CLINICAL STUDY OF JOSAMYCIN FOR MYCOPLASMAL PNEUMONIA IN CHILDREN

• Published in: The Japanese Journal of Antibiotics Vol. 36; no. 6; pp. 1359 - 1376
• Main Authors: MOTOHIRO, TAKASHI, TANAKA, KOICHI, KOGA, TATSUHIKO, SHIMADA, YASUSHI, TOMITA, NAOFUMI, SAKATA, YASUTAKA, FUJIMOTO, TAMOTSU, NISHIYAMA, TOHRU, ISHIMOTO, KOJI, TOMINAGA, KAORU, YAMASHITA, FUMIO, WATARI, HIROSHI, TAKAJO, NOBUHIKO, ARAKI, HISAAKI, YAMAMOTO, MASASHI, KOMATSU, YOSHIHARU, TANAKA, CHIHEI, TOMOISHI, TAISUKE, KAMEZAKI, KENJI, OHYAMA, KOTOKU, TANAKA, MIKIHISA, TAKASAKI, KOSEI, HATA, KEIJI, YOSHIKANE, TAKASHI, OKI, SHIGEMI, YOSHINAGA, YOZO, KAWANO, NOBUHARU, NAGAI, TAKAYUKI, TOYODA, JUNICHI, SHIMOHIDA, TAKASHI
• Format: Journal Article
• Language: Japanese
• Published: Japan Antibiotics Research Association 25.06.1983
• ISSN: 0368-2781; 2186-5477
• DOI: 10.11553/antibiotics1968b.36.1359

Thirty-one strains of Mycoplasma pneumoniae were tested for drug sensitivity to both josamycin (JM) and erythromycin (EM),to evaluate the efficacy of JM for mycoplasmal pneumonia in children. In addition to the sensitivity tests of 31 M. pneumoniae strains against JM and EM, 50 patients, between the ages of 3 years 1 month and 13 years 3 months, suspected of suffering from mycoplasmal pneumonia were treated with 50 or 200 mg JM tablets at an average daily dose of 43.1mg/kg t. i. d. or b. i. d. for an average period of 14 days; an additional 31 patients between the ages of 2 years 9 months and 11 years, suspected of suffering from this disease were treated with tablet or dry syrup of EM, with the exception of EM estolate, t. i. d. or b. i. d.at an average daily dose of 72.5mg/kg for an average period of 15 days. Patients were selected in 37 and 22 mycoplasmal pneumonic patients respectively for JM and EM. Clinical and bacteriological effects, efficacy and side effects of the drugs on this disease were studied and the following resuls were obtained. 1. Drug sensitivity test Of all 31 strains tested for JM sensitivity the populations which exhibited 0.125mcg/ml were most abundant (18/31,58.1%) and MIC pattern of all strains were distributed from 0.0313 to 0.125mcg/ml. In the EM group, 61.3% (19/31) of the populations were sensitive at 0.015mcg/ml, exhibiting the dominant distribution pattern and MIC range of all organism varied from 0.0078 to 0.0313 mcg/ml. Resistant strains were found to neither JM nor EM.EM was approximately 2 to 10 times more active than JM in MIC evaluation. 2. Clinical effects of JM by daily doses Clinical effects relative to the daily dose were evaluated in 3, 7, 10 days after administration of drugs. The response was favorable, according to assessments of the attending doctors,in 96.7, 100% and 95.8% of the patient group given JM in a daily dose of 40-49 mg/kg,the group to which the largest number of patients belonged. Similar favorable results were obtained by the assessments of Evaluation Committee,showing 86.7, 96.7% and 100% of favorable response. Upon comparison, in the same interval, of these results with those of the groups given EM in a daily dose of 50 mg/kg, the group in which the largest number of patients were seen, there was no significant difference in the assessments either of the attending doctors or of the Evaluation Committee. 3. Global effects The Evaluation Committee assessed the global effects at days 3, 7 and 10 of treatment and obtained high efficacy rates with both JM and EM, namely 96.7% with JM and 86.7% with EM. JM was 10% more effective than EM, but there was no significant difference between the 2 drugs.Efficacy relative to daily dose was 95.8% in the group receiving 40-49 mg/kg JM and 88.9% in that receiving 50 mg or more/kg EM, 7% higher in JM than in EM. However, no significant difference was present. These results suggest that clinical JM, when administered at a daily dose of 40-49 mg/kg, could be as effective as EM. 4. Comparison of efficacy of JM and EM according to the starting date of administration JM and EM were compared in efficacy without regard to dose levels. Apart from the limited number of cases in each group, no significant difference could be determined. According to the global judgement of the Evaluation Committee, there were no noticeable differences at any state of the comparisons. 5. Bacteriological effects Bacteriological effects were noted in 8 JM-treated patients and in 3 EM-treated ones: JM displayed an eradication of organisms in 3 patients with no effect observed in the other 5, and EM in 1 patient and the other 2 patients respectively. 6. Efficacy judged by the attending doctors Efficacy was assessed at 86.5% in JM and 86.4% in EM, with an extreme same profile and no significant difference.