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We investigated the clinical and bacteriological effects of Cefpodoxime proxetil (CPDX-PR) in pediatric infections in 118 boys and 111 girls aged one month to 14 years and 7 months. The diagnosis was acute otitis media in 89, acute tonsillitis in 81, acute pharyngolaryngitis in 34, paranasal sinusitis in 22, and other infections in 3. The daily dose of CPDX-PR was usually 9 mg/kg, but some adjustments were made depending on the effect. In 165 patients the causative organisms were cultured: H. influenzae was the most common, followed by S. aureus and S. pneumoniae. Gram-positive bacteria were detected in 54.2%, Gram-negative bacteria in 45.3%, and fungi in 0.5%. The incidence of Gramnegative infection is higher in children than in adults. The efficacy rate was 91.3%. Side effects were noted in 4 patients but they were mild. Rapid hematological effects on WBC counts, ESR, and differential counts were observed with the administration of CPDX-PR.

Banan® (cefpodoxime proxetil CPDX-PR) was administered to 177 patients with infections in the department of otorhinolaryngology, and its clinical and bacteriological effects, and its concentration in tissue and blood were determined.The clinical effect was 90.5% for acute otitis media, 59.0% for chronic otitis media, 92.0% for acute sinusitis, 84.2% for chronic sinusitis, and 88.2% for tonsillitis. The bacteriological bacterial elimination rate was 82.4% for acute otitis media, 62.5% for chronic otitis media, 88.9% for acute sinusitis, 64.7% for chronic sinusitis, and 91.3% for tonsillitis.The concentration of the drug in tissue was 0.25 to 0.70μ/ml, and the concentration in blood was 0.12 to 2.45μg/ml.Side effects were not observed in any of the cases.

Formation of an intratracheal granuloma is one of the sequelae in tracheotomy. We reported a man of intratracheal granuloma. The patient underwent an emergency tracheotomy in another hospital to secure his air way for unconsciousness caused by the traffic accident. Six weeks later, his tracheostoma was closed. After the closure of the tracheostoma, shortness of breath increased gradually. After six months, as his dyspnea became severe, he visited our hospital urgently. We removed the intratracheal granuloma through the new tracheostoma which was made by us. We cited a few factors as the cause of the intratracheal granuloma, that is, infection around the tracheostoma, mechanical irritation of the cannula and unskillful technique in the tracheotomy. It is concluded that we must pay much attention to surgical managements in tracheotomy in order to avoid complications and sequelae, even though the tracheotomy is in emergency.

Infections of the ears, nose and thsoat are caused by a variety of pathogens at different sites and under various pathological conditions. Therefore, treatment with one antibiotic agent is sometimes not effective. In this study we evaluated the clinical and bacteriological results of combination therapy with aztreonam (AZT) and fosfomycin (FOM) in 4g patients with an acute exacerbation of chronic otitis media, chronic sinusitis or chronic tonsillitis.The clinical effectiveness was 80.4%. Of the 41 strains of bacteria isolated, disappeared, 6 decreased and 9 were unchanged after the treatmedt of AZT and FOM. No side effects were observed.

In recent years, the number of adults with acute deterioration of chronic otorhinolaryngological infections has been increasing.Problems that we encounter in the treatment of chronic otorhinolaryngological infections include an increase of drug-resistant bacteria and unsatisfactory penetration of drugs into the tissues. The authors recently used Tarivide (ofloxacin), a new drug of the quinolone family, to treat 20 patients with acute deterioration of chronic otorhinolaryngological diseases (tonsillitis, nasosinusitis and tympanitis). The drug proved to be clinically effective in 95.0% and bacteriologically effective in 88.2% of the 20 patients. In 6 patients who were treated with this drug preoperatively, the blood and tissue concentrations of the drug were high.These results indicate that ofloxacin can be useful for the treatment of chronic infections in the field of otorhinolaryngology.

In recent years, adult tonsillectomies have tended to increase, and with more adult patients there has been increased bleeding during the operation, as well as a tendency for postoperative taste disorders and numbness of the tongue, presumably because the operative field is fixed with a Davis mouth-opening device in pediatric tonsillectomies, and unnecessary compression is applied to the tongue.The authors have devised the Kinki mouth-opening device which combines the advantages of the Whitehead and Davis devices. AA comparison between the Kinki and Davis devices showed that the mouth opening angle and the space between the teeth and the root of the tongue were all greater with the Kinki device than with the Davis device, indicating that the mouth was opened wider with the Kinki device. The postoperative changes in taste were measured with an electric gustometer, and the Davis device caused more loss of taste than the Kinki device. The incidence of tongue numbness was also greater with the Davis device than with the Kinki device. The Kinki mouth-opening device appears to be ideal for adult tonsillectomies.

The clinical and microbiological effects of norfloxacin were assessed in 26 adults with acute tonsillitis or acute pharyngolaryngitis. The concentration of norfloxacin in blood and tissue was measured during tonsillectomy. The clinical cure rate was 83.4% for acute tonsillitis and 87.5% for acute pharyngolaryngitis. The bacteriocidal rates for four bacteria ranged from 75% to 100%. Concentration of norfloxacin in blood and tissue was high. Thus, norfloxacin had high efficacy in the treatment of tonsillitis and pharyngolaryngitis.

We performed clinical and bacteriological studies on Ceftriaxone, (Rocephin®) a broad spectrum antibacterial agent with a long half-life, in the treatment of adult infections of the upper respiratory tract (14 cases of tonsillitis and 20 cases of pharyngolaryngitis).The rate of clinical improvement was 92.8% for tonsillitis and 85.9% for pharyngolaryngitis. In terms of its bacteriological effect, rate of improvement for S. aureus and B. streptococcus was 87.5% and 81.8%, and 100% and 100% for tonsillitis and pharyngolaryngitis, respectively. The blood concentration of Ceftriaxone after a single injection was 169.2, 81.0, 45.1 and 16.8μg/ml at 1, 6, 12 and 24hr, respectively.These results suggest the effectiveness of Ceftriaxone in the treatment of infections of the upper respiratory tract.

We reviewed 64 cases of peritonsillar abscess treated at our clinic between May, 1975 and March, 1988. The patients consisted of 42 males and 22 females, aged 3 to 68 years. The abscess was on the right side in 35 cases, on the left in 28 cases and bilateral in 1 case. Bacteriological study of the abscess revealed a high percentage of α-streptococcus and β-streptococcus in aerobic culture, and Bacteroides sp., Peptostreptococcus sp., and Peptococcus., in anerobic culture. All patients were treated with antibiotics. Removal of abscess by puncture was performed in 23 patients, and incision for drainage was perfomed in 41. Interval tonsillectomy was perfomed in 3 patients and immediate tonsillectomy was perfomed in 1 patient. Recurrent peritonsillar abscess was observed in one patient who had not undergone tonsillectomy. Puncture of abscess, incision for drainage and administration of antibiotics are essential in the treatment of peritonsillar abscess.

We studied the therapeutic effect of high-dose administration of a thrombolytic agent (Abbokinase®) in 33 patients with sudden deafness.The treated group received 120, 000IU of Abbokinase for 7 days and the results were compared with those in an untreated group.In terms of clinical efficacy, the treated group showed 9 higher rate of recovery from sudden deafness than the untreated group.Abbokinase was considered to effective in patients with sudden deafness.