J Infect Dis, 1989 Aug, 160(2), 305 - 11 Reactivation of Toxoplasma gondii by cytomegalovirus disease in mice: antimicrobial activities of macrophages; Pomeroy C et al.; Reactivation of Toxoplasma gondii infection often occurs concurrently with active cytomegalovirus (CMV) disease in immunocompromised patients, and CMV disease results in immunosuppression . To determine if murine CMV (MCMV) infection decreases resistance to T . gondii, mice with latent T . gondii infection were infected with MCMV . T . gondii infection reactivated, manifested primarily as pneumonia . Lung macrophages supported the growth of T . gondii before, during, and after T . gondii reactivation . Peritoneal macrophages inhibited the growth of T . gondii as pneumonia developed and became permissive as pneumonia resolved . Mice with latent T . gondii infection could survive larger doses of MCMV than could controls . Thus, MCMV infection led to reactivation of latent T . gondii infection in mice . Activation of lung macrophages, assessed by their ability to inhibit replication of T . gondii in vitro, was not associated with control of T . gondii infection. Acta Paediatr Jpn, 1989 Aug, 31(4), 439 - 54 How suitable is human milk for pre-term babies? Davies DP. Optimum nutrition for pre-term babies can be defined as that which permits satisfactory growth and health in the short term, free from metabolic problems and infection, and in the long-term fulfillment of growth and neuro-developmental potential . This paper examines how human milk meets these requirements . The composition of the various types of human milk available to the pre-term baby is described along with their short-term influences on early growth, infection, necrotising enterocolitis and protein allergy and long-term effects on physical size and neuro-psychological function . The conclusion reached is that while admitting that human milk will often fail to meet some of the special nutritional needs of small pre-term babies, there is as yet insufficient evidence to discourage its feeding to these babies . Its antimicrobial properties, potential immunological benefits and possible advantages to body (and brain) composition justify its continued use, particularly in those parts of the world where risks of neonatal infection are high. Antimicrob Agents Chemother, 1989 Aug, 33(8), 1252 - 4 Does pyrazinoic acid as an active moiety of pyrazinamide have specific activity against Mycobacterium tuberculosis? Heifets LB, Flory MA, Lindholm-Levy PJ. The commonly accepted hypothesis explaining the mechanism of action of pyrazinamide (PZA) is based on the assumption that PZA-susceptible Mycobacterium tuberculosis strains produce pyrazinamidase, which hydrolyzes PZA to the antibacterial moiety pyrazinoic acid (POA) . It is not clear whether POA has specific antimicrobial activity or the inhibition of growth caused by POA is due to its ability to lower the pH of the environment below the limits of tolerance of M . tuberculosis growth . We confirmed in this study that POA, depending on the concentration, lowered the pH of 7H12 broth (pH 6.0), which ranged from 5.8 at 120.0 micrograms/ml to 4.6 at 960.0 micrograms/ml . Therefore, we tested the inhibitory effects of different concentrations of POA in broth in which the final pH was adjusted to 5.6 by adding appropriate amounts of phosphoric acid or dipotassium phosphate . Under these conditions, we found a clear dose-response correlation, proving that POA does have specific antimicrobial activity . The MIC of POA at pH 5.6 was 240 to 480 micrograms/ml, 8- to 16-fold higher than the MIC of PZA under the same conditions and much higher than the concentrations achievable in humans . This suggests that the action of POA in an acid environment is a combined effect of its specific activity and its ability to lower the pH below the limits of tolerance of the target organism. FEBS Lett, 1989 Jul 31, 252(1-2), 1 - 4 Towards the development of antimicrobial drugs acting by inhibition of pathogen attachment to host cells: a need for polyvalency; Matrosovich MN; The development of inhibitors of microbial attachment to target cells has been proposed recently as a possible novel approach to antimicrobial chemoprophylaxis and treatment . In this paper an attempt is made to contend that such artificial inhibitors must be polyvalent, i.e . capable of binding to the pathogen or its target by multiple bonds. JAMA, 1989 Jul 21, 262(3), 355 - 9 Infections with Escherichia coli O157:H7 in Washington State . The first year of statewide disease surveillance; Ostroff SM et al.; In 1987, Washington became the first state to require that infection with Escherichia coli serotype O157:H7 be reported . In the first year of surveillance, 93 cases were reported, yielding an annual incidence of 2.1 cases per 100,000 population . The median age of case patients was 14 years (range, 11 months to 78 years), with the highest attack rate among children younger than 5 years (6.1 cases per 100,000 population per year) . Bloody diarrhea was present in 95% of reported cases, 12% of patients developed either hemolytic-uremic syndrome or thrombotic thrombocytopenic purpura, and one patient died . Suspected secondary cases were seen in 5% of households . Fifty-six (60%) cases occurred during June through September, as did 73% of the cases of hemolytic-uremic syndrome or thrombotic thrombocytopenic purpura . Cases reported during the summer months were more likely than cases reported at other times of the year to be in children younger than 10 years . Medications, including antimicrobial medications, did not influence the duration of symptoms, nor did they appear to alter the risk of developing hemolytic-uremic syndrome or thrombotic thrombocytopenic purpura . This newly established surveillance system in Washington demonstrates that E coli O157:H7 is an important and common cause of bloody diarrhea in the United States. Biochem Pharmacol, 1989 Jul 15, 38(14), 2363 - 73 Isoniazid-mediated irreversible inhibition of the myeloperoxidase antimicrobial system of the human neutrophil and the effect of thyronines; van Zyl JM et al.; During aerobic myeloperoxidase-catalysed oxidation of isoniazid at pH 7.8, compound III was generated . Oxidation of isoniazid or hydrazine sulphate at pH values of 6.5 or 7.8 in a myeloperoxidase-H2O2 system caused considerable haem loss, which was associated with compound III formation . Haem loss and also compound III formation could be inhibited when 8 microM thyroxine was included in the reaction mixtures . During the reaction with isoniazid, an intense pink-coloured pigment with maximum absorbance at 500 nm was formed which could be bleached with ascorbate or hypochlorous acid . The pigment was more stable at pH 7.8 than at pH 6.5 . A similar pink colour was generated when a mixture of isoniazid and thyroxine in alkaline solution was irradiated with light of wavelength greater than 300 nm . A possible product of thyroxine oxidation, 3,5-diiodotyrosine, could not protect the enzyme against isoniazid-mediated haem loss and no colour formation was observed . Haem loss was most extensive when isoniazid was oxidised in a myeloperoxidase system at pH 7.8 in the presence of 0.1 M NaCl . Thyroxine (8 microM), however, could still inhibit haem loss under these conditions . A good correlation was found between haem loss and irreversible loss of peroxidase activity. J Biolumin Chemilumin, 1989 Jul, 4(1), 342 - 5 Mutants of luminous bacteria selected for bioluminescent toxicity tests; Wagner A et al.; Mutants of the luminescent bacterial strain NRRL B-11177 were isolated with pleiotropic hypersensitivity towards hydrophobic antimicrobial agents . SDS-PAGE analyses of outer membrane proteins and lipopolysaccharides revealed that the outer membrane structure of the ahs-mutants was altered . QSAR analysis showed that the inhibitory effect of chloro-substituted phenols on bioluminescence of the ahs-mutants depended on their hydrophobicity . The effect of chlorinated phenols and detergents on bioluminescence was increased in the ahs-mutants . The potential use of these mutants in bioluminescent toxicity tests was discussed. Invest New Drugs, 1989 Jul, 7(2-3), 147 - 54 Cytotoxicity of synthetic racemic ptilocaulin: a novel cyclic guanidine; Ruben RL et al.; (+)-Ptilocaulin, a novel cyclic guanidine extracted from the Caribbean sponge Ptilocaulis aff . P . Spiculifer, is reported to have broad spectrum antimicrobial activity in vitro as well as in vitro activity against L1210 murine leukemia . To more fully evaluate this compound as an anticancer agent, the in vitro cell growth inhibitory potencies of synthetic racemic ptilocaulin and ten clinical anticancer drugs were determined and compared in 16 different normal and transformed human and murine cell populations . Potency, expressed as the 50% inhibitory concentration (IC50), was determined by a tetrazolium reduction (MTT) assay . Ptilocaulin showed a fairly broad spectrum of in vitro activity against colon and mammary adenocarcinomas, melanomas, leukemias, transformed fibroblasts and normal lymphoid cells (IC50s 0.05- greater than 10 micrograms/ml) . This activity was comparable to that of many of the clinical drugs, including vinca alkyloids, antibiotics, alkylators and antimetabolites . Cell viability was affected only after a 72 hr exposure to the compound . In a clonogenic assay, cytocidal effects were observed after 24-72 hr exposures to 10 x IC50 concentrations of ptilocaulin, as evidenced by failure of cells to resume growth after removal of the compound . Cytostatic effects were observed at less than or equal to IC50 concentrations, as evidenced by resumption of growth to near-control levels after removal of the compound . Ptilocaulin was toxic at 50 and 25 mg/kg in an in vivo L1210 tumor model and was ineffective at lower concentrations (T/Cs 100-112%) . In vivo studies in a more sensitive tumor system are recommended but are limited by the lack of availability of sufficient quantities of the compound. Cesk Zdrav, 1989 Jul, 37(6-7), 308 - 12 {The results of provisions for the rational use of antimicrobial drugs--survey in a regional polyclinic}; Chudacek J; The