC of ABK with a beta-lactam is an important point in considering the effectiveness of a combination therapy.

[Combined effects of arbekacin with other antibiotics against methicillin-resistant Staphylococcus aureus. III. Combined effects of arbekacin with cefotiam or cefuzonam]

Antibacterial effects of combination use of arbekacin (ABK) with cefotiam (CTM) or cefuzonam (CZON) were evaluated against methicillin-resistant Staphylococcus aureus (MRSA) and the following results were obtained. 1. Antibacterial effects of combinations of ABK with CTM and with CZON were equally potent against MRSA at clinically expected 1 MIC of ABK in blood. However, at a sub MIC of ABK the different effects were observed between the 2 combinations. The antibacterial effect of the former was strong and that of the latter was a little weak. 2. In either combination the potency of the antibacterial activity was less dependent on the concentration of CTM or CZON, but was strongly dependent on ABK concentrations. These results suggest that antibacterial effects of the combinations were highly dependent on antibacterial potency and concentration of ABK as previously reported for combinations of ABK with other drugs. 3. The combination use of ABK with CTM appears to be useful in cases of infection by MRSA alone while the combination use of ABK with CZON appears to be useful in cases of double infection with MRSA and Gram-negative bacterium.

[Antimicrobial activities of major oral antibacterial agents against clinically isolated microbial strains from outpatients with respiratory tract infection]

Minimum inhibitory concentrations (MICs) were determined for major oral antibacterial agents for clinically isolated microbial strains from materials collected from outpatients with respiratory tract infections in 1988, 1989 and 1990, and the following conclusions were obtained. 1. Methicillin-resistant Staphylococcus aureus (MRSA) appeared to be responsible for community-acquired respiratory tract infections, but there also was a tendency showing that MRSA increased year by year. 2. A tendency was observed indicating that benzylpenicillin (PCG)-insensitive Streptococcus pneumoniae (PISP) increased year by year. 3. Beta-lactamase-producing strains of Haemophilus influenzae were observed in a certain ratio, and also those of Branhamella catarrhalis were found in high ratios. 4. A tendency of increasing resistance of Klebsiella pneumoniae to new quinolones was observed. 5. It is of a great importance to evaluate methods of selecting primary choice antibiotic agents since increasing numbers of new oral antibacterial agents are becoming rapidly available.

[Antibacterial activities of sisomicin against fresh clinical isolates]

To investigate antibacterial activities of sisomicin (SISO), MICs of SISO as well as other aminoglycosides (AGs) were determined against many clinical isolates which were obtained in 1991. Results are summarized below: 1. No SISO-resistant strains were observed among isolates of Escherichia coli, Citrobacter diversus, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter aerogenes, Proteus mirabilis and Morganella morganii. 2. In comparison with the results of our previous study against isolates obtained in 1986, the rate of methicillin-resistant Staphylococcus aureus (MRSA) was higher, and SISO-resistant strains were observed at a high rate among the MRSA. Also, SISO-resistant strains of Serratia marcescens increased. However, the rate of SISO-resistant strains of Pseudomonas aeruginosa decreased, and among Citrobacter freundii, Enterobacter cloacae and Proteus vulgaris, SISO-resistant strains did not increase over the years. 3. MICs of SISO against Providencia rettgeri and Providencia stuartii were high, suggesting that antibacterial activities of SISO was weak against genus Providencia. 4. For comparison, according to MICs of ofloxacin and imipenem, new quinolone-resistant strains were observed at a high rate among various organisms, and carbapenem-resistant strains were observed at a high rate among S. marcescens and P. aeruginosa. 5. SISO is still one of the useful AGs in the 1990's since it maintains its strong antibacterial activities against most clinical isolates obtained in recent years and its potential as a combination drug with beta-lactams is being reported.

[Combined effects of arbekacin with other antibiotics against methicillin-resistant Staphylococcus aureus. II. The combined effect of arbekacin with imipenem or cefminox]

Combined antibacterial effects of imipenem (IPM)+arbekacin (ABK) and cefminox (CMNX)+ABK against methicillin-resistant Staphylococcus aureus (MRSA) were examined and the obtained results are summarized below. 1. Either combination, IPM+ABK or CMNX+ABK, showed a strong antibacterial effect against MRSA when blood concentration of ABK were sustained at MIC as could be expected in clinical situations. While at sub MICs of ABK the antibacterial effect of these combination was slightly less than those of the previously reported combinations of ABK and other antibiotics. 2. Antibacterial effects of the combinations against MRSA were strongly dependent on the concentration of ABK and less dependent on the concentration of IPM or CMNX. As were observed in the previously tested combinations of ABK with other antibiotics, the antibacterial effect of the combination appeared to be highly dependent on the antibacterial activity and the concentration of ABK. 3. As IPM has potent antibacterial activities against Gram-negative bacteria (GNB) including Pseudomonas aeruginosa while CMNX has potent antibacterial activities against GNB except P. aeruginosa, it is likely that the combinations of IPM+ABK or CMNX+ABK are useful for treatment of infections with MRSA together with GNB.

