Educational effects using a robot patient simulation system for development of clinical attitude.

INTRODUCTION: The aim of this study was to assess the effectiveness of improving the attitude of dental students towards the use of a full-body patient simulation system (SIMROID) compared to the traditional mannequin (CLINSIM) for dental clinical education. MATERIALS AND METHODS: The participants were 10 male undergraduate dental students who had finished clinical training in the university hospital 1 year before this study started. They performed a crown preparation on an upper pre-molar tooth using SIMROID and CLINSIM as the practical clinical trials. The elapsed time for preparation was recorded. The taper of the abutment teeth was measured using a 3-dimensional shape-measuring device after this trial. In addition, a self-reported questionnaire was collected that included physical pain, treatment safety and maintaining a clean area for each simulator. Qualitative data analysis of a free format report about SIMROID was performed using text mining analysis. This trial was performed twice at 1-month intervals. RESULTS: The students considered physical pain, treatment safety and a clean area for SIMROID significantly better than that for CLINSIM (P < .01). The elapsed time of preparation in the second practical clinical trial was significantly lower than in the first for SIMROID and CLINSIM (P < .01). However, there were no significant differences between the abutment tapers for both systems. For the text mining analysis, most of the students wrote that SIMROID was similar to real patients. CONCLUSION: The use of SIMROID was proven to be effective in improving the attitude of students towards patients, thereby giving importance to considerations for actual patients during dental treatment.

Influence of lower extremity rotation on knee kinematics in single-leg landing.

OBJECTIVES: Although the rotation of lower extremities has gained increasing recognition as a risk factor for anterior cruciate ligament (ACL) injury. This study clarified the influence of lower extremity rotation on the knee during single-leg landing. DESIGN AND SETTING: We recruited 30 students to perform single-leg landing from a height of 30 cm with their lower extremities in neutral, and externally and internally rotated. The knee abduction, flexion angles, and abduction angular velocity were measured. Furthermore, the abduction angle was analyzed at knee flexion angles of 15°, 20°, 25°, and 30° and compared among the three conditions using a repeated measures analysis of variance with Bonferroni post hoc tests. RESULTS: The maximum abduction angle was significantly greater when internally rotated than in the neutral. The maximum abduction angular velocity was significantly greater in the internally rotated compared to in the neutral. Finally, the abduction angle at a knee flexion angle of 30° was significantly greater when internally rotated compared to in the neutral. CONCLUSION: Rotation of the lower extremities affects knee kinematics, and landing on a knee that is internally rotated may increase the risk of ACL injury.

Human tail associated with lipomeningocele--case report.

A 3-month-old boy presented with a tail associated with lipomeningocele. Computed tomography and magnetic resonance imaging clearly demonstrated the presence of spina bifida and lipoma continuous from the tail to the thickened conus medullaris. The human tail may be related to spinal dysraphism and requires detailed neuroimaging investigation, and possibly microsurgery to prevent the tethered cord syndrome.

[Experimental study on transferability to cerebrospinal fluid of cefodizime in combination with ampicillin].

A study was done on cefodizime (THR-221, CDZM) in combination with ampicillin (ABPC) for its transferability to cerebrospinal fluid (CSF) of rabbits with experimental meningitis caused by Staphylococcus aureus. Blood and CSF were collected at 15, 30, 45, 60, 90, 120 and 180 minutes after intravenous administration of CDZM at 100 mg/kg to 6 rabbits, ABPC at 100 mg/kg to 4 rabbits and simultaneous administration of both drugs at 100 mg/kg each to 5 rabbits. Drug concentrations were assayed with an high performance liquid chromatography method, and pharmacokinetic parameters were calculated. The comparison revealed no significant difference in concentrations achieved among different groups. Therefore, the mutual transferability of these drugs to CSF was not considered to interact adversely due to the simultaneous administration of both drugs. Accordingly, CDZM may be a candidate of chemotherapeutics in the therapy of purulent meningitis, and it is worthy of further investigations.

[Clinical evaluation of an ampicillin suppository (KS-R1)].

