| Budget Amount *help |
¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 1994: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1993: ¥1,100,000 (Direct Cost: ¥1,100,000)
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| Research Abstract |
The intractability of complicated UTI to antibacterial treatment is caused by the biofilm produced by the infecting bacterial bacterial. Therefore, we studied the efficacy of clarithromycin (macrolide antimicrobial agent) on the biofilm in comolicated UTL,both experimentally and clinically.
1.Experimental study :
We devised a computer-controlled complicated bladder model(biofilm model of urinary tract)enabling us to simulate the time-course of concentration of antimicrobial agents in the urine. Using this model, we investigated clarithromycin, which has been reported to have anti-biofilm action, at concentrations close to its urinary levels at the time of clinical use in order to predict its effect on biofilm of the urinary tract. Experimentally, we demonstrated that the biofilm disappeared due to the action of clarithromycin, and the inhibition of glycocalyx production may be implicated in the mechanism by which clarithromycin prevents biofilm formation.
2.Clinical study :
Based on the experimental findings, a clinical study was carried out to determine the efficacy of combined administration of ciprofloxacin and clarithromycin in patients with complicated UTI.As the results, the efficacy rate were significantly higher in the ciprofloxacin combined with clarithromycin treatment group than in the ciprofloxacin-only treatment group in the complicated UTI cases without indwelling catheter. On the other hand, in cases with indwelling catheter, there was no significant difference among the two groups. Based on the above results, we surmise that the combined use of an antimicrobial agent which is active against the causative microbe and antibiofilm agent such as clarithrromycin will show some degree of efficacy in the patients with complicated UTI.
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