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細菌性下痢症における抗生剤の非経口的投与について : ウサギ下痢症における実験的研究


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Title: 細菌性下痢症における抗生剤の非経口的投与について : ウサギ下痢症における実験的研究
Other Titles: Experimental Study on the Parenteral Use of Antibiotics for the Treatment of Bacterial Diarrheal Diseases
Authors: 一ノ瀬, 休生 / 岩永, 正明
Authors (alternative): Ichinose, Yoshio / Iwanaga, Masaaki
Issue Date: 30-Mar-1983
Publisher: 長崎大学熱帯医学研究所 / Institute of Tropical Medicine, Nagasaki University
Citation: 熱帯医学 Tropical medicine 25(1). p11-21, 1983
Abstract: 我々が最近新しく開発した感染症モデル(ウサギコレラ)を使用して,非経口的に投与された抗生剤の便中への移行とその効果並びに移行経路について検討した.非経口的に投与された各種抗生剤は,急性期コレラにおいて,まもなく便中に出現した.その移行率はゲンタマイシンでは非常に高率であり,セフォチアムでは僅かな移行しかみられなかった.ミノサイタリンは中等度であり,リファンピシンの移行は良好であった.1回投与の後,ミノサイクリンとセフォチアムは8~10時間で便中から消失したが,ゲンタマイシンとリファンピシンは長時間にわたって便中から検出された.腸管ループテストとの結果と比較することによって,便中のゲンタマイシンはその殆ど全てが腸粘膜を通過してきたものであり,リファンピシンはその大半が肝・胆系を通じて便中に現われるということが判明した.ミノサイタリンでは両経路の差は少ないが粘膜経路をとるものが多く,セフォチアムでは肝・胆経路をとる量の方がやや多かった.便中のゲンタマイシン濃度は,使用したコレラ菌に対するin vitroでの最小発育阻止濃度を10~20倍も上まわっていたが,コレラ菌の増殖と毒素産生は全く抑制されていなかった.リファンピシンの殺菌効果は卓越していたが,10^<-6>~10^<-7>の割合で自然耐性菌が存在し,一旦便中のコレラ菌が消失したかに見えてもまもなく高度耐性菌による増殖がみとめられた. / The movement of parenterally given antibiotics to the diarrheal stool was studied by using two kinds of adult rabbit model for experimental cholera (T-model and Intestinal loop model). Four antibiotics (cefotiam=CTM, 20mg/kg; gentamicin=GM, 3mg/kg; minocycline=MINO, 10mg/kg; rifampicin=RFP, 5mg/kg) were administered with intravenous shot to the animals infected with cholera. All drugs appeared in the stool soon after medication. The concentration of the drugs in the stool was highest in GM, and lowest in CTM. RFP was detected from the stool for more than 24 hours after the single dose, but CTM was not detected after 8 hours. The pathway of GM from the blood vessels to the intestinal lumen was almost totally through the intestinal mucosa (mucosal pathway), while that of RFP was mainly through the bile system (hepatic pathway). Mucosal pathway was predominant in the movement of MINO. Hepatic pathway was predominant in CTM, although the movement of this drug was not much directed to the intestine. Different from antibacterial activity in vitro, GM did not work against the pathogen at all in vivo. Vibrio cholerae in the intestine kept on proliferating and producing cholera toxin under the presence of GM in high concentration. RFP showed an excellent bactericidal effect as well as in vitro, but a problem of naturally resistant strain with the frequency of 1 to 10^6-10^7 remained. The necessity of abundant defecation to eliminate the pathogen was suggested in the case with bacteriostatic antibiotics such as MINO. The benefit of parenteral use of antibiotics for the treatment of bacterial diarrheal diseases was discussed.
URI: http://hdl.handle.net/10069/4344
ISSN: 03855643
Type: Departmental Bulletin Paper
Appears in Collections:Volume 25, No. 1

Citable URI : http://hdl.handle.net/10069/4344

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