Efficacy of combination therapy against MRSA in Ibaraki prefecture

M. Otsuka, T. Sawahata, T. Nakai, S. Hasegawa, S. Iwata, Y. Yoshizawa, H. Ishida, M. Irokawa, A. Goto, Y. Shinohara, S. Togawa, Y. Monma

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Abstract

Clinical efficacies of fosfomycin (FOM) or arbekacin (ABK) plus β-lactam combination therapies against methicillin-resistant Staphylococcus aureus (MRSA) infections were examined in 15 major hospitals in Ibaraki Prefecture. The subjects were 54 inpatients from January 1991 to April 1993, and most of them showed moderate to severe infections with underlying diseases. MRSA alone was isolated from 23 patients and the other 31 patients had polymicobes including MRSA. Pseudomonas aeruginosa was the most frequent among the co-isolated strains. The number of patients treated with FOM and cefmetazole (CMZ) was 22 (Group C) and that with FOM and flomoxef (FMOX) was 25 (Group F). CMZ or FMOX was administrated 60 minutes after FOM administration. To 8 nonresponding patients in group C and F and 7 nonresponders to the other therapies, ABK and ceftazidime (CAZ) or ABK and piperacillin (PIPC) were treated simultaneously (Group A). The clinical efficacies of Groups C and F were 63.6% and 64%, respectively. The bacteriological efficacies (eradication rates) of both groups including microbial substitutions were 42.9% in the former and 56.5% in the latter. No statistical differences were observed in the clinical and the bacteriological efficacies between Groups C and F. The clinical and bacteriological efficacies in Group A were 66.7% and 46.2%, respectively. No side effects were observed in any cases. Mild disturbances of hepatic functions were observed in 2 cases of Groups C and F, and there were no abnormal laboratory test results in Group A. The combination therapy with FOM plus β-lactam may be useful for the treatment of MRSA infections, but the ABK plus CAZ or PIPC combination is more effective to the patients with multi-drug-resistant MRSA infections.

Original languageEnglish
Pages (from-to)781-789
Number of pages9
JournalJapanese Journal of Antibiotics
Volume47
Issue number6
Publication statusPublished - 1994
Externally publishedYes

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Fosfomycin
Methicillin-Resistant Staphylococcus aureus
Cefmetazole
Lactams
Piperacillin
Ceftazidime
Infection
Therapeutics
Pseudomonas aeruginosa
Inpatients
habekacin
Liver
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmacology

Cite this

Otsuka, M., Sawahata, T., Nakai, T., Hasegawa, S., Iwata, S., Yoshizawa, Y., ... Monma, Y. (1994). Efficacy of combination therapy against MRSA in Ibaraki prefecture. Japanese Journal of Antibiotics, 47(6), 781-789.

Efficacy of combination therapy against MRSA in Ibaraki prefecture. / Otsuka, M.; Sawahata, T.; Nakai, T.; Hasegawa, S.; Iwata, S.; Yoshizawa, Y.; Ishida, H.; Irokawa, M.; Goto, A.; Shinohara, Y.; Togawa, S.; Monma, Y.

In: Japanese Journal of Antibiotics, Vol. 47, No. 6, 1994, p. 781-789.