[Antimicrobial activities of major oral antibacterial agents against clinically isolated microbial strains from inpatients]

Antimicrobial activities were examined for major antibacterial agents against clinically isolated microbial strains which were isolated and identified from materials collected from inpatients with various infections in 1988, 1989 and 1990, and the following conclusions were obtained. 1. Among strains isolated each year, methicillin-resistant Staphylococcus aureus (MRSA) were found frequently. 2. CEPs-resistant Escherichia coli strains were observed among strains isolated each year. 3. Increasing tendencies in resistances of Citrobacter freundii, Enterobacter spp., Serratia marcescens to cephems and new quinolones were observed. 4. Increasing tendencies in resistances of Proteus vulgaris to ceftazidime (CAZ) and new quinolones appeared to exist. 5. Among strains isolated each year, resistances of Pseudomonas aeruginosa to CAZ and quinolones were observed in high rates, but also their resistances to imipenem appeared to increase. 6. Many of recently increasing multiple resistant bacteria seem to have different sites of drug action and/or to have non-hydrolytic modes of resistance.

[Combined effects of arbekacin with other antibiotics against methicillin-resistant Staphylococcus aureus. I. The combined effect of arbekacin with fosfomycin or clavulanic acid/ticarcillin]

As arbekacin (ABK) has a highly potent antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA), its combined effects with fosfomycin (FOM) and clavulanic acid/ticarcillin (CVA/TIPC) against MRSA were examined. The obtained results are summarized as follows. 1. Against MRSA either combination, FOM+ABK or CVA/TIPC+ABK showed a strong antibacterial effect at the MIC or the sub MIC of ABK in the blood expected from clinical observations. The MIC of ABK by the combination use seemed to be equivalent to the MBC value. 2. Effective concentrations of antibiotics in these combinations appeared to be strongly dependent on the effective concentration of ABK and less dependent on that of FOM or CVA/TIPC. Therefore, the antibacterial activity of a combination seems to mostly depend on the antibacterial activity and the concentration of ABK. 3. As FOM and CVA/TIPC have antibacterial activities against Pseudomonas aeruginosa, combinations of ABK with these antibiotics are likely to be effective against double infection with P. aeruginosa in MRSA infected patients.

Ecological structure and incidence rates of schizophrenia in Nagasaki City

The purpose of this study was to investigate the relationship between incidence rates of schizophrenia and residential features in Nagasaki City, Japan. Social features of residents in 259 areas in the Nagasaki City ecological structure were determined using the results of the 1980 national census. Six residential factors--employment status, occupational and academic career, household status, length of residence, housing tenure and young male predominance--were selected as factors that clearly reflect residential differentiation of residents. Contrary to the findings of many other studies conducted in Western cities, no statistically significant differences were observed, although it seemed that incidence rates were comparatively higher in the lower social classes. These results possibly reflect differences in cultural and social values and structures.

Treatment of tardive dyskinesia with ceruletide: a double-blind, placebo-controlled study

The effectiveness of a once-weekly i.m. injection of ceruletide (0.8 microgram/kg) in suppressing the symptoms of neuroleptic-induced tardive dyskinesia (TD) was evaluated in a double-blind, placebo-controlled, matched-pairs study. Global evaluation of the severity of TD symptoms over the 8-week study period revealed a significant improvement with ceruletide as compared with placebo. Analysis of the therapeutic response to ceruletide over the course of treatment revealed a slow, but long-lasting improvement of TD symptoms. Side effects, which were mild and transient, consisted mainly of nausea and epigastric discomfort. The incidence of side effects did not differ between the ceruletide- and placebo-treated groups. Ceruletide appears to be a novel and practical treatment that can substantially alleviate the symptoms of dyskinesia.

