Clinical effect of 3g/day administration of meropenem on severe pneumonia

We examined the clinical effect of Meropenem (MEPM) on severe pneumonia. We administered 3g of Meropenem daily to 20 patients with severe pneumonia: 8 communityacquired pneumonia patients, 9 nursing and healthcare-associated pneumonia patients, and 3 hospital-acquired pneumonia patients. It was effective in 15 of the 20 patients (75%): 8 of 8 community-acquired pneumonia patients (100%), 6 of 9 nursing and healthcare-associated pneumonia patients (66.6%), and 1 of 3 hospital-acquired pneumonia patients (33.3%). Bacteriologically, 9 of a total of 10 strains (90%) were eradicated: 4 of 4 Streptococcus pneumoniae strains, 2 of 2 methicillin-sensitive Staphlococcus aureus strains, 1 of 2 Enterococcus faecalis strains, 1 of 1 Klebsiella pneumoniae strain, and 1 of 1 Escherichia coli strain. Hepatic dysfunction was observed as a side effect in 8 patients (40%). Based on the above, administration of MEPM daily 3 g is extremely effective for community-acquired pneumonia, while it appears ineffective in many cases of nursing and healthcare-associated pneumonia or hospital-acquired pneumonia, and results in hepatic dysfunction at a high frequency

Q fever in acute upper respiratory tract infection

We examined whether or not acute upper respiratory tract infection is associated with Q fever (Coxiella burnetii infection). The subjects consisted of 124 patients with acute upper respiratory tract infection. At initial medical consultation, the presence or absence of serum C. burnetii was examined by nested PCR method. Of the 124 patients, no patients (0 percent) were positive for C. burnetii in serum. These results suggested that the involvement of Q fever in acute upper respiratory tract infection is extremely low

Clinical effect of sulbactam/ampicillin on community-acquired pneumonia with positive Streptococcus pneumoniae urinary antigen test

We investigated the efficacy of intravenous penicillin (sulbactam/ampicillin: SBT/ABPC) in adult patients with positive Streptococcus pneumoniae urinary antigen test requiring hospitalization. We administered 3g of SBT/ABPC intravenously in the morning and evening for 7-14 days to 32 adult community-acquired pneumonia patients with positive Binax NOW(R) S. pneumoniae urinary antigen. Clinical efficacy, bacteriological efficacy, and side effects of these patients were prospectively examined. We observed clinical efficacy in a total of 28 of 32 patients (87.5%); 24 of 26 moderate patients (92.3%), and four of six severe patients (66.7%). Side effects were drug eruption, increased GOT, increased AMY, and decreased WBC, observed in one patient each; however, all were mild. SBT/ABPC is extremely useful in patients with positive S. pneumoniae urinary antigen test requiring hospitalizatio

Association between ImmunoCard Mycoplasma test and particle agglutination (PA) method in Mycoplasma pneumonia diagnosis

We examined the association between ImmunoCard Mycoplasma test and particle agglutination (PA) method in Mycoplasma pneumonia diagnosis. Subjects were 105 pneumonia patients who were positive for ImmunoCard Mycoplasma test at initial consultation and followed up by PA method using paired sera. The coincidence rates of positive cases of ImmunoCard Mycoplasma test and positive cases of PA method were examined by generation. The results showed that the coincidence rate was 87.5% in aged less than 19 years, 48.8% in aged 20-39 years, 36.4% in aged 40-59 years, 21.1% in aged 60-79 years, and 25.0% in aged 80 or greater, for a total of 44.8% (47 of 105 patients). The results suggested that a positive result for ImmunoCard Mycoplasma test may be due to acute infection in patients aged 19 years or less; however, 50% or more of patients aged 20 years or greater were false positive, which may reflect the presence of past infection

柴朴湯が著効を示した呼吸困難の１例

　西洋医学的検査に異常を認めない呼吸困難に，柴朴湯が著効した症例を経験したので報告する．症例は，２年間続く呼吸困難を訴える68歳の男性である．胸部Ｘ線，心電図，肺機能検査に異常なく，吸入ステロイド薬，吸入β2刺激薬の効果はなかった．そこで，柴朴湯を投与したところ，１週後には，呼吸困難が軽減し，２週後には，呼吸困難は完全に消失した．柴朴湯は，気管支喘息に用いる漢方薬として有名であるが，不安神経症にも効果があるとされる．本例のように，西洋医学的に異常がなく，心身症的な要素の強い呼吸困難患者に柴朴湯が有効であると考えられた．　A case in which Saibokuto has been effective for dyspnea without abnormalities in Western medical examination is reported. The case was 68-year-old male who complained of dyspnea lasting 2 years. His chest X-ray, electrocardiogram and pulmonary function test showed no abnormality, and inhaled corticosteroids and inhaled β2 stimulants had no effects on his dyspnea. Therefore, Saibokuto was administered, as a result, dyspnea was alleviated after one week and disappeared completely after two weeks. Saibokuto is famous as herbal medicine to be used for bronchial asthma, and it is said to have an effect on anxiety neurosis. As shown in this case, it is considered that Saibokuto is effective for dyspnea with strong psychosomatic factor showing no abnormality in Western medical examination