Clinical evaluations of ampicillin (ABPC) suppository (KS-R1) were performed in 9 cases with infectious diseases in the pediatric field and the following results were obtained; When 2.7 mg/kg of KS-R1 was rectally administered to 1 case, the plasma levels of ABPC were 3.9 micrograms/ml at 15 minutes, 2.2 micrograms/ml at 30 minutes and 1.2 micrograms/ml at 60 minutes after administration. The urinary excretion rate within 6 hours was 5.0%. Clinical effects of KS-R1 were examined in 6 cases (4 cases of tonsillitis and 2 cases of urinary tract infection) at the dose of 20 approximately 50 mg/kg/day for 3 approximately 7 days. Clinical responses were excellent in 4 cases, good in 1 case and poor in 1 case (tonsillitis). As to the side effects, slight increase of eosinophil was observed in 1 case, but no diarrhea, perianal redness and eruption were observed. Since discharge ratio of KS-R1 within 5 minutes was 11.0%, the tolerance of KS-R1 was considered to be good. From the above results, KS-R1 is useful for treating the pediatric patients with various infections, who refuse to oral administration or are impossible to give oral administration because of vomiting and are multiple handicapped ones.

[Evaluation of latamoxef in the treatment of infections of newborn infants].

The usefulness of latamoxef (LMOX) in the treatment of newborn infants was investigated. The results that were obtained are summarized below. LMOX was injected intravenously in a dose of about 20 mg/kg, and 30 minutes later the concentration of the drug in the serum was determined. In a very low-birth-weight infant, weighing only 978 g at the time of birth, the serum concentration on the 3rd day after birth was 94 micrograms/ml, while it was found to be 100 micrograms/ml when the dosing and determination were performed on the 37th day after birth. Another premature infant weighed 1,980 g at birth, and on the 8th day of life the serum concentration was 73 micrograms/ml. The half-lives of LMOX in these 3 administrations were 4.74, 3.95 and 3.20 hours, respectively. LMOX was administered by intravenous injection to 4 patients diagnosed as having 6 diseases (2 patients each had both septicemia and a urinary tract infection; 1 patient had pneumonia; 1 patient had septicemia). Each dose ranged from about 15 to 25 mg/kg, and 3 doses were administered daily (in 1 patient, 4 doses were given over a 2-day period). The evaluation of the clinical results for each disease case showed 4 excellent cases and 2 poor cases. The 2 poor cases consisted of 1 case of pneumonia caused by S. aureus, and 1 case of a mixed urinary tract infection caused by E. coli and S. faecalis.(ABSTRACT TRUNCATED AT 250 WORDS)

[Bacteriological and clinical evaluation of BRL 25000 (clavulanic acid-amoxicillin) granules in the pediatric field].

Bacteriological and clinical evaluations of BRL 25000 (1 part clavulanic acid plus 2 parts amoxicillin) granules in the pediatric field have been performed. The MICs of BRL 25000 against 25 clinically isolated strains of S. aureus, 40 E. coli, and 14 K. pneumoniae were compared with those of AMPC. Against beta-lactamase non-producing strains of S. aureus and E. coli, the MICs of both drugs were nearly equal, however, against beta-lactamase producing strains of these species and K. pneumoniae, BRL 25000 was superior to AMPC. The blood levels of AMPC and CVA after single oral administration of approximately 15 mg/kg of BRL 25000 granules to fasted children were studied in 3 subjects. The mean levels of AMPC and CVA peaked about 1 hour after administration at values of 11.40 and 5.49 micrograms/ml, respectively, with half-lives of 0.91 and 1.02 hours, and AUCs of 23.52 and 12.66 hr X micrograms/ml, respectively. The 6-hour urinary recovery of AMPC ranged from 30.59% to 52.03% and for CVA from 16.31% to 45.18%. There was no significant difference between the blood level of AMPC following single oral administration of approximately 10 mg/kg AMPC granules and that of AMPC following single oral administration of approximately 15 mg/kg BRL 25000 granules to the same children. Clinical evaluation of BRL 25000 granules administered orally 3-4 times a day at total daily doses of between 42.9-52.9 mg/kg resulted in improvement, judged excellent or good, in all 7 cases of tonsillitis and 2 cases of pyelonephritis. In particular, the clinical effect was excellent in the case of tonsillitis where a beta-lactamase producing H. influenzae was isolated. In the total 11 cases treated, including 2 cases of mycoplasmal pneumonia excluded from the clinical evaluation, 1 case of rash and eosinophilia was observed. No other adverse reactions or abnormal laboratory findings were observed. The taste and flavor of the drug were well accepted by the children. It was concluded that BRL 25000 granules are promising new drug which should be markedly useful in the treatment of infections in pediatric outpatients.

[Clinical application of cefotetan in pediatrics].