[Antimicrobial activities of ceftriaxone against clinically isolated strains]

Antibiotic activities (MICs) of ceftriaxone (CTRX) against 1,210 strains of bacteria including 28 spp. isolated in 1987 and 1990 were compared with those of other cephems. 1. When compared to data on clinically isolated strains reported in the early 1980s, strains of the following species isolated in 1990 showed extremely elevated MIC90s of CTRX: Staphylococcus spp., Streptococcus pneumoniae, Escherichia coli, Citrobacter spp., Enterobacter spp., Serratia spp., Proteus vulgaris, Morganella morganii and Providencia spp. No changes were observed in MIC90s between the 2 periods for microorganisms such as Streptococcus pyogenes, Haemophilus influenzae, Klebsiella pneumoniae, Proteus mirabilis and Peptostreptococcus spp. 2. The MIC90 of CTRX to S. pneumoniae was high because a large number of benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP) was present among this species. The MIC80 to Bacteroides fragilis group was also high because highly resistant B. fragilis and B. thetaiotaomicron were isolated in large proportions among the bacteria of this group. Other oxime-type cephems also had high MICs against the above mentioned bacteria. Therefore, a further evaluation has to be made with regard to activities of oxime-type cephems such as CTRX against PISP and B. fragilis group. 3. Sample strains included, in high ratios, methicillin-resistant Staphylococcus aureus (MRSA), cephamycin-resistant as well as oxime-type cephem-resistant intestinal bacteria, Gram-negative bacteria, and new-quinolone-resistant bacteria. Some of there resistant bacteria are also CTRX-resistant, and CTRX had insufficient activities against them. 4. With regard to the assessment of changes of frequencies of specific drug-resistant bacteria, including those with CTRX-resistance from year to year, the authors would like to point out the following comment of theirs made in 1989 and 1991, which appears to be increasing its significance, "Subjects of future studies should include dose on the mechanisms for the acquisition of bacterial resistance to entire beta-lactam antibiotics and the social circumstances in which resistant bacteria appear". 5. It appears that those strains resistant to cephems including CTRX are increasingly found among clinically isolated strains in recent years. CTRX, however, was found still effective against most clinical pathogens. Furthermore, considering that CTRX is one of the few drugs which sustain high blood concentrations of active forms we concluded that CTRX is a useful cephem-group antibiotic.

[Bacteriological evaluations of combination therapies with minocycline and beta-lactams for methicillin-resistant Staphylococcus aureus. I. Cefotiam plus minocycline]

Since methicillin-resistant Staphylococcus aureus (MRSA) is resistant to multiple antibiotics, only a limited number of antibacterial agents shows efficacy against this bacteria. Therefore, combination therapy is often attempted for MRSA infections. Most of the MRSA strains recently isolated, however, have been found to show very high resistance, and some of the antibiotics which had previously been effective have been failing to produce good responses in increasing numbers of patients. Thus, the drugs used for combination therapy in MRSA infections need to be reevaluated. We assessed the bacteriological efficacy of cefotiam (CTM) plus minocycline (MINO) therapy against MRSA in an in vitro system (CTM shows relatively strong antibacterial activities against MRSA with moderate resistance, and MINO shows strong antibacterial activities against highly resistant MRSA. 1. Against MINO-susceptible MRSA strains, CTM + MINO demonstrated potent antibacterial activities at MINO concentrations of MIC or sub-MIC levels, irrespective of the MIC of CTM against MRSA strains being tested. 2. Against MINO-resistant MRSA strains (strains for which MICs of MINO exceeded the upper limit of the clinically expected plasma MINO level), CTM + MINO showed no significant antibacterial activity. These results suggested that the effect of this combination was dependent on the antibacterial activity of MINO. Therefore, the usefulness of this combination in patients with MRSA infections can be predicted based on susceptibilities of involved strains to MINO. 3. The potent antibacterial effect of this combination against MINO-susceptible MRSA strains was considered to be the result of damage to the cellular membrane by MINO and the subsequent antibiotic effect of CTM.(ABSTRACT TRUNCATED AT 250 WORDS)

[Bacteriological evaluations of combination therapies with minocycline and beta-lactams for methicillin-resistant Staphylococcus aureus. II. cefuzonam plus minocycline]

We performed an in vitro assessment of the antibacterial activity of therapy with cefuzonam (CZON) plus minocycline (MINO) against methicillin-resistant Staphylococcus aures (MRSA) infections. 1. Studies using MINO-susceptible and MINO-resistant MRSA strains suggested that the antibacterial activity of CZON + MINO was dependent on the antibiotic action of MINO, similarly to the case with cefotiam (CTM) + MINO. 2. The antibacterial activity (including the FIC index) of this combination was slightly inferior to that of CTM + MINO. However, the time course of antibacterial efficacy of CZON + MINO in MRSA pretreated with MINO was comparable to that of CTM + MINO. 3. CZON + MINO appeared to be a very useful combination in patients with mixed infections due to MRSA and Gram-negative bacteria.