Research output: Contribution to journalArticle

Otsuka, M, Sawahata, T, Nakai, T, Hasegawa, S, Iwata, S, Yoshizawa, Y, Ishida, H, Irokawa, M, Goto, A, Shinohara, Y, Togawa, S & Monma, Y 1994, 'Efficacy of combination therapy against MRSA in Ibaraki prefecture', Japanese Journal of Antibiotics, vol. 47, no. 6, pp. 781-789.
Otsuka M, Sawahata T, Nakai T, Hasegawa S, Iwata S, Yoshizawa Y et al. Efficacy of combination therapy against MRSA in Ibaraki prefecture. Japanese Journal of Antibiotics. 1994;47(6):781-789.
Otsuka, M. ; Sawahata, T. ; Nakai, T. ; Hasegawa, S. ; Iwata, S. ; Yoshizawa, Y. ; Ishida, H. ; Irokawa, M. ; Goto, A. ; Shinohara, Y. ; Togawa, S. ; Monma, Y. / Efficacy of combination therapy against MRSA in Ibaraki prefecture. In: Japanese Journal of Antibiotics. 1994 ; Vol. 47, No. 6. pp. 781-789.
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abstract = "Clinical efficacies of fosfomycin (FOM) or arbekacin (ABK) plus β-lactam combination therapies against methicillin-resistant Staphylococcus aureus (MRSA) infections were examined in 15 major hospitals in Ibaraki Prefecture. The subjects were 54 inpatients from January 1991 to April 1993, and most of them showed moderate to severe infections with underlying diseases. MRSA alone was isolated from 23 patients and the other 31 patients had polymicobes including MRSA. Pseudomonas aeruginosa was the most frequent among the co-isolated strains. The number of patients treated with FOM and cefmetazole (CMZ) was 22 (Group C) and that with FOM and flomoxef (FMOX) was 25 (Group F). CMZ or FMOX was administrated 60 minutes after FOM administration. To 8 nonresponding patients in group C and F and 7 nonresponders to the other therapies, ABK and ceftazidime (CAZ) or ABK and piperacillin (PIPC) were treated simultaneously (Group A). The clinical efficacies of Groups C and F were 63.6{\%} and 64{\%}, respectively. The bacteriological efficacies (eradication rates) of both groups including microbial substitutions were 42.9{\%} in the former and 56.5{\%} in the latter. No statistical differences were observed in the clinical and the bacteriological efficacies between Groups C and F. The clinical and bacteriological efficacies in Group A were 66.7{\%} and 46.2{\%}, respectively. No side effects were observed in any cases. Mild disturbances of hepatic functions were observed in 2 cases of Groups C and F, and there were no abnormal laboratory test results in Group A. The combination therapy with FOM plus β-lactam may be useful for the treatment of MRSA infections, but the ABK plus CAZ or PIPC combination is more effective to the patients with multi-drug-resistant MRSA infections.",
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AU - Sawahata, T.

AU - Nakai, T.

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AU - Iwata, S.

AU - Yoshizawa, Y.

AU - Ishida, H.

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N2 - Clinical efficacies of fosfomycin (FOM) or arbekacin (ABK) plus β-lactam combination therapies against methicillin-resistant Staphylococcus aureus (MRSA) infections were examined in 15 major hospitals in Ibaraki Prefecture. The subjects were 54 inpatients from January 1991 to April 1993, and most of them showed moderate to severe infections with underlying diseases. MRSA alone was isolated from 23 patients and the other 31 patients had polymicobes including MRSA. Pseudomonas aeruginosa was the most frequent among the co-isolated strains. The number of patients treated with FOM and cefmetazole (CMZ) was 22 (Group C) and that with FOM and flomoxef (FMOX) was 25 (Group F). CMZ or FMOX was administrated 60 minutes after FOM administration. To 8 nonresponding patients in group C and F and 7 nonresponders to the other therapies, ABK and ceftazidime (CAZ) or ABK and piperacillin (PIPC) were treated simultaneously (Group A). The clinical efficacies of Groups C and F were 63.6% and 64%, respectively. The bacteriological efficacies (eradication rates) of both groups including microbial substitutions were 42.9% in the former and 56.5% in the latter. No statistical differences were observed in the clinical and the bacteriological efficacies between Groups C and F. The clinical and bacteriological efficacies in Group A were 66.7% and 46.2%, respectively. No side effects were observed in any cases. Mild disturbances of hepatic functions were observed in 2 cases of Groups C and F, and there were no abnormal laboratory test results in Group A. The combination therapy with FOM plus β-lactam may be useful for the treatment of MRSA infections, but the ABK plus CAZ or PIPC combination is more effective to the patients with multi-drug-resistant MRSA infections.

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