Clinical evaluation was made on cefotetan (CTT), a new cephamycin antibiotic, and the following results were obtained. Following 6 patients were treated with a daily dose of 31.0-47.5 mg/kg of CTT, which was given in 3 divided doses by an intravenous injection or a 1 hour drip infusion; 2 patients with cystitis (causative organism: E. coli and P. mirabilis, respectively), 3 with pyelonephritis (E. coli in 3) and 1 patient with Salmonella enteritis (S. typhimurium). CTT showed a remarkable therapeutic effect on cystitis and pyelonephritis but was ineffective against Salmonella enteritis. Neither adverse clinical reactions nor abnormal laboratory findings were noted. Based on the above results, CTT is considered to be an appropriate and useful new antibiotic in the treatment of bacterial infections, particularly urinary tract infections in children. The fact that longer duration of blood concentrations has made is possible to give this antibiotic in 2 divided doses will be of great practical benefit.

[Clinical studies of aspoxicillin in pediatrics].

A clinical and laboratory evaluation and a blood level studied on aspoxicillin (ASPC), a new injectable penicillin derivative; the following results were obtained. ASPC was intravenously administered in 3 or 4 divided doses at a daily dosage ranging from 83.3 to 111.9 mg/kg to 5 patients (1 case of lacunar tonsillitis caused by H. influenzae, 3 cases of pneumonia caused by H. influenzae, 1 case of pneumonia caused by E. coli). As the results, a global effect were excellent in 3 cases and good in 2 cases. The overall efficacy ratio was 100%. All isolated organisms were eradicated, excluding the only case of pneumonia due to H. influenzae infection. No side effects were found in any of the 7 patients including 2 patients who were dropped out the efficacy evaluation because of Mycoplasma pneumonia. Laboratory findings showed a slight elevation of GOT and GPT in 2 cases and temporary eosinophilia in 1 case. Blood level of ASPC in 2 cases after 10 mg/kg administration by intravenous injection was 28.5 or 35.5 micrograms/ml at 30 minutes, 14.3 or 20.7 micrograms/ml at 1 hour, 6.1 or 8.8 micrograms/ml at 2 hours, 1.3 or 3.02 micrograms/ml at 4 hours. The half-life was 0.81 or 1.01 hours, respectively. Judging from the results of this blood level and the MIC of ASPC against clinically isolated organisms, good efficacy will be obtained to pediatric infections by the sensitive strains, if it is given 10 mg/kg to mild patients or 20 mg/kg to moderate or severe patients in 3 or 4 divided dose at a daily dosage.

[Transferability of cefpirome to cerebrospinal fluid of rabbits with meningitis caused by Staphylococcus aureus].

The transferability of cefpirome (HR810, CPR) to cerebrospinal fluid (CSF) was studied employing rabbits with experimental meningitis caused by Staphylococcus aureus. The mean serum concentration was 362 +/- 6.63 micrograms/ml at 15 minutes after intravenous administration of the drug at a dose level of 100 mg/kg. The mean concentration in CSF was maximum at 60 minutes after administration, and the mean maximum concentration was 14.6 +/- 2.85 micrograms/ml. Pharmacokinetic parameters calculated from these values were as follows, Cmax (CSF/serum): 4.04%; AUC (CSF/serum): 5.14% between 15 and 60 minutes, 8.12% between 15 and 120 minutes and 10.4% between 15 and 180 minutes; T 1/2 for CPR in CSF: 154 minutes; T 1/2 (CSF/serum): 3.96. In comparison to those of other beta-lactam antibiotics which were obtained in the same way, the transferability of CPR was intermediate, but the peak CSF level was high, and in consideration of the antimicrobial potency against the main pathogens of meningitis, it appears worthwhile of running clinical trials for this drug.

[Clinical studies on norfloxacin in the field of pediatrics].

We studied clinical effects of norfloxacin (NFLX, AM-715) tablets. The results we found are summarized as follows: 1. Ten patients with 5 diseases were medicated with 7.0-14.8 mg/kg of the drug 3 times daily for 6-8 days. They consisted of one-each with tonsillitis, pharyngitis, bronchitis, 4 with Campylobacter enteritis, 3 with other enteritis. Clinical responses to the treatment were excellent in 8, good in 1 and fair in 1, with an efficacy rate of 90%. Bacteriologically, of 9 isolates for which changes in populations were followed, 6 were eradicated and 3 remained unchanged, with an eradication rate of 66.7%. 2. No. adverse reactions nor abnormal laboratory test values attributable to the drug were observed. 3. These results suggest that this new quinolone drug may be useful, against bacterial infections in children 6 years and older.