author discusses the effect of provisions for the rational use of antimicrobial drugs, issued at the end of 1986 . He draws attention to the reduced frequency of antimicrobial treatment in the first half of 1987 in surgeries of the territorial polyclinic, as compared with the same period in 1985 . The decline is significant even after standardization with regard to the more favourable epidemiological situation in 1987, as compared with 1985 . The author also draws attention to the significant rise of the number of microbiological examinations in conjunction with antimicrobial treatment . He evaluates the general decline of consumption of antimicrobial drugs by 30% in the catchment area of the polyclinic and the altered structure of prescribed antimicrobial drugs . The results of the work, which has the character of a pilot study, indicate the favourable effect of the mentioned provisions for the rational treatment with antimicrobial drugs. Cesk Epidemiol Mikrobiol Imunol, 1989 Jul, 38(4), 234 - 6 {Immunologic reactivity of tylosin and erythromycin}; Bebrova E et al.; The authors investigated the antibody response to erythromycin and tylosine in experiments and in a clinical investigation . The results proved in 90-100% a crossed immunological reactivity of the two macrolid antimicrobial preparations . In view of the wide use of tylosine in veterinary practice and its presence in residues of slaughter animals as well as in serological tests, it is very probable that this preparation participates in a major way in the increased incidence of allergic reactions against erythromycin in humans . Clinical results confirmed this assumption. Rev Infect Dis, 1989 Jul-Aug, 11(4), 600 - 7 Pseudomonas cepacia typing systems: collaborative study to assess their potential in epidemiologic investigations; Rabkin CS et al.; To determine the utility of available Pseudomonas cepacia typing systems for confirming the relatedness of isolates, we applied these methods to isolates associated with previously investigated nosocomial outbreaks . We compared chromosome analysis, serologic reactions, biochemical tests, bacteriocin production and susceptibility, and antimicrobial susceptibility in their ability to determine outbreak relatedness . Chromosome analysis, serologic reactions, and biochemical tests were each demonstrated to be epidemiologically useful methods for typing isolates . Determination of the sensitivity and specificity of these typing techniques will facilitate their application in the epidemiologic study of this increasingly important nosocomial pathogen. J Med Assoc Thai, 1989 Jul, 72 Suppl 2, 46 - 8 Sterilization and disinfection; Kobayashi H; Sterilization and disinfectant are the most important measures to control nosocomial infections . Their indications and instructions must be followed strictly to ensure efficacy . However, other measures should not be neglected . They include proper hospital planning, aseptic techniques, antimicrobial treatment, surveillance, guidelines for various procedure, and education of health personnel. J Clin Pharmacol, 1989 Jul, 29(7), 650 - 4 Effect of quinolone antimicrobials on theophylline pharmacokinetics; Prince RA et al.; The purpose of the research was to ascertain the comparative differences of quinolone antibiotics on theophylline pharmacokinetics . Eight healthy male volunteers were randomly assigned to four treatments . Each was administered norfloxacin (NOR) 800 mg/d, ciprofloxacin (C) 1 g/d, nalidixic acid (NAL) 2 g/d and placebo (P) for 7 days . On the seventh day of each treatment, theophylline (5 mg/kg) iv was administered . The elimination half-life (T 1/2), total body clearance (CL) and volume of distribution at steady state (Vss) of theophylline were calculated using model-independent methods . ANOVA for repeated measures was used for data comparisons . The mean (SD) theophylline results were: CL l/kg/h--NOR .038 (.006), C .033 (.006), NAL .045 (.008), P .044 (.007); T 1/2 h--NOR 9.2 (1.8), C 10.6 (1.8), NAL 8.3 (1.8), P 7.5 (1.4) . Theophylline Vss differences by treatment were not significant . NOR and C significantly decreased theophylline's clearance and the clearance change can be of clinical significance. J Am Vet Med Assoc, 1989 Jul 1, 195(1), 64 - 8 Colostral and serum IgG, IgA, and IgM concentrations in Standardbred mares and their foals at parturition; Kohn CW et al.; Immunoglobulin G, IgM, and IgA concentrations were measured in serum collected from 36 Standardbred mares within 12 hours of foaling, in colostrum collected within 6 hours of foaling, and in serum collected from foals 24 to 48 hours after birth . In serum collected from mares after parturition, mean concentrations of IgG, IgM, and IgA were 2,463.9 +/- 1,337.3 mg/dl, 136.4 +/- 218 mg/dl, and 305.2 +/- 237.5 mg/dl, respectively . In serum from foals, mean concentrations of IgG, IgM, and IgA were 1,953.3 +/- 1,635 mg/dl, 33.8 +/- 30.4 mg/dl, and 58.4 +/- 42.2 mg/dl, respectively . In colostrum, mean concentrations of IgG, IgM, and IgA were 8,911.9 +/- 6,282.2 mg/dl, 957 +/- 1088.1 mg/dl, and 122.9 +/- 77.3 mg/dl, respectively . The IgG concentrations in foal serum were poorly correlated with IgG concentrations in colostrum (r = 0.462, P less than 0.01) . Correlations of IgM or IgA concentrations in serum from foals with IgM or IgA concentrations in colostrum and correlations of IgG concentrations in serum from mares with those in colostrum were not significant (P less than 0.01) . Of 36 foals, 1 (2.8%) had a serum IgG concentration less than 400 mg/dl . Of 36 foals monitored for 4 months, 6 developed infectious respiratory tract disease requiring antimicrobial therapy at ages varying from 55 to 113 days; these infections were probably not related to failure or partial failure of passive transfer of antibody. Am J Hosp Pharm, 1989 Jul, 46(7), 1376 - 80 Streamlining antimicrobial therapy through pharmacists' review of order sheets; Briceland LL et al.; The impact of a pharmacy-conducted intervention program designed to contain costs by "streamlining" antimicrobial therapy is described . Streamlining of antimicrobial therapy may involve simplifying routes of administration, decreasing the dose or frequency of antimicrobial administration, or converting from multiple-agent therapy to single-agent therapy . Beginning on December 1, 1987, pharmacists at this university-affiliated teaching hospital used the antimicrobial order sheet (AOS) filled out by all prescribers of anti-infective agents to identify orders that were potential candidates for streamlining . Interventions involved a discussion between the pharmacist and prescriber in which the pharmacist specified the reasoning behind the recommended change . For each recommendation that was accepted by the prescriber, the cost savings per day was determined by subtracting the daily cost of the recommended streamlined therapy from the daily cost of the original "problem" therapy . Data collection continued until May 1, 1988 . During that five-month period, 162 out of 173 pharmacist-initiated streamlining recommendations were accepted by prescribers, resulting in a total cost savings of $19,864 . The average cost savings per intervention was $122.62 . The most frequent intervention involved decreasing the frequency of i.v . administration, decreasing the dose, or both . The intervention that resulted in the greatest average cost savings involved simplifying the route of administration or discontinuing antimicrobial therapy entirely . The projected annual cost savings of this program is $47,700 . By using information from AOSs to identify problem antimicrobial orders, pharmacists were able to recommend streamlining of antimicrobial therapies that resulted in an average cost savings of about $122 per intervention. J Antibiot (Tokyo), 1989 Jul, 42(7), 1056 - 62 Structural investigation of the antibiotic sporaviridin . XIV . Isolation of components of intact sporaviridin; Harada K et al.; Six components of sporaviridin (SVD) were successfully isolated by HPLC using methano-1 M ammonium chloride as the mobile phase . Each component possesses expectedly antimicrobial activity . To ensure the structural relationship between the intact SVD and N-acetylated sporaviridins (N-Ac-SVD), they were converted to the corresponding of N-acetates by acetylation in methanol, whose structures had already been determined as glycosides consisting of a 34-membered macrocyclic lactone, viridopentaoses, D-glucose and N-acetylvancosamine. J Antibiot (Tokyo), 1989 Jul, 42(7), 1043 - 8 Hatomamicin (YL-0358M-A), a new alkaloid antibiotic: fermentation, isolation, structure, and biological properties; Imai H et al.; Hatomamicin, a new alkaloid antibiotic, was isolated from the culture filtrate of a strain of Saccharopolyspora . The antibiotic was extracted with EtOAc and purified by silica gel column chromatography . The free alkaloid was obtained as pale yellowish prisms from CH3CN solution . It exhibits antimicrobial activity against Gram-positive organisms . The apparent molecular formula of hatomamicin was determined to be C22H31NO5 . The structure has been established by a combination of spectroscopic and X-ray crystallographic studies. Am J Clin Nutr, 1989 Jul, 50(1), 109 - 13 Dietary deficiency of phylloquinone and reduced serum levels in febrile neutropenic cancer patients; Conly J et al.; In 34 cancer patients with 40 neutropenic febrile episodes requiring broad-spectrum antimicrobial therapy, detailed dietary assessments revealed that deficient and severely deficient phylloquinone intakes (less than or equal to 70 and less than or equal to 25 micrograms/d) were identified during 88% and 38% of all days recorded, respectively . Serum phylloquinone levels and serial prothrombin times (PT) drawn in a similar group of 32 patients revealed that an elevated PT (greater than or equal to 2 s beyond control) was significantly associated (p less than 0.01) with a serum phylloquinone level of less than 4.4 nmol/L . Patients on antimicrobial regimens that suppressed menaquinone-producing intestinal microflora and that contained an N-methylthiotetrazole (NMTT) moiety had an elevated PT significantly more often than did