We investigated the usefulness of a combination therapy with cefuzonam (CZON) plus minocycline (MINO) in 15 cases of severe infections caused by methicillin (DMPPC)-resistant Staphylococcus aureus (MRSA). These comprised 5 cases of acute pneumonia, 7 of chronic repiratory infections, 2 of infection supervening on lung cancer and 1 of urinary tract infection. Twelve of 15 patients were treated with 1 to 2 g of cefuzonam plus 100 mg of minocycline, b.i.d., respectively (combination therapy). Three of 15 patients w^ere treated with 2 to 4 g/day of cefuzonam (monotherapy). Clinical efficacy was excellent in 1, good in 10, fair in 1 and poor in 3 cases. The efficacy rate was 66.7% in 12 cases treated with the combination therapy, after which 9 of 15 MRSA strains disappeared. All 12 strains, whose MICs were determined by a microbroth dilution method using the MIC 2000 system, were resistant to cefuzonam (MICs exceeding 12.5 μg/ml), but six of them were sensitive to minocycline (MICs less than 0.39 μg/ml). Against these six strains, the combination's FIC (fractional inhibitory concentration) indices, determined by a checkerboard method, were 0.5 — 0.75, and the mean was 0.581. No adverse reactions were observed in any of the 15 cases. One case each of elevated GOT, elevated GOT and GPT, eosinophilia, and leucocytopenia plus thrombocytopenia was noted, but values returned to normal after completion of the therapy. From the above results, we conclude that combination therapy of cefuzonam plus minocycline against MRSA infections is useful.
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