Among the bacteria isolated from clinical specimens of hospitalized patients, one of the most intractable species was Pseudomonas aeruginosa, the causative agent of P. aeruginosa. It resists a variety of antibacterial agents. Carbapenem is known as one of a few that are efficacious for P. aeruginosa infections. Maintaining the drug susceptibility of pathogens leads to the favorable clinical outcome in patients with infections diseases. The excessive use of carbapenem and other antimicrobial agents results in the increase of drug-resistant mutants of P. aeruginosa. At a meeting of the Health Ministry's infectious disease control committee in June 2007, the necessity of using antibacterial agents in more rational ways was highlighted on the suggestion of some member pharmacists. Incidentally, during the periods from January to June and from July to December 2007, we studied the antimicrobial use density (AUD) of carbapenem agents and the occurrence ratio of carbapenem-resistant mutamts of P. aeruginosa. The results showed that the occurrence of drug-resistant mutants decreased in proportion to the decrease of AUD. We believe the investigation of the AUD of any antibacterial agents is an important task pharmacists should take upon themselves to control infectious diseases. By reporting the results of our investigation on a regular basis, we are going to make a modest contribution toward the optimum use of antimicrobial agents.
Pseudomonas aeruginosa ; Antibacterial drugs ; Carbapenems ; control ; occurrence

We present a patient with short bowel syndrome (SBS), successfully treated with the Kampo medicine, shigyakuto-kagen. The patient was a 74 year old female complaining of severe diarrhea, abdominal distention, and abdominal pain. She was diagnosed as having tuberculous peritonitis when she 23 years of age. A partial resection of the small bowel and colon was performed for ileus, secondary to her tuberculous peritonitis, eventually causing her short bowel syndrome (SBS). Severe abdominal distention and pain had persisted even after the resection surgery. She consulted our clinic at 60 years of age in order to receive Kampo therapy. Bukuryoshigyakuto was prescribed, and her condition markedly improved. Zanthoxylum piperitum was added to bukuryoshigyakuto, and the regimen had the reactivity of daikenchuto. She regained her pre-operation body weight. It is significant that this case was followed for 14 years with therapy based on Kampo diagnosis, without remarkable complications, although patients with SBS often tend to have poor prognosis.
Short Bowel Syndrome ; Medicine, Kampo ; Treated with ; Therapeutic procedure ; Peritonitis