patients receiving antimicrobial agents that preserved the microflora and contained no NMTT moiety (3 of 10 vs 10 of 11, respectively; p = 0.02 Fisher's exact) . These data suggest that these patients have a profound deficiency of oral vitamin K intake that may be further augmented by antimicrobial therapy. Arch Stomatol (Napoli), 1989 Jul-Sep, 30(3), 571 - 80 {The effects of subgingival irrigation with antimicrobial agents on periodontal disease}; Labella R et al.; This report evaluates the role of local pharmacotherapy by subgingival irrigation to enhance clinical and microbiological periodontal status . This kind of chemical therapy is not a substitute to scaling and root planing, but possibly could increase its beneficial effects. Medicina (Firenze), 1989 Jul-Sep, 9(3), 275 - 7 {Travelers' diarrhea}; Moroni M; Travelers' diarrhea is an acute infection of the gastrointestinal tract which has been known for many years, but which only recently has acquired epidemiologic and economic importance . The etiology is multiple and includes bacteria, viruses and protozoa, but the most frequently found agent is enterotogenic E . coli (ETEC) . The symptomatology is characterized by watery acute diarrhea, without mucus, inflammatory cells and blood, usually without febrile elevation . The syndrome is normally self-limiting, without any specific antibiotic therapy, while antidiarrheal agents reduce entity and length of the symptomatology . Antimicrobial therapy is indicated in persistent forms only after ascertainment of the etiologic agent. Arch Esp Urol, 1989 Jul-Aug, 42(6), 515 - 8 {Approaches to the study of chronic bacterial prostatitis}; Martinez Torres JL et al.; We report the results of a prospective study on 30 patients with chronic bacterial prostatitis who were seen at the University Hospital of Granada in 1987 and submitted to antimicrobial therapy . Patients with a positive prostate ultrasound scan and rectal examination, and those with prostatitis from Gram-negative rods evolved poorly . No significant difference was observed in patient response to therapy. Z Gesamte Hyg, 1989 Jul, 35(7), 399 - 402 {The use of impedance measurements in medical microbiology}; Strassburger J et al.; The versatility of the impedance method makes it a valuable tool in clinical microbiology . Impedance can be used to estimate total number of bacteria or to determine bacterial susceptibility to antimicrobial agents . The impedance method provides a unique opportunity to determine microbial activity and kinetics . Impedance microbiology represents a different approach to qualitative and quantitative microbiology . The method is very simple to operate, requires no sample preparation, allows rapid detection of bacterial growth, and interprets with microcomputer results automatically. FEMS Microbiol Lett, 1989 Jul 1, 51(1), 41 - 4 Aerobactin production and plasmid distribution in Escherichia coli clinical isolates; Martinez JL et al.; The distribution of plasmids as a function of aerobactin production, antibiotic resistance and antimicrobial agents production was studied in 139 Escherichia coli strains obtained from clinical sources . Ninety eight per cent of the strains analyzed presented plasmids with a median value of 2.97 plasmids per cell . Differences in the number of plasmids were observed for aerobactin production (3.52 for aerobactin producing strains, 2.56 (for non-producing ones) and antibiotic resistance (3.19 for antibiotic resistant strains and 2.58 for the sensitive ones) . But this was not the case for antibacterial agent production (2.96 for the producing strains, 2.98 for the non-producing ones . Ecological implications of these results are discussed. J Pharm Sci, 1989 Jul, 78(7), 550 - 5 Definition of a physiologic pharmacokinetic model of cutaneous drug distribution using the isolated perfused porcine skin flap; Williams PL et al.; A physiologic pharmacokinetic model describing drug disposition in the isolated perfused porcine skin flap (IPPSF) is derived . The IPPSF is well suited for experimental studies of dynamic drug distribution into skin because arterial and venous drug fluxes can be continuously monitored . The system parameters of the model are uniquely identifiable and describe the cutaneous efflux profile as a function of arterial input flux and tissue partitioning or extraction . This model allows experimental results obtained from an in vitro preparation to serve as a quantitative input to an in vivo, whole animal pharmacokinetic system . Experimental infusion applications of the cancer chemotherapeutic agents cisplatin and carboplatin and the antimicrobials tetracycline and doxycycline are reported herein. J Antimicrob Chemother, 1989 Jul, 24(1), 39 - 43 Antimicrobial synergism in the therapy of experimental cerebral nocardiosis; Gombert ME et al.; A mouse model of cerebral nocardiosis was used to determine the efficacy of synergistic antimicrobial combinations in reducing bacterial colony counts per gram of brain tissue . The combinations of imipenem-cefotaxime and imipenem-trimethoprim/sulphamethoxazole (TMP/SMP) were compared with each other and with each agent used alone . A saline treated control group was also included . At the completion of 72 h of therapy the combinations of imipenem-cefotaxime and imipenem-TMP/SMX were the most effective in reducing bacterial colony counts . These were statistically superior to cefotaxime and TMP/SMX used alone but not statistically superior to imipenem alone . TMP/SMX was not effective in this model and was inferior to all other antibiotic treatments. Z Gesamte Inn Med, 1989 Jul 1, 44(13), 395 - 8 {Antimicrobial chemotherapy of cholecystitis and cholangitis}; Tauchnitz C; Antibacterial chemotherapy of cholecystitis and cholangitis is of limited value, i.e . as a supportive measure . Early cholecystectomy and endoscopic-invasive procedures (in the case of cholangitis) are indicated primarily . If causal therapy is not possible long-term suppressive antimicrobial chemotherapy should be tried . Microbiological diagnosis is difficult . Therefore chemotherapy in most cases is done on empirical basis . Blood cultures are useful as well as quantitative cultures of duodenal secretions (in cases of cholangitis only) . The most frequently used chemotherapeutics are discussed . Single dose chemoprophylaxis (bactericidal substances) is effective. Rev Infect Dis, 1989 Jul-Aug, 11 Suppl 5, S1046 - 57 Tissue penetration of the new quinolones in humans; Gerding DN et al.; Data on the penetration of new quinolones into selected extravascular sites in humans, i.e., blister fluid, sputum, prostatic secretions, cerebrospinal fluid, aqueous humor, bone, prostate tissue, and cells, are reviewed and the data presented in tabular form . Published reports indicate that penetration into all sites, including intracellular sites, is high and exceeds that achievable for other commonly used antimicrobial agents, including penicillins, cephalosporins, and aminoglycosides . Available clinical treatment data support the expected favorable outcome predicted by the high extravascular concentrations achieved with quinolones. Indian J Lepr, 1989 Jul, 61(3), 333 - 44 Application of ATP assay for in vitro drug screening testing against human derived M . leprae; Katoch VM et al.; In this study, the ATP content of M . leprae exposed to various antimicrobial agents has been measured to evaluate its usefulness in drug sensitivity screening . Purified M . leprae suspensions from human biopsies have been incubated at 30 degrees C in a modified Dubos medium in the presence of different concentrations of various drugs viz., Rifampicin, Ethionamide, Ethambutol, Cycloserine, Dapsone, Clofazimine, Erythromycin and Tetracycline . ATP levels were estimated at 0, 7 days, 14 days of incubation by the procedures modified and standardised at this laboratory . ATP decay was accelerated by ethionamide, rifampicin, clofazimine, dapsone, erythromycin and to a lesser extent by cycloserine, whereas ethambutol and tetracycline did not have any significant effect . The rate of decay depended on the concentrations of these drugs . ATP assay promises to be a useful system for in vitro drug sensitivity screening against M . leprae isolated from patients. Circ Shock, 1989 Jul, 28(3), 235 - 48 Protection against clinical endotoxemia in horses by using plasma containing antibody to an Rc mutant E . coli (J5); Spier SJ et al.; Thirty-two horses with clinicopathologic evidence of endotoxic shock were randomly selected for a double-blind trial of hyperimmune lipopolysaccharide (LPS) core antigen plasma . Horses were suffering from acute toxic enteritis (n = 15), 360 degrees volvulus of the large colon (n = 9), proximal jejunitis/duodenitis (n = 6), or strangulating obstruction of the small intestine (n = 2) . Plasma was harvested from suitable equine plasma donors (preimmune plasma) and horses were immunized with a whole-cell bacterin of an Rc mutant E . coli (J5) . Plasma was again harvested from these horses when IgG ELISA titers recognizing LPS core antigen were greater than 1:32,000 . All horses included in the trial received either preimmune or hyperimmune plasma in addition to traditional therapy (fluids, antimicrobials, antiinflammatory agents, etc.) as dictated by the attending clinician . The mortality rate in the group of horses receiving hyperimmune plasma was 13%; in the control group receiving preimmune plasma, the mortality rate was 47% (P = .045) . Horses receiving J5 hyperimmune plasma had a significantly improved clinical appearance 48 hours after plasma administration (P less than .05) and a shorter period to recovery than control horses (P = .069). DICP, 1989 Jul-Aug, 23(7-8 Suppl), S8 - 12 Choosing cephalosporins for the formulary; Tartaglione TA; Proper selection of antibiotics for any formulary requires cooperation and communication with members of the pharmacy and therapeutics (P&T) committee and departments of infectious diseases, microbiology, and epidemiology . Ideally, P&T members need to know their institution's incidence and sources of infection (hospital- or community-acquired), antibiotic cure rates, and the adverse effects profiles of