[Clinical studies of S-1108 granules in the pediatric field].

We studied the clinical use of S-1108 granules in the pediatric field. The results are summarized as follows. 1. S-1108 was administered orally at doses ranging 6.85 and 17.6 mg/kg/day t.i.d. to 9 patients, including 5 cases of pharyngitis and 1 case each of lacunar tonsillitis, bronchitis, pneumonia and urinary tract infection. Clinical efficacies were excellent in 4 cases and good in 5 cases, hence an efficacy rate of 100% was obtained. 2. Haemophilus influenzae, Haemophilus parainfluenzae (2 strains each) and Streptococcus pyogenes, Staphylococcus aureus, Escherichia coli and Enterococcus faecalis (1 strain each) were identified in these cases. Seven of the 8 strains were eliminated upon treatment and the other strain was decreased, hence an eradication rate of 87.5% was obtained. 3. Side effects observed were 1 case each of soft stools and diarrhea. As an abnormal laboratory test result, an increase in GPT level was observed. 4. No refusal of the drug occurred. 5. From the above results, we consider that this drug would be a useful new oral antibiotic for the pediatric field.

[Investigation on the use of amikacin in the newborn].

The use of amikacin (AMK) in newborns was investigated and the results obtained are summarized as follows. 1. AMK was administered to 3 rabbits at an intramuscular dose of 6 mg/kg. Mean blood levels determined according to methods of bioassay (BIO) and fluorescent immunoassay (FIA) were 28.6 and 22.2 micrograms/ml, respectively, at 30 minutes after dosing. Then, the blood levels declined rapidly. Mean T 1/2 values obtained with the above 2 assay methods were 0.76 and 0.63 hours, respectively. 2. When AMK was administered at a dose of 5.7 mg/kg to a 64 day-old newborn by drip intravenous infusion for 30 minutes, a peak blood level was attained at the end of drip intravenous infusion, which was 20.0 micrograms/ml according to BIO and was 15.5 micrograms/ml according to FIA. The blood levels declined gradually thereafter with a T 1/2 value of 2.33 hours (BIO) or 2.03 hours (FIA). When the drug was administered at 5.3 mg/kg to a 26 day-old newborn using the same infusion method, the peak blood level obtained at the end of drip intravenous infusion was 18.0 micrograms/ml according to BIO and was 14.8 micrograms/ml according to FIA, and T 1/2 values were 4.76 and 3.68 hours, respectively. 3. As there was a close correlation between the values obtained with BIO and with FIA in both rabbits and clinical cases, with a coefficient of 0.990, and also the BIO values could be estimated using a formula of FIA value X 1.2 + 2.2, it would be possible to monitor AMK levels in the blood of patients at bedside using the FIA.(ABSTRACT TRUNCATED AT 250 WORDS)

[Penetration of aztreonam and ampicillin to cerebrospinal fluid in the concomitant administration to rabbits with Staphylococcus aureus meningitis].

Aztreonam (AZT) and ampicillin (ABPC) were independently administered to 6 and 7 rabbits respectively, with S. aureus meningitis. Additionally, AZT and ABPC were concomitantly given to 6 rabbits with S. aureus meningitis. Concentrations of AZT and ABPC in cerebrospinal fluid (CSF) and serum were determined by HPLC method, and the results in concomitant treatment were compared with those for single treatment of each agent. Results were as follows: Maximum serum concentrations of AZT in concomitant treatment of AZT and ABPC were higher than those in single treatment of AZT. However, there was no significant difference between the 2 treatment groups with regard to maximum CSF concentration, percentage of AUC of CSF to serum, and T1/2 of the CSF and serum concentrations of AZT. ABPC in the concomitant treatment did not influence the CSF concentration of AZT. There was no significant difference in serum concentration of ABPC between concomitant treatment and the single one. However, the values of maximum CSF concentration, percentage of maximum CSF to serum concentration and percentage of AUC of CSF to serum in the concomitant treatment were lower than those in the single treatment of ABPC. With regard to T1/2 of CSF concentration of ABPC, there was no remarkable difference between the 2 treatment groups. The above results suggest that the distribution of ABPC into CSF is suppressed in the concomitant treatment of AZT and ABPC. AZT has no antimicrobial activity against Gram-positive bacteria. The CSF concentration of ABPC is suppressed in the concomitant treatment. Those facts suggest that AZT should be administered for meningitis cases after the identification of causative pathogens.

