Eleven patients who underwent total middle ear reconstruction for infection of the radically mastoidectomized ears and six patients who underwent tympanoplasty at university of Tokyo hospitals between January 1997 and March 1999, were studied. They were given cefozopran (CZOP) 2g intravenously at 30 minutes before operation, and the drug concentrations in mucosa of the middle ear and in subcutaneous tissue of the mastoid antrum were measured 60 minutes after the intravenous administration. Thereafter, CZOP was given for 7-8 days at 2g×twice/day, and its clinical effect was studied.
In the patients who underwent total middle ear reconstruction, the concentrations in mucosa of the middle ear and in subcutaneous tissue of the mastoid antrum were 27.8μg/g and 29.8μg/g respectively. In the patients who underwent tympanoplasty, the concentrations were 33.2μg/g and 13.9μg/g respectively. Thus, in comparison with MIC80, of CZOP against various bacteria except MRSA, this drug is considered to have maintained concentrations that exhibited sufficient antibacterial activity.
After administration of CZOP, all strains of Gram-positive coccus disappeared, and Pseudomonas aeruginosa disappeared or its bacterial count decreased. After administration, although fungi etc. developed newly in seven patients, no problems in postoperative treatment happened.
In respect to effectiveness rate and usefulness rate, both were 90.9%(10/11) in patients with total middle ear reconstruction. In patients with tympanoplasty, the rates were both 100%(6/6). After tympanoplasty, exceptionally fever, urinary protein and neutropenia developed in one patient. However, the symptoms disappeared with administration of an antipyretic drug or discontinuation of CZOP.