antimicrobial agents used . In addition, members need to be briefed on the findings of antibiotic utilization reviews performed . In vitro activity should be compared among similar classes of antibiotics and, when possible, local resistance rates should be considered . The pharmacokinetic properties of an antibiotic, such as peak concentration, protein binding, distribution characteristics, and elimination half-life, should be evaluated during the selection process, as should total cost of the drug, including costs associated with monitoring therapy . The three generations of cephalosporins are used as examples here to delineate differences in potency, pharmacokinetics, efficacy, and potential for causing adverse reactions during the ideal formulary evaluation process. Am J Hosp Pharm, 1989 Jul, 46(7), 1408 - 12 Stability of cefazolin sodium, cefoxitin sodium, ceftazidime, and penicillin G sodium in portable pump reservoirs; Stiles ML et al.; The stability of cefazolin sodium, cefoxitin sodium, ceftazidime, and penicillin G sodium in prefilled drug reservoirs that were stored at -20 degrees C for 30 days, thawed at 5 degrees C for four days, and pumped at 37 degrees C for one day was studied . Each antimicrobial agent was diluted with sterile water for injection to a concentration representative of the most common dosage when administered via a portable infusion pump . Ten milliliters of each drug solution was placed in individual glass vials to serve as controls, and volumes appropriate to deliver the designated dosages were loaded into the drug reservoirs . Triplicate reservoirs were prepared for each drug . One-milliliter samples from all containers were taken on days 0, 30, 31, 32, 33, 34, 34.5, and 35 . All solutions were observed for color change and precipitation . Drug concentrations were determined using high-performance liquid chromatography . Leaching of the plasticizer diethylhexyl phthalate (DEHP) was analyzed by packed-column gas chromatography on days 0 and 35 . No color change or precipitation was observed . No DEHP concentrations above 1 ppm were detected . More than 90% of the initial concentrations of each drug remained, except penicillin G sodium, which had a mean concentration of 83.9 +/- 0.5% at the end of the study . Cefazolin sodium, cefoxitin sodium, and ceftazidime in admixtures with sterile water for injection are stable under the conditions of this study . Penicillin G sodium should not be administered for more than 12 hours after such a cycle of freezing and thawing. Geriatrics, 1989 Jul, 44(7), 33 - 6, 39 Reviewing the safe use of antibiotics in the elderly; Gleckman RA et al.; As the elderly segment of our population expands, physicians will be prescribing medications more frequently for this age group . Physiologic changes, drug-drug interactions, and untoward adverse reactions are more common in the elderly . In addition, therapeutic decisions regarding antimicrobial agents for infectious disease in the aged are also complicated by the burgeoning number of compounds available to clinicians . A thorough knowledge of various antibiotic interactions, potential toxicities, and pharmacokinetics is necessary to safely and effectively prescribe these agents for elderly patients. Dent Mater, 1989 Jul, 5(4), 281 - 2 Technical note: antimicrobial action of glass-ionomer lining cement on S . sanguis and S . mutans; Barkhordar RA et al.; There are a number of glass-ionomer lining cements available to the profession . It is generally agreed that the glass-ionomer cements demonstrate reasonably good biocompatibility . The purpose of this study was to evaluate the antimicrobial activity of six glass-ionomer cements on S . sanguis and S . mutans . Forty-eight plates of TSA-SRBC (10%), each with 3.0-mm-diam . wells, were divided into two groups (1 and 2) of 24 each . Group 1 was inoculated with S . sanguis (10558) and Group 2 with S . mutans (6715-13 w.t.) . Each well was filled with 4.0 mg of one of the following liners: Glassic (A), Shofu lining cement (B), GC lining cement (C), Ever Bond (D), Gingiva Seal (E), and Ketac Bond (F); the empty wells served as control . Plates were incubated under microaerophilic conditions at 37 degrees C, and checked daily over seven days for inhibition zones . Average inhibition zones (mm) at 7 days were as follows: Group 1-1A = 10.00, 1B = 7.83, 1C = 18.50, 1D = 13.00, 1E = 8.67, and 1F = 9.33; Group 2-2A = 3.08, 2B = 10.25, 2C = 12.75, 2D = 15.58, 2E = 8.83, and 2F = 3.20 . All control wells were 0.0 GC liner and Ever Bond showed significantly greater overall inhibition of microbial growth than did other tested liners (p less than 0.5) . A one-way ANOVA and SNK test showed that all tested liners were significantly more toxic toward S . sanguis than toward S . mutans (p less than 0.05). Rev Infect Dis, 1989 Jul-Aug, 11 Suppl 5, S1083 - 90 Drug interactions with quinolones; Davies BI et al.; Numerous drug interactions with the new 4-quinolone antimicrobial agents have now been established . Many, but not all, quinolones are extensively metabolized and can have inhibitory effects on the liver cytochrome P450 enzyme system, leading to reduced metabolism and clearance of certain other drugs that are normally thus eliminated . Examples include the highly significant interaction between enoxacin and theophylline and the interaction between ciprofloxacin and theophylline, which may also be important clinically . The quinolone-caffeine interaction does not usually cause problems . Absorption of all quinolones from the stomach and small intestine is greatly reduced by antacids containing magnesium or aluminium salts, including sucralfate, probably as a result of the formation of nonabsorbable chelates . Cimetidine can reduce the clearance of pefloxacin (but not of ciprofloxacin) through its effects on liver metabolism, although newer H2-inhibitors appear not to have these effects . Probenecid reduces the renal elimination of some quinolones by inhibiting tubular secretion . New evidence is now coming to light of interactions between certain nonsteroid antiinflammatory drugs (e.g., fenbufen), quinolones, and gamma-aminobutyric acid (GABA) receptors, producing increased cerebral excitation and, sometimes, epileptiform convulsions. Eur J Clin Microbiol Infect Dis, 1989 Jul, 8(7), 651 - 3 Comparative antimicrobial activity of the new macrolides against Borrelia burgdorferi; Preac-Mursic V et al.; The in vitro and in vivo activity of the new macrolides azithromycin, clarithromycin and roxythromycin was compared with that of erythromycin against Borrelia burgdorferi . In in vitro tests using ten clinical isolates all macrolides were highly active against Borrelia burgdorferi (MIC90 0.015-0.06 micrograms/ml) . Azithromycin was more potent than the other macrolides in experimental animal infection, eradicating the organism in all animals tested at a dosage of 8 mg/kg. Rev Infect Dis, 1989 Jul-Aug, 11 Suppl 5, S902 - 11 Mode of action of the quinolone antimicrobial agents: review of recent information; Hooper DC et al.; Recent studies concerning the mechanism of action of quinolones against DNA gyrase are reviewed . DNA gyrase is an essential bacterial enzyme known to be a primary target of quinolone agents . Quinolone-resistant alleles of both the gyrA and gyrB genes of DNA gyrase have been sequenced, and domains that affect the action of quinolones have been identified within the amino terminus of the gyrase A peptide and the midportion of the gyrase B peptide . In addition, an ATP-induced structural transition of DNA complexed with DNA gyrase was shown to be blocked by norfloxacin, but the means by which quinolones effect this change and the molecular site of quinolone binding remain unclear . Studies of structure-activity relationships of the quinolone molecule have been expanded and have included effects of quinolones on DNA gyrase . Stereochemical effects at positions 1 and 7 have been found . Substitutions at position 7 that improve potency against gram-positive bacteria have also been identified . Novel mono- and three-ring structures and an isothiazolo substitution at position 3 have broadened the range of structures known to have activity . Studies of bacterial killing by quinolones have revealed additional correlations with markers of DNA damage and additional alterations in bacteria and growth conditions that affect bacterial killing . The exact events responsible for quinolone-mediated lethality, however, remain undefined. J Postgrad Med, 1989 Jul, 35(3), 144 - 6 Co-existence of N . gonorrhoeae and U . urealyticum in male urethra; Deodhar L et al.; PIP: The results of a study of 840 men aged 15-55 with urethritis attending a sexually transmitted disease clinic of a general hospital were that 31.6% had cultures isolated for N . gonorrhoeae, 16.1% for U . urealyticum, and 12.6% for both organisms . Bacteria were identified with the standard procedures of Finegold and Martin, and antimicrobial susceptibility testing was described by Cruickshank et al . The presence of microplasmas in patients with N . gonorrhoeae has been found in other investigations . Shepard et al . reported an association in 11.5% of patients compared with the 12.6% reported in this study, although other higher rates have been reported . There is morphological evidence that T strain mycoplasmas attach to cell wall projections on the surface of gonococci, and multiplication and viability are encouraged . Treatment involves penicillin or spectinomycin for gonococcal urethritis and tetracycline for U . urealyticum urethritis, thereby warranting differentiating the strains . Contact Dermatitis, 1989 Jul, 21(1), 46 - 8 Contact sensitivity to topical antimicrobials (I) . Epidemiology in Singapore; Goh CL; 18% (571/3145) of patients attending a contact dermatitis clinic in Singapore had contact sensitivity to one or more topical antimicrobials . The rates in males and females were similar . The rate for patients under 50 years old was 16% and for those over 50 years old 30% (p less than 0.0001) . There were no significant differences in the rates among Chinese, Malays, Indians and other races . The antimicrobials proflavine, neomycin and clioquinol