[Evaluation of the clinical effects of cefotiam against infections in neonates and premature infants].

Using cefotiam (CTM) against infections in neonates and premature infants, we obtained the following results: With intravenous administration of the drug to 2 cases each of pyoderma, pneumonia, and fetal infection, the drug was effective in all the cases except in 1 premature infant with pneumonia. Dose levels at individual injections were between 18.6 and 27.8 mg/kg, per dose, with an exception in 1 case of pyoderma (36.4-54.5 mg/kg), and 2 to 4 doses per day were given to each patient. For prophylactic purposes, the drug was administered to 1 case of turbid amniotic fluid and 3 cases of massive aspiration syndrome, and no infection was observed in any case. In a total of 11 cases consisting of the above mentioned 10 cases and an additional case which had been excluded from the evaluation because of the detection of P. aeruginosa, neither side effects nor abnormal laboratory values were recognized. In 5 cases of 4 to 31-day old infants, CTM concentrations in blood were measured after one-time intravenous injection of the drug at a dose level of about 20 mg/kg. Blood concentrations of CTM were low in 1 case with levels of 14.4 and 4.5 micrograms/ml at 30 minutes and 2 hours after the intravenous injection, respectively, whereas they were high in another case with readings of 82 and 65 micrograms/ml. In the remaining 3 cases, however, 30-minute and 2-hour values were between 41 to 52, and 13.5 to 22.8 micrograms/ml, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical evaluation of cefpiramide in pediatrics].

A clinical study was made of cefpiramide (CPM) a new cephem-type antibiotic for injection and the following results were obtained. Blood level of CPM, after 20 mg/kg administration by drip infusion over a period of 1 hour, reached its peak of 86 micrograms/ml at the end of the infusion and declined to 19.8 micrograms/ml at 4th hour after infusion with the half-life value of 3.02 hours. Its urinary recovery rate up to 9 hours was 29.2% and the urine concentration from 0 to the 3rd hour was 820 micrograms/ml and from the 3rd to the 5th hour 650 micrograms/ml. In another case of the same dose with intravenous administration, the blood level at the end of the first 1 hour reached 56 micrograms/ml and by the 4th hour it had fallen to 20.6 micrograms/ml and by the 6th hour to 13.6 micrograms/ml. The half-life value was estimated as 2.44 hours. CPM was administered in 2 or 3 divided doses at a daily dosage ranging from 41.7 to 62.5 mg/kg by intravenous injection or by 1-hour drip infusion to 6 patients (3 cases of pneumonia, 2 cases of urinary tract infections, 1 case of purulent cervical lymphadenitis) and the following clinical results were obtained; "markedly effective" 3 cases, "effective" 2 cases, and "ineffective" 1 case. The overall efficacy rate was 83.3%. No side-effects or abnormal laboratory findings were found in any of the 7 patients including 1 patient who was excluded from the efficacy evaluation because of Kawasaki's disease.(ABSTRACT TRUNCATED AT 250 WORDS)

[Transferability of meropenem to cerebrospinal fluid in rabbits with meningitis caused by Staphylococcus aureus].

The transferability of meropenem (MEPM) to cerebrospinal fluid (CSF) was studied employing rabbits with experimental meningitis caused by Staphylococcus aureus. The mean serum concentration was 93.1 +/- 13.5 micrograms/ml at 15 minutes after intravenous administration of MEPM at a dose level of 100 mg/kg. The mean concentration in CSF was maximum at 15 minutes after administration at 4.42 +/- 2.24 micrograms/ml. Pharmacokinetic parameters calculated from these values were as follows: Cmax (CSF/serum) 4.75%, AUC (CSF/serum) 10.4% between 15 and 60 minutes, 13.9% between 15 and 120 minutes and 15.7% between 15 and 180 minutes, T 1/2 for MEPM in CSF: 50.9 minutes, T 1/2 (CSF/serum): 2.19. In comparison to those of imipenem which were obtained in the same way, the transferability of MEPM was similar and in consideration of the antimicrobial potency against the main pathogens of meningitis, it appears worth-while of running clinical trials for this drug.

[Pharmacokinetic, bacteriological and clinical studies on cefdinir fine granules in the field of pediatrics].

