EFFECT OF MIDECAMYCIN ACETATE ON INTESTINAL BACTERIAL FLORA OF CHILDREN, AND RESULTS OF CLINICAL STUDY ON MIDECAMYCIN ACETATE IN TREATMENT OF MYCOPLASMAL PNEUMONIA

• Published in: The Japanese Journal of Antibiotics Vol. 35; no. 11; pp. 2491 - 2529
• Main Authors: MOTOHIRO, TAKASHI, TANAKA, KOICHI, KOGA, TATSUHIKO, SHIMADA, YASUSHI, TOMITA, NAOFUMI, SAKATA, YASUTAKA, FUJIMOTO, TAMOTSU, NISHIYAMA, TOHRU, NAKAJMA, TETSUYA, ISHIMOTO, KOJI, TOMINAGA, KAORU, YAMASHTTA, FUMIO, YUKIZANE, SHIGENORI, SUZUKI, KAZUSHIGE, TAKAJO, NOBUHIKO, ARAKI, HISAAKI, KAWANO, YUKO, MATSUURA, SHUJI, IMAI, SHOICHI, YUASA, TAKEBSHI, TANAKA, YOSHIMI, TSUGAWA, SHIN, NAGAYAMA, KIYOTAKA, YAMAMOTO, MASASHI, KOMATSU, YOSHIHARU, TANAKA, CHIHEI, MATSUYAMA, MARIKO, KOGA, TATSUO, SHIOTSUKI, KAZUHIDE, KINOSHITA, SHOHEI, HARAGUCHI, KENJI, MATSUO, HIROSHI, IMUTA, FUSAE, OHTA, MASANORI, KUBOTA, KAORU, ICHIKAWA, KOHTARO, HARADA, YUTAKA, NAKAMURA, MASAHIRO
• Format: Journal Article
• Language: Japanese
• Published: Japan Antibiotics Research Association 25.11.1982
• ISSN: 0368-2781; 2186-5477
• DOI: 10.11553/antibiotics1968b.35.2491

A dry syrup containing, per1g, 200mg(potency)of midecamycin acotate(MOM), a newly-doveloped demivative of midccamycin, was administered to 9 children rarging in age from 1 year and 2 months to 10 years and 9 months.The mean daily dosage administered to these subjects was 21.4mg/kg, Which was divided into 3 equal doses and given after the 3 moals in the day. The mean dumation of this drug administration was 12 days. The effect of this drug treatment on the bacterial flora of the irtostinal tmct was investigated. In addition to this study, a second irvestigation was carried out;An MOM dry syrup containing 100 mg(potency)/1g(200mg(potecy)/g in the case of the 9 subjects studied for changes in the intestinal bacterial count)was administered to 162 pationts diagnosed as having mycoplasmal pneumonia. These patients ranged in age from 10 months to 16 ycars and 7 months.They had been outpatients, but were hospitalized in the authors department or in asgociatod hospitals during the 1-year-and-5-months period from June 1980 through October 1981.For comparison,an erythromycin dry syrup (other than EM estolate)was administered to 54 patients showing a similar age range and also diagnosed as having mycoPlasmal pneumonia. These 2 drug treatment groups were then compared in terms of the clinical efficacy,the bacteriological efficacy,the usefulness and the occurrence of side effects.THe results were described as following. Of the 162 mycoplasmal pneumonia patients who were treated with MOM,it was possible to evaluate the clinical efficacy in 100 patients.The mean daily dosage in those patients was 21.8 mg/kg.The drug was divided into 3 equal doses and administred after meals in 90 of the patients, while the 3 doses were switched to 4 in 1 patient,and 9 patients were given the MOM dry syrup in 4 epual doses.The overwhelming majority of these patients thus took the drug in 3 daily doses.The mean duration of the MOM treatment was 12 days.Similarly,of the 54 mycoplasmal pneumonia patients treated with EM,it was possible to evaluate the clinical emcacy in 36.The mean daily dosage was 46.4mg/kg,and this was administered in 3 daily doses to 5 patients and in 4 daily doses to 31 patients.The mean duration of this EM dry syrup therapy was 12 days. 1.In order to determine the effect of the MOM dry syrup on the bacterial flora of the intestinal tract,samples were collected and studies were performed at 4 different times;prior to the start of the drug administration,on days 3-4 and 5-7 during the administration period,and on days 4-6 following the completion of the administration program.It was found that there was no effect on E.coli,which is representative of the Gram-negative bacilli.In 1 subject,K.oxytoca was isolated at 1.2×107cells/g on the 3rd day after the start of the MOM administrations,but the subject showed no symptoms of diarrhea and this bacterium could no longer be detected on day 5 of the administrations.Citrobacter sp.were compared before and after the MOM dosing Period:Most of the subjects yielded these microbes on days 3-4 and 5-7 during the administration period and days 4-6 after completing the dosings. The mean bacterial counts of these species at the 4 times of detection were 1.7×109cells/g, 1.6×1010 cells/g5.6×106cells/g and 2.4×108cells/g,which shows that these bacteria increased.However,if we consider the enterobacteriaceae overall,there was no fixed pattrn at the 4 times of sampling.Within the Gram-positive cocci,Staphylococcus sp.showed findings similar to those for enterobacteriaceae.A comparison of the population of Streptocoms sp.before and after the MOM administrations showed that the count of these bacteria increased at each successive sampling time;however,the counts were still within the normal range of values for these species.