were the commonest sensitizers. In Vivo, 1989 Jul-Aug, 3(4), 243 - 7 Chemical modification potentiates paramylon induction of antimicrobial activity; Sakagami H et al.; Induction of antimicrobial activity by two water-insoluble polysaccharides, paramylon and TAK, was significantly potentiated by introduction of positively charged groups (such as N,N-dimethylaminoethyl; N,N-diethylaminoethyl; and 2-hydroxy-3-trimethylammoniopropyl), but not by introduction of negatively charged groups (such as carboxymethyl or sulfate) . Cross-linking of these derivatives with epichlorohydrin did not increase their potentiating activity . The effects of these derivatives did not always correlate with their ability to accumulate polymorphonuclear cells and to stimulate the generation of luminol-dependent chemiluminescence by peritoneal exudate cells. Proc Natl Acad Sci U S A, 1989 Jul, 86(14), 5610 - 4 Antibiotic proteins of human polymorphonuclear leukocytes; Gabay JE et al.; Nine polypeptide peaks with antibiotic activity were resolved from human polymorphonuclear leukocyte azurophil granule membranes . All but 1 of the 12 constituent polypeptides were identified by N-terminal sequence analysis . Near quantitative recovery of protein and activity permitted an assessment of the contribution of each species to the overall respiratory-burst-independent antimicrobial capacity of the cell . Three uncharacterized polypeptides were discovered, including two broad-spectrum antibiotics . One of these, a defensin that we have designated human neutrophil antimicrobial peptide 4, was more potent than previously described defensins but represented less than 1% of the total protein . The other, named azurocidin, was abundant and comparable to bactericidal permeability-increasing factor in its contribution to the killing of Escherichia coli. Schweiz Rundsch Med Prax, 1989 Jun 27, 78(26), 745 - 50 {Bacterial susceptibility to chemotherapeutic agents (Zurich, 1987)}; Wust J et al.; This paper describes the frequency of susceptibility of Gram-positive and Gram-negative bacteria against antibacterial agents . The data are based on all susceptibility tests performed at the Department of Medical Microbiology of the University of Zurich . The evaluation of the results from 1975 to 1987 shows that susceptibility against standard antimicrobial agents has not decreased in this period . These tables may be a valuable help for the physician in his decision for a "calculated chemotherapy". J Am Vet Med Assoc, 1989 Jun 15, 194(12), 1764 - 6 Silicone ocular prosthesis in horses: 11 cases (1983-1987); Provost PJ et al.; Horses experience a number of ophthalmic diseases and injuries that may result in loss of function of the eye . In the treatment of end-stage ophthalmic disease or injury that precludes salvage of the eye, the use of an inert, silicone prosthetic implant is a cosmetic alternative to simple enucleation . Eleven horses treated either by enucleation and insertion of an intraorbital prosthesis (n = 9) or by evisceration and insertion of an intraocular prosthesis (n = 2) were evaluated for postoperative complications and for long-term cosmetic results . Of the 11 horses treated, complication rate was low; during hospitalization, 1 horse with an intraorbital implant developed a localized incisional infection that resolved in response to antimicrobial therapy . Nine horses were available for follow-up evaluation . Cosmetic appearance was rated as excellent in 5 horses and good in 4 horses . Insertion of an intraocular implant had the best cosmetic result . Complications were not reported by any owner or caretaker . Routine use of intraorbital and intraocular implants is encouraged because of their modest cost and ease of insertion. J Am Vet Med Assoc, 1989 Jun 15, 194(12), 1721 - 3 Treatment of canker in horses; Wilson DG et al.; Seven horses with canker had radical surgical debridement and various irritant substances applied to the wounds . Four of the horses were clinically normal in (mean) 3.6 months, 1 mare was lame, and 2 horses were euthanatized because of complications of their treatments . Seven horses that had minor surgical debridement and antimicrobial agents used systemically and topically were clinically normal in (mean) 1.4 months . Seemingly, canker in horses should be managed using minor surgical debridement and appropriate antimicrobial therapy. Schweiz Rundsch Med Prax, 1989 Jun 6, 78(23), 667 - 70 {Peripheral neuropathies caused by drugs}; Uldry PA et al.; Peripheral neuropathy is a common manifestation of chemotherapeutic agents . Most drugs produce a distal axonal degeneration and long axons are predominantly affected, giving a clinical picture characterized by a symmetrical sensory neuropathy . The toxicity of therapeutic agents to the peripheral nervous system particularly includes those used in cancer-chemotherapy (cisplatin, vinca alkaloids), but antimicrobial agents such as isoniazide or nitrofurantoin and vitamin abuse (pyridoxine) are also discussed. J Biol Chem, 1989 Jun 5, 264(16), 9505 - 9 Cloning of the cDNA of a human neutrophil bactericidal protein . Structural and functional correlations; Gray PW et al.; The bactericidal permeability increasing protein (BPI) is a 50-60-kDa membrane-associated protein isolated from granules of polymorphonuclear leukocytes . A full-length cDNA clone encoding human BPI has been isolated and the derived amino acid sequence reveals a structure that is consistent with previously determined biological properties . BPI may be organized into two domains: the amino-terminal half, previously shown to contain all known antimicrobial activity, contains a large fraction of basic and hydrophilic residues . In contrast, the carboxyl-terminal half contains more acidic than basic residues and includes several potential transmembrane regions which may anchor the holoprotein in the granule membrane . The cytotoxic action of BPI is limited to many species of Gram-negative bacteria; this specificity may be explained by a strong affinity of the very basic aminoterminal half for the negatively charged lipopolysaccharides that are unique to the Gram-negative bacterial envelope . The amino-terminal end of BPI exhibits significant similarity with the sequence of a rabbit lipopolysaccharide-binding protein, suggesting that both molecules share a similar structure for binding lipopolysaccharides. FEBS Lett, 1989 Jun 5, 249(2), 219 - 23 Magainin 2 amide and analogues . Antimicrobial activity, membrane depolarization and susceptibility to proteolysis; Juretic D et al.; We compared the abilities of synthetic magainin 2 amide and its analogues to inhibit the growth of Escherichia coli and to cause membrane depolarization in E . coli cells and cytochrome oxidase liposomes . The analogue, magainin A, was about 40-times more active than magainin 2 amide in inhibiting the growth of E . coli and had a much more sustained effect on the membrane potential . In the liposomal system, however, there was only approx . 20% difference between these two peptides in the reduction of membrane potential and uncoupling of respiration . Studies with pronase digestion suggested that the difference in potency may be due to differential susceptibility to proteolysis in the presence of membranes. Jpn J Antibiot, 1989 Jun, 42(6), 1271 - 8 {Pharmacokinetic evaluations and analysis of aztreonam in children}; Kawasaki H; Aztreonam (AZT), monocyclic beta-lactam antimicrobial agent, was administered to 9 children at a dose level of 30 mg/kg through intravenous drip infusion for half-hour . Using serum levels of the drug obtained in blood samples, pharmacokinetic parameters were calculated and a simulation curve of serum levels was drawn automatically using a micro-computer . The mean values (n = 9) for elimination constant (Kel) and half-life (T 1/2) were 0.67 hr-1 and 1.08 hours, respectively . The mean apparent volume of distribution was 4.29 L, and serum clearance was 0.17 L/kg/hr . A basic analysis for the efficacy dose of AZT was performed using above mentioned parameters. Chem Pharm Bull (Tokyo), 1989 Jun, 37(6), 1543 - 6 Studies on the constituents of Japanese mistletoes from different host trees, and their antimicrobial and hypotensive properties; Fukunaga T et al.; The chemical constituents of Japanese mistletoes, Taxillus yadoriki Danser, Taxillus kaempferi Danser, and Korthalsella japonica Engler, epiphyting to different host trees were compared, and the antimicrobial and hypotensive properties of some isolated flavonoids were examined . Two known flavonoid glycosides, hyperin and quercitrin, were isolated from Taxillus yadoriki Danser, together with fatty acids, phytosterol, and phytosterol-glucoside . There was remarkable variation of contents of quercitrin among the plants on different host trees . From Taxillus kaempferi Danser, fatty acids, phytosterol, phytosterol-glucoside, quercetin, avicularin, and taxillusin were isolated, and quercitrin and hyperin were also identified . There was no remarkable variation of compositions of flavonoid glycosides among the plants on different host trees . A known flavone glycoside, chrysoeriol-4'-O-glucoside, was isolated from Korthalsella japonica Engler, together with fatty acids, phytosterol, oleanolic acid, and phytosterol-glucoside . Chrysoeriol-4'-O-glucoside is contained in this plant irrespective of the host trees. Appl Environ Microbiol, 1989 Jun, 55(6), 1570 - 3 Metabolism and some characteristics of ruminal strains of Megasphaera elsdenii; Marounek M et al.; Megasphaera elsdenii belongs to the group comprising the ruminal and intestinal lactate- and sugar-fermenting species . In the present study the fermentation characteristics, metabolism of glucose and lactate, and susceptibility to antimicrobial agents of four ruminal strains were investigated . Particular attention was given to the mixed-substrate fermentation pattern and resultant fermentation acid profile . Lactate was utilized more rapidly than glucose in media with both carbon sources . Interaction of the two substrates changed the composition of fermentation end products toward more valerate and less propionate in cultures with glucose and lactate . Contrary