Studies on multiple-resistant Staphylococcus aureus. (VIII). Effective combined regimen of arbekacin plus cefuzonam in respiratory infections and sepsis caused by methicillin-resistant Staphylococcus aureus

Akira Watanabe, Yushi Nakai, Yoshihiro Honda, Akira Narumi, Masakichi Motomiya, Mitsunobu Honma, Shigeki Nishimura, Akihiko Onodera, Kenichi Asakura, Kenji Yazaki, Kazuo Sato, Kenji Baba, Makoto Kashiwagi, Noboru Aso, Kosaku Nagai, Jun Nakagawa, Hideo Arai, Harukuni Sasaki, Yoshiyuki Anzai, Kazunao NiizumaShigeo Takizawa, Kenji Yanase, Mikae Nakamura, Kotaro Oizumi, Yoichiro Ichikawa, Naoto Tokunaga, Tomotaka Kawayama, Masashi Kawahara, Kozo Ishii, Atsuhiro Akashi, Hisami Matumoto, Kazuhiro Ouchi, Tohru Higuchi, Matsuhisa Inoue

    Research output: Contribution to journalArticlepeer-review

    Abstract

    A combined regimen of arbekacin (200 mg/day) plus cefuzonam (2g/day) was continued for 14.5 days (mean) in 29 cases of infection caused by methicillin-resistant Staphylococcus aureus (MRSA) consisting of 19 cases of pneumonia, four cases each of chronic respiratory infection and lung cancer plus infection, and two cases of sepsis, and the therapeutic efficacy, bacteriological efficacy, pharmacokinetics and combined effect of the regimen against isolated MRSA were evaluated. All of the above 29 patients had underlying diseases, of which respiratory diseases and cerebrovascular diseases constituted the majority. MRSA and other species, mostly Pseudomonas aeruginosa, were isolated simultaneously from 9 of the 29 patients. Clinical efficacy was excellent in two patients, good in 22, fair in two and poor in three (efficacy rate: 82.8%). After treatment, 12 strains of MRSA had been eradicated, 10 had decreased and seven persisted. The mean FIC index of the combined regimen against causative MRSA was 0.53. Peak serum concentrations of arbekacin (8.2 μg/ml) and cefuzonam (45.7 μg/ml) were reached at the end of 30 minutes of intravenous drip infusion. The Tl/2 was 130 minutes for arbekacin and 77 minutes for cefuzonam. Safety was evaluated in 37 patients consisting of the 29 above and eight more cases in whom clinical effects could not be evaluated. Transient diarrhea was observed in one patient. Abnormal laboratory data were found in 17 blood samples from 10 patients (27.0%). Four samples exhibited eosinophilia, three elevated γ-GTP, two each elevated GOT, elevated AL-P, elevated BUN and elevated s-creatinine, and one each anemia and elevated T-bilirubin. Such abnormal laboratory data may be attributable to the severity of the underlying diseases. We conclude from the results described above that the combined regimen of cefuzonam plus arbekacin is useful chemotherapy for the treatment of MRSA infections.

    Original languageEnglish
    Pages (from-to)26-36
    Number of pages11
    JournalChemotherapy
    Volume42
    Issue number1
    DOIs
    Publication statusPublished - 1994

    ASJC Scopus subject areas

    • Pharmacology (medical)
    • Infectious Diseases
    • Pharmacology
    • Drug Discovery
    • Oncology

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