SPARFLOXACIN IN THE TREATMENT OF PATIENTS WITH SURGICAL INFECTIONS

• Published in: CHEMOTHERAPY Vol. 39; no. Supplement4; pp. 601 - 619
• Main Authors: Morimoto, Ken, Kinoshita, Hiroaki, Nakatani, Shuichi, Lee, Kwanchon, Sakai, Katsuji, Fujimoto, Mikio, Ohno, Kohichi, Ueda, Takami, Hirata, Sanae, Muramatsu, Hideki, Mizugami, Kenji
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Chemotherapy 28-08-1991
• Subjects: Quinolones; Sparfloxacin
• ISSN: 0009-3165; 1884-5894
• DOI: 10.11250/chemotherapy1953.39.Supplement4_601

We gave sparfloxacin to five patients after biliary surgery for bile study, 11 patients after breast biopsy for skin study, and two patients with three abscesses for pus study, and studied the pharmacokinetics of the drug. We treated 37 surgical infections of 36 patients with the same drug and evaluated its clinical effects. In the pharmacokinetic study, 300 mg was given orally. Levels of the drug were high for long periods in the plasma and bile. The peak levels in the plasma, 0.94-2.75μg/ml, were at 4-8 hours; the level had decreased to 0.38-0.69μg/ml at 24 hours, and to 0.09-0.35μg/ml at 48 hours. The peak levels in the bile, 8.4-16.7μg/ml, were observed at 4-10 hours, decreasing to 5.6-11.7μg/ml at 12-24 hours, and 2.5-11.9μg/ml at 24-48 hours. The concentrations of sparfloxacin glucuronide in same sample were 2.3 to 23 times higher than those of sparfloxacin. The skin levels of the drug exceeded the plasma levels in 8 of the 11 patients. Of the 37 surgical infections, the clinical efficacy of the drug was excellent in 13, good in 14, fair in 8, and poor in 2, with an efficacy rate of 73%. The bacteriological response was evaluated in 28 of the 37 infections. The bacteria were eradicated in 24 patients, were replaced in three patients, and persisted in one patient, with an eradication rate of 96%. The MIC levels were examined for 41 of the bacterial strains isolated. All were 6.25μg/ml or less. For the four strains of Staphylococcus aureus isolated, the MIC was 0.2μg/ml or less, and one of them was methicillin-resistant, with an MIC of 0.1μg/ml. For the two strains of Streptococcus haemolyticus isolated, the MIC level was 0.025μg/ml, and for the one strain of Streptococcus agalactiae isolated, the MIC level was 1.56μg/ml. For the three strains of Pseudomonas aeruginosa isolated, the MIC levels were 0.78μg/ml or less, but one strain was not eradicated. A transient skin rash was observed in one 24-year-old man.