to the indications in Bergey's Manual of Systematic Bacteriology, butyrate, not caproate, was the main end product of glucose metabolism . The strains examined were rather insensitive to many antimicrobial compounds, especially to ionophores and other antimicrobial feed additives. Antimicrob Agents Chemother, 1989 Jun, 33(6), 968 - 9 In vitro susceptibility of Bordetella parapertussis to various antimicrobial agents; Watanabe M et al.; The in vitro activity of 18 antimicrobial agents against 32 strains of Bordetella parapertussis isolated from whooping cough patients was studied . The most active antimicrobial agents were piperacillin and minocycline, followed (in descending order of activity) by moxalactam, erythromycin, cefoperazone, tetracycline, ampicillin, cefotaxime, chloramphenicol, josamycin, sulfamethoxazole, and nalidixic acid . Isolates were resistant to benzylpenicillin, cephalothin, cefatrizine, cefaclor, streptomycin, and cephalexin. Am J Vet Res, 1989 Jun, 50(6), 838 - 44 Survival analysis for evaluation of corneal ulcer healing times in calves with naturally acquired infectious bovine keratoconjunctivitis; Edmondson AJ et al.; A clinical trial examining the efficacy of 2 drugs for treatment of a natural epizootic of infectious bovine keratoconjunctivitis was performed . The study was conducted in 103 grazing Hereford calves during the summer of 1985 . The calves were prospectively and randomly assigned to 1 of 3 groups at the beginning of the study on June 17, and were examined 3 times weekly thereafter until the final observation on August 6 . Calves in group 1 (n = 34) were not treated and were used as controls . Calves of group 2 (n = 34) with corneal ulcers were treated with a long-acting oxytetracycline formulation (OTC group) . The parenteral treatment was repeated in 72 hours . Affected calves of group 3 (n = 35) were treated topically with furazolidone spray when they developed new corneal ulcers, or when existing lesions worsened during subsequent examination periods (NFZ group) . Healing times of the corneal ulcers were reported in 3 ways: the combined times for ulcers present in both eyes of a calf simultaneously (method A), independent times of each ulcer on a calf (method B), and time of the first ulcer for each calf (method C) . Censored healing times were examined as left censored (ulcer present at the beginning of the study), right censored (ulcer not healed at the end of the study), or uncensored (true) healing times . The effect that the treatments had on healing times were investigated by use of notched box and whisker plots, life tables, and Cox regression models . The analysis indicated that treatment of calves with either antimicrobial reduced the healing time of corneal ulcers, compared with untreated controls.(ABSTRACT TRUNCATED AT 250 WORDS) J Pharm Sci, 1989 Jun, 78(6), 504 - 7 Serum protein binding of lomefloxacin, a new antimicrobial agent, and its related quinolones; Okezaki E et al.; The serum protein binding of lomefloxacin (LFLX), a new quinolone (pyridonecarboxylic acid), and its related analogues was studied by an ultrafiltration technique . The extent of binding of quinolones was independent of the concentration of quinolones below 100 micrograms/mL in rat serum; but, above this concentration, the binding decreased with increased drug concentration in the case of nalidixic acid and analogue 3 . The extent of binding in rat serum differed widely among the quinolones examined {i.e., from 15% (norfloxacin) to 84% (nalidixic acid) at concentrations of 0.4-10.0 micrograms/mL} . Lomefloxacin was bound to serum proteins to the extent of 28.1, 20.1, and 20.6% in the sera of rats, dogs, and humans, respectively . The binding of nalidixic acid with rat serum albumin, which was very similar to that in rat serum, was concentration dependent . Some quinolone derivatives with a piperazinyl group or a relatively large-sized substituent at the 7-position exhibited a percentage unbound of approximately 70-80%, while some derivatives with small-sized substituents gave a low percentage unbound of 20-30% . This suggests that there is a steric effect of the substituents at the 7-position of quinolones on their binding characteristics with serum proteins . The results of the present study indicate that quinolones bind mainly with albumin among serum proteins and that the remarkable difference of the extent of binding of quinolone analogues is related to the size of the substituent at the 7-position of the molecule, possibly due to its steric effect. Am J Hosp Pharm, 1989 Jun, 46(6), 1179 - 82 Effect of a pharmacist's and a nurse's interventions on cost of drug therapy in a medical intensive-care unit; Katona BG et al.; The effect of interventions by a pharmacist and a nurse on the cost of drug therapy in a medical intensive-care unit (ICU) was determined . A pharmacist taught cost-avoidance concepts related to medication use to a senior member of the nursing staff . The pharmacist and the nurse documented during a 91-day period all interventions that resulted in a discontinuation or change in drug therapy or involved nonformulary drug requests or serum drug concentration determinations . Costs that were avoided or added as a result of these interventions were determined using drug acquisition costs and (for interventions involving i.v . therapy) the cost of related supplies . Costs were calculated for both the initial 24-hour period after each intervention and the expected duration of therapy . The 345 interventions of the pharmacist and the nurse represented $6,383 in 24-hour cost avoidance and $23,993 in total cost avoidance . The majority of interventions resulted in discontinuation of medications or changes in drug dosage; most of those interventions involved antimicrobial agents . Other frequent interventions involved changes in route of administration and the interchange of therapeutic alternates . A pharmacist and a nurse had a positive impact on the cost of drug therapy in a medical ICU. Scand J Dent Res, 1989 Jun, 97(3), 233 - 41 Antimicrobial and antiplaque effects of a chlorhexidine and Triton X-100 combination; Giertsen E et al.; This study aimed to assess the in vitro antimicrobial effect and in vivo plaque-inhibiting capacity of chlorhexidine (CH) combined with the nonionic detergent Triton X-100 . Synergistic inhibition was observed by the combination of Triton X-100 and CH on in vitro growth of S . sobrinus OMZ 176 and of S . sanguis 10556 . In the clinical experiments, 10 subjects rinsed twice daily with 10 ml aqueous solutions of 11.6 mM Triton X-100, and 0.55 mM CH, and with a combination of the two agents . All mechanical oral hygiene was suspended during the test periods . Sucrose enhanced plaque accumulations were recorded after 4 days of rinsing . The combination of CH-Triton X-100 decreased plaque accumulations significantly compared to placebo, but was less effective than CH alone (P less than 0.05) . Thus no beneficial clinical effect was gained by combining the nonionic agent Triton X-100 with the cationic agent CH . The results also clearly demonstrate that addition which increase the antibacterial activity of CH do not necessarily coincide with improved in vivo antiplaque efficacy. J Antibiot (Tokyo), 1989 Jun, 42(6), 989 - 92 Stimulatory effect of cefodizime on macrophage-mediated phagocytosis; Oishi K et al.; We evaluated the ingestion of anti-sheep erythrocyte (anti-E) IgG- and IgM-coated sheep erythrocytes by murine peritoneal macrophages exposed to cefodizime, a new semisynthetic cephalosporin, and other antibiotics . Cefodizime enhanced the ingestion of anti-E IgG-coated erythrocytes by peritoneal macrophages from CD-1 and BALB/c mice in a dose-dependent manner, but had no effect on uncoated or IgM-coated erythrocytes . Similar enhancement was observed only in the case of cefpimizole (AC-1370), among the other antibiotics examined . These results suggest that the favorable in vivo activity of cefodizime and cefpimizole may result from their phagocytosis-enhancing as well as antimicrobial properties. Ann Emerg Med, 1989 Jun, 18(6), 684 - 7 Otitic hydrocephalus: an uncommon complication of a common condition; Isaacman DJ; A 14-year-old girl presented with bilateral sixth nerve palsies and papilledema after a two-week history of ear drainage and progressive right-sided temporal headache . A computed tomography scan of the head was normal, as were plain films of the mastoids . Lumbar puncture revealed a markedly elevated opening pressure with an otherwise normal cerebrospinal fluid examination, and she was given the diagnosis of pseudotumor cerebri . Despite treatment with acetazolamide, prednisone, and repeated lumbar punctures, her symptoms worsened . A magnetic resonance imaging study revealed thrombosis of the right sigmoid sinus, and repeat computed tomography showed evidence of mastoiditis . Definitive therapy consisted of a right mastoidectomy and antimicrobial therapy, to which the patient responded promptly . This case illustrates an unusual sequela of otitis media--termed otitic hydrocephalus--that resulted from obstruction of the sigmoid sinus . Although otitis media is generally a benign illness, clinicians must be alert to suppurative complications, which may evolve insidiously. Am J Med, 1989 Jun, 86(6 Pt 2), 771 - 5 Natural history of acquired immunodeficiency syndrome in women in Rhode Island; Carpenter CC et al.; PURPOSE: Current recommendations for treatment of human immunodeficiency virus (HIV) infection and for prophylaxis against associated opportunistic infections in North America are largely based on observations of HIV infection in males . In an effort to determine whether the natural history and clinical course may be different, with implications relevant to prophylaxis against opportunistic infections, we have documented the clinical courses of the first 24 known cases of acquired immunodeficiency syndrome (AIDS) in women in Rhode Island, most of whom developed Centers for Disease Control-defined AIDS before the availability of an effective antiviral agent (i.e., zidovudine) or a well-defined approach to prophylaxis against opportunistic infections (e.g., oral