The Pharmacokinetics and clinical effectiveness of cefdinir (CFDN, FK482) were examined in pediatric patients. The results are summarized as follows. 1. Plasma concentrations and urinary excretions of CFDN after administration of 5% fine granules were investigated on 4 children at a dose level of 6 mg/kg. Average plasma concentrations peaked at 4 hours after administration at 0.99 micrograms/ml with a half-life of 2.12 hours. The first 24-hour urinary recovery rates of CFDN in 3 children averaged 22.0%. 2. CFDN was given to 24 children (11 with pharyngitis, 3 with tonsillitis, 8 with scarlet fever, 1 with urinary tract infection and 1 with enteritis due to Salmonella); 15 were treated with 5% fine granules and 9 with 10% fine granules at daily doses of about 10 mg/kg in 2 to 3 divided portions. Clinical effects were excellent in 16, good in 7 and not evaluable in 1, with an overall efficacy rate of 100%. 3. Identified causative organisms were 12 strains of Streptococcus pyogenes, 4 of Haemophilus influenzae, 5 of Haemophilus parainfluenzae, 1 of Escherichia coli, and 1 of Salmonella. Bacteriological effects were rated as "eradicated" for 19 strains, "unchanged" for 4 with an eradication rate of 82.6%. 4. No side effects were observed. As for abnormal laboratory test results, a transient decrease of white blood cells was observed in 1 patient. 5. The CFDN fine granule preparations were preferably accepted by the children. 6. The fine granular preparations of CFDN, a new oral antibiotic, were useful for the treatment of bacterial infections in pediatrics.

[Clinical evaluation of flomoxef in neonatal infections].

Serum concentrations, urinary excretion and clinical responses of flomoxef (FMOX) were studied. The results are summarized as follows. 1. Serum concentrations of FMOX were 17.4 micrograms/ml 1-hour after intravenous injection on the average in 5 cases who received approximately 10 mg/kg, 41.8 micrograms/ml in 2 cases given 20 mg/kg, and 69.6 micrograms/ml in 2 cases given 40 mg/kg, indicating that serum concentrations of FMOX changed in a dose-dependent manner in this range. Average serum half-life (T 1/2) in 4 mature babies was 2.48 hours and that in 6 premature babies was 3.17 hours, indicating that elimination rates in premature cases tend to be slower than those in mature cases. Urinary recovery rates averaged 39.2% in the first 6 hours in 5 cases examined. 2. Five newborns or premature babies received FMOX 33.1-80.2 mg/kg (b.i.d. or t.i.d.) via intravenous route for 5 to 8 days. FMOX showed excellent or good clinical effectiveness in the treatment of all patients including 1 case each of sepsis with urinary infection, furunclal otitis, impetigo, uterogenic fetus infection and urinary infection. Bacteriological responses were also studied, and eradication of identified organisms (Escherichia coli 3 strains and Staphylococcus aureus 2 strains) was obtained upon the FMOX treatment, but in 1 strain of S. aureus showed only a decrease. No adverse reactions were observed in any cases, but a slight elevation of eosinophil was noted in 1 patient receiving a dose of 210 mg a day. From the results obtained in these tests, FMOX appears to be very usefull and safe for the treatment of some infectious diseases in neonates.

[Clinical studies on cefozopran in pediatrics].

Cefozopran (CZOP) was administered via intravenous injection to 9 patients (ages ranging from 1 month to 13 years) with pediatric bacterial infections, at daily dose levels between 56.7 and 200 mg/kg, divided into 3 or 4 doses. The following results were obtained. 1. Eight patients, including 1 with purulent meningitis, 1 with sepsis, 3 with acute pneumonia and 3 with lymphadenitis, were treated and subjected to clinical evaluation. Clinical effects were excellent in 6 cases and good in 2, with an overall efficacy rate of 100%. One case with pyoderma was not evaluated because of a combined use of an external antibiotic. 2. Organisms suspected as pathogens included 5 strains: 3 strains of Haemophilus influenzae, 1 strain of Staphylococcus aureus and 1 of Escherichia coli. Bacteriologically, all the strains were eradicated. 3. Side effects or abnormal laboratory test results were observed in 4 cases; wheal in 1 case, elevated GOT and GPT in 2 cases and eosinophilia in 1 case. 4. From the results described above, we considered that CZOP would be an effective drug for use in pediatric bacterial infections.