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効能
抗結核薬, タンパク質合成阻害薬
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説明
Capreomycin is a semisynthetic antibiotic (34.1.21) that is isolated from
the cultural fluid of Streptomyces capreolus, and it is a complex of a minimum of four
microbiologically active ingredients that have only partially been characterized.
Capreomycin has a pronounced suppressive effect against Mycobacterium tuberculosis
and Mycobacterium bovis. Most strains of Mycobacterium kansasii are also sensitive to
kanamycin, while other, nontuberculous strains are not sensitive to it. It is often used upon
necessity of using parenternal therapy through deep intramuscular injections.
Capreomycin is less toxic than kanamycin and has somewhat more of a bacteriostatic
effect. Synonyms of this drug are capromycin, capastat, ogostal, and others.
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使用
Capreomycin is a complex of cyclic pentopeptides isolated from Streptomyces capreolus, first reported in 1962. The complex has two major components, IA and IB, with an exocyclic lysine residue and two minor delysinyl components, IIA and IIB. Capreomycin is a potent antibiotic with activity against mycobateria, Gram positive and Gram negative organisms. Capreomycin acts by binding to the 23S ribosomal subunit, disrupting protein synthesis.
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適応症
Capreomycin (Capastat) is a polypeptide antibiotic derived
from Streptomyces capreolus. It is bacteriostatic
against most strains of M. tuberculosis, including the
MDR strain. In addition, it is active against M. kansasii,
M. avium, and in high concentrations, some grampositive
and gram-negative bacteria. Like other antitubercular
drugs, resistance to capreomycin occurs rapidly
if the drug is used alone.There is no cross-resistance between
streptomycin and capreomycin, but some isolates
resistant to capreomycin are resistant to viomycin.
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薬理学
Capreomycin is poorly absorbed from GI tract and
so must be given parenterally. It is excreted mainly unchanged
in the urine following glomerular filtration.
Capreomycin is a used as a second-line agent in combination
with other drugs. It appears to be particularly
useful in multidrug regimens for the treatment of drugresistant
tuberculosis, especially with streptomycin resistance.
Capreomycin is associated with ototoxicity and
nephrotoxicity, and these adverse effects can be severe
in patients with preexisting renal insufficiency.