trimethoprimsulfa) . PATIENTS AND METHODS: The subjects in this study are 24 women with AIDS who were treated by members of the Brown University medical faculty from June 1982 through June 1988 . All patients had thorough clinical evaluations and appropriate laboratory studies as they became available . All were followed at intervals no greater than two months . All opportunistic infections were treated by appropriate, specific antimicrobial therapy . When zidovudine became available, it was administered to all remaining patients in the study . All subjects were counseled about HIV infection, its modes of transmission, and the early symptoms of opportunistic infections . RESULTS: These observations yielded the following three major findings: (1) Candida esophagitis was the most common (38%) AIDS-defining event; (2) Pneumocystis carinii pneumonia was less frequently the AIDS-defining event (13%) and occurred less commonly during the illness (29%) than in North American males with AIDS; (3) Of 14 women in whom the diagnosis of AIDS was established before January 1, 1987, the mean survival time after diagnosis was greater than 20 months . CONCLUSION: More information on the natural history of HIV infection in North American women is urgently needed . If more extensive data from other geographic regions confirm the observations in this study, the optimal approach to prophylaxis against opportunistic infections in women with AIDS may be substantially different from that which is most appropriate for males. Postgrad Med, 1989 Jun, 85(8), 249 - 54 Acute and chronic bronchitis . A practical management strategy; Brown RB; Bronchitis is a common diagnosis in the primary care physician's office, especially during winter . Acute bronchitis is usually caused by viruses but a number of other pathogens may also be responsible . Therapy for acute bronchitis is generally supportive . Chronic bronchitis, characterized by prolonged sputum production, is most often caused by cigarette smoking, which decreases mucociliary transport velocity . This and other pathophysiologic effects of smoking can lead to exacerbations of the disease that may necessitate antimicrobial therapy . Antimicrobial agents and vaccines may have both prophylactic and therapeutic roles in the management of chronic bronchitis. Laryngoscope, 1989 Jun, 99(6 Pt 1), 655 - 9 Preoperative therapeutic considerations in chronic suppurative otitis media; Papastavros T et al.; The present randomized, prospective study of 119 cases of chronic suppurative otitis media compares the effectiveness of inexpensive, atoxic, nonallergenic disinfectants applied locally, to that of a number of occasionally toxic antimicrobial chemotherapeutic agents, administered systemically . Systemic treatment resulted in a cure rate of 53.5% (SEp = 5.9%) while ototopical treatment resulted in a 39.5% cure rate (SEp = 7%) . Eradication of pathogens or colonization by a nonpathogen occurred in 50.7% (SEp = 5.9%) with systemic treatment, and in 39.5% (SEp = 7%) with ototopical treatment . Bacteriological modification was 2.5 times more frequent with systemic treatment than with ototopical treatment . No recurrences were noted with ototopical treatment, while 13% to 36% recurrence rates were noted in various subgroups of cases treated systemically . Cure rates achieved with particular drug regimens (administration based on sensitivity tests in vitro) were: Azactam 25% (5%-57% confidence limits), sulfamethoxazole plus trimethoprim 58.6% (38%-76%), ciprofloxacin 87.5% (47%-99%), ciprofloxacin plus metronidazole 90% (55%-99%) . Cure rates with other drugs were inconclusive because of the limited number of observations. J Med Chem, 1989 Jun, 32(6), 1398 - 401 Synthesis and antimicrobial properties of substituted beta-aminoxypropionyl penicillins and cephalosporins; Balsamo A et al.; Some beta-aminoxypropionyl penicillins (3) and cephalosporins (4 and 5), planned on the basis of the hypothesis that the (methyleneaminoxy)methyl group (greater than C = NOCH2) could be a "bioisoster" of either aryls or other aromatic groups, were synthesized and assayed for their antimicrobial properties . Compounds 3-5, tested on Gram-positive and Gram-negative bacteria, both sensitive to enzyme inactivation and otherwise, exhibited an activity trend that was not substantially different from that of the corresponding phenylacetamido derivatives taken as terms of comparison. Rev Fr Endod, 1989 Jun, 8(2), 9 - 15 {Endodontic microbiology: antimicrobial canal medications}; Seltzer S et al.; Medicaments used for reducing or eliminating microorganisms from infected root canals include: irrigating solutions, such as sodium hypochlorite, urea peroxide and hydrogen peroxide, chloramine, iodine-potassium-iodide solution, and chlorhexidine solution . In addition, various intracanal drugs, such as calcium hydroxide and antibiotics, are in use . The characteristics of these drugs are discussed. J Dent Hyg, 1989 Jun, 63(5), 222 - 5, 241 The effect of professional and home subgingival irrigation with antimicrobial agents on gingivitis and early periodontitis; Wolff LF et al.; The purpose of this investigation was to study the effect of a professionally applied subgingival antimicrobial agent (stannous fluoride) delivered at periodontal prophylaxis, combined with home personal subgingival delivery of an antimicrobial agent (iodine) on patients with gingivitis and early periodontitis . A control group of 32 individuals was instructed to use dental floss and a sulcular toothbrushing method as a regular oral hygiene regimen . The test group of 42 subjects received professional subgingival irrigation with a 1.64% stannous fluoride solution delivered after scaling . These subjects were also instructed in the home subgingival delivery of an iodine solution along with the use of dental floss and sulcular toothbrushing . Subjects were clinically evaluated at baseline and again after eight weeks . Individuals in the test group, when compared to the control group, had a significantly lower gingival index score at eight weeks . In addition, the test group had significantly lower bleeding and gingival index scores at eight weeks when compared to baseline . Professional subgingival irrigation with stannous fluoride, when combined with home subgingival delivery of an iodine solution, was effective in improving gingival health for patients with gingivitis and early periodontitis. J S Afr Vet Assoc, 1989 Jun, 60(2), 122 - 4 Enrofloxacin: a new antimicrobial agent; Schroder J; A review is given of available literature on a new antimicrobial agent, enrofloxacin . The chemical is a quinolone carboxylic acid derivative, and has a broad spectrum of activity against Gram-positive and Gram-negative bacteria as well as against Mycoplasma spp . in various animals . Several formulations and routes of administration have been tested, and equally good absorption and efficacy have been demonstrated after oral and parenteral administration . In South Africa, a 10% solution for use in the drinking water of poultry, has been registered, while different formulations for other species are still under development. Acta Chir Scand, 1989 Jun-Jul, 155(6-7), 351 - 4 Bactericidal antimicrobial cover in primary suture of perianal or pilonidal abscess . A prospective, randomized, double-blind clinical trial; Lundhus E et al.; The effect of 1-day treatment vs . 4-day treatment with metronidazole and ampicillin in association with primary closure of perianal and pilonidal abscesses was evaluated in a double-blind clinical trial . The patients were randomly allocated to 1-day (group I) or 4-day (group II) antibiotic regimen . No clinical signs of sepsis appeared in any patient . Primary healing, without fistula formation was achieved in all 17 perianal abscesses in the 1-day therapy group and in 14 of 15 in the 4-day group (non-significant difference) . Excision with primary suture of pilonidal abscess resulted in primary healing in 20 of 26 cases in group I and 20 of 30 in group II (non-significant difference) . Healing with formation of a new sinus or secondary healing occurred in four and two cases, respectively, in the 1-day therapy group, and in two and nine of the 4-day group . One-day administration of metronidazole/ampicillin is as effective as 4-day treatment in primary closure of perianal and pilonidal abscess . The procedure appears to be safe in both groups, but more efficacious in perianal abscess. Obstet Gynecol Clin North Am, 1989 Jun, 16(2), 381 - 400 Infections after gynecologic surgery; Hemsell DL; Infections observed after gynecologic surgical procedures are polymicrobial and require parenteral broad-spectrum antimicrobial therapy until the patient has been afebrile 24 to 72 hours . Therapy should be tailored to the specific infection and patient response thereto . When the infections are complicated by abscess or infected hematoma, combination therapy appears to be effective in a shorter period of time, and surgical drainage is infrequently necessary other than drainage of those in the supravaginal, extraperitoneal space . Administration of antibiotics immediately before surgery to women at high risk for postoperative infection has essentially eliminated pelvic infections . These infections range from cuff cellulitis through pelvic abscess and include pelvic thrombophlebitis . Pelvic infections and those in an abdominal, perineal, or vaginal incision can occur during the immediate postoperative period or after discharge from the hospital . As many as 50 per cent of these infections may occur after the patient is discharged from the hospital . Without question, the most appropriate means of objectively identifying infection rates, appropriate and inappropriate use of antimicrobials, and trends in morbidity is with an infection control program, usually consisting of an epidemiologist or specially trained nurses . Their contribution to appropriate patient care is significant . Information uncovered may put some clinicians on the defensive . This need not happen if gynecologic surgeons participate in and define criteria to be used for various infection diagnoses and similar situations . These diagnoses must be based on physical examination evidence, not "presumptive evidence." Antimicrobial administration and selection has an emotional component; objective evaluation avoids this bias . Optimal and efficient patient care is the goal and these programs should be established with that as their only goal . Several synergistic polymicrobial infections involve skin, subcutaneous tissue, and perhaps fascia; these are infrequently observed but require prompt recognition and antimicrobial therapy as well as wide surgical excision to healthy tissue to effect a cure . Clinical presentation extends to both ends of the spectrum with respect to degree of illness . These infections also occur spontaneously in gynecologic sites, and do so only in patients at high risk, such as those with diabetes, delibitating disease, advanced age, or evidence of arteriosclerotic disease . Another infection that was diagnosed and managed only surgically (that is, septic pelvic thrombophlebitis) can now be accurately diagnosed without surgery and can be adequately treated medically.(ABSTRACT TRUNCATED AT 400 WORDS) J Periodontol, 1989 Jun, 60(6), 310 - 5 Effect of a chemotherapeutic agent delivered by an oral irrigation device on plaque, gingivitis, and subgingival microflora; Ciancio SG et al.; Sixty-six adults were examined in a double-bind study which examined the effect of an antimicrobial agent delivered by an oral irrigating device . Each subject received a randomized half mouth dental prophylaxis . The Gingival Index, gingival crevicular fluid volume, Plaque Index, Modified Papillary Bleeding Index, probing pocket depth, and probing attachment levels were determined at baseline, 3 weeks, and 6 weeks . The composition of the subgingival microflora in the prophied and non-prophied quadrants was examined by phase contrast microscopy and by immunofluorescence . This study demonstrates that an antimicrobial product delivered by an oral irrigating device could result in significant reductions in plaque, bacterial cell counts, and gingival bleeding and may, therefore, be an effective adjunct to normal oral hygiene. Infect Dis Clin North Am, 1989 Jun, 3(2), 357 - 70 The role of prophylactic antibiotics in the prevention of prosthetic device infections; Segreti J et al.; This article examines available information concerning the use of antimicrobial agents to prevent prosthetic device infection at the time of surgical implantation . Additionally, the authors comment on the dearth of information concerning prophylactic antibiotics prior to elective surgical or dental procedures to prevent contamination of prosthetic devices already in place. Infect Dis Clin North Am, 1989 Jun, 3(2), 339 - 55 Infectious complications of modern cataract surgery and intraocular lens implantation; Carlson AN et al.; Over one million intraocular lenses are implanted each year during cataract surgery in the United States alone . Despite an impressive overall success rate, infection remains an important postoperative complication . Virtually every microbial organism has the potential to be an intraocular pathogen, and this article addresses both generalized and localized forms of microbial endophthalmitis . Successful outcome requires prompt clinical recognition, appropriate laboratory evaluation, initiation of antimicrobial therapy, control of inflammatory sequelae, and when necessary, surgical intervention. Am J Forensic Med Pathol, 1989 Jun, 10(2), 140 - 3 Evaluation and treatment of patients with human bite marks; Gold MH et al.; Physicians and other health care workers who care for patients who have sustained human bite marks need a working protocol to ensure that these patients receive proper care . This protocol involves taking a thorough history and performing a physical examination, approximately determining the bite mark age, and administering proper therapy . The history will help to determine whether a criminal act has been committed and which agencies need to be notified . The American Board of Forensic Odontology published criteria for bite mark analysis in 1984 that included a description of the bite mark including its size, shape, and color, along with techniques for collection of evidence from both the victim and suspect . To determine bite mark age, tissue response to injury (inflammation, granulation tissue formation, and matrix formation and remodeling) is reviewed . Finally, the bacteria that are found in these wounds and the proper use of antimicrobial agents are expanded upon. Clin Lab Med, 1989 Jun, 9(2), 341 - 7 DNA probes for antimicrobial susceptibility testing; Tenover FC; As DNA probes are used more frequently in the clinical laboratory for the detection and identification of pathogens in clinical samples, a means of determining the antimicrobial susceptibility profile of those pathogens will be required . DNA probes directed to specific resistance determinants offer a solution to this problem . Methods of determining the susceptibility of viruses to antiviral agents can also be accomplished with DNA probes . This article explores the advantages and disadvantages of using hybridization methods for susceptibility testing of organisms contained in clinical samples. Clin Lab Med, 1989 Jun, 9(2), 203 - 19 Standardization of antimicrobial susceptibility testing; Barry AL; In summary, methods for measuring bacterial susceptibility to antimicrobial agents in vitro were initially developed with little direction or coordinated effort . When a need appeared, most laboratory workers simply devised a method that would solve their own immediate problem . That resulted in a chaotic array of testing procedures that were being used in different laboratories and most of those procedures were not carefully controlled . Standardization of methods being used in the United States was brought about under the guidance of Dr . John C . Sherris and many others . As a result of the efforts that occurred in the late 1950s and early 1960s, susceptibility testing in the United States has reached a fairly sophisticated level of maturity . The National Committee for Clinical Laboratory Standards has accepted the challenge of maintaining the level of standardization that we have learned to expect. Arch Surg, 1989 Jun, 124(6), 705 - 7 Oral prophylaxis with neomycin and erythromycin in colorectal surgery . More proof for efficacy than failure; Kling PA et al.; In an open, prospective, and randomized investigation on the prophylactic efficacy of peroral neomycin sulfate-erythromycin base vs intravenous ceftriaxone-metronidazole preparation in colorectal surgery, no significantly diverging results between regimens were recorded (1/27 {3.7%} and 2/27 {7.4%} wound infections, respectively) . Commentary is made about the diverging results from earlier studies on antimicrobial prophylaxis and on the multifactorial causality of surgical infection . We believe that variables such as physical condition of the patients, virulence and local resistance patterns of bacteria, and technical skill of the surgeons are far more important in regard to the postoperative outcome concerning septic complications than is the choice of proper antibiotics . Thus, to determine the efficacy of antimicrobial prophylaxis, we call for larger investigations in the future, preferably double-blind, where it is possible to better control and diminish the influence of determinants other than the antibiotics being compared. Am J Med, 1989 Jun, 86(6 Pt 2), 801 - 8 Therapy of lower extremity infections with ciprofloxacin in patients with diabetes mellitus, peripheral vascular disease, or both; Peterson LR et al.; PURPOSE: Lower extremity infections in the presence vascular insufficiency are difficult and costly to treat . Few well-controlled clinical trials evaluating the management of these infections exist . We decided to investigate the ability of a new fluoroquinolone, ciprofloxacin, to reduce the morbidity associated with these infections and the amount of in-hospital time required for the administration of antibiotic therapy . PATIENTS AND METHODS: Forty-eight patients with peripheral vascular disease (46 with diabetes mellitus) who presented to the hospital for treatment of lower extremity infections were randomized in a blinded fashion to receive oral ciprofloxacin at a dosage of either 750 mg or 1,000 mg twice daily . Patients with osteomyelitis received three months of therapy and those with infections limited to soft tissues, three weeks of ciprofloxacin treatment . All subjects were followed for one year . RESULTS: One patient received an amputation 24 hours after enrollment, and two patients discontinued therapy after 20 and 34 days because of adverse effects and were not evaluable . At the one-year follow-up, 27 of the 45 (60 percent) evaluable patients had a fully successful outcome defined as not requiring either repeat antimicrobial therapy for their initial infection or amputation of the involved extremity . In the group of 18 patients in whom therapy failed, a total of only nine amputations were required . In the 15 patients whose lesion closed during therapy, 93% (14 patients) experienced a long-term successful outcome . CONCLUSION: Treatment with this new fluoroquinolone offers promise for the improved outcome of patients with the serious infectious complication of infected lower extremity ulcerations in peripheral vascular disease, diabetes mellitus, or both. Am J Med, 1989 Jun, 86(6 Pt 1), 668 - 72 Empiric antifungal therapy in febrile granulocytopenic patients . EORTC International Antimicrobial Therapy Cooperative Group; Clinical evaluation of a nystatin pastille for treatment of denture-related oral candidiasis; University of Washington, School of Dentistry, SeattleNystatin has been formulated in the form of a flavored pastille (troche) as an alternative to the oral suspension . This parallel, double-blind, randomized, placebo-controlled study evaluated the acceptance and effectiveness of the nystatin pastille at two different dosages . Twenty-four subjects were selected on the basis of clinical signs of denture stomatitis and culture isolation of Candida spp . Each subject was randomly assigned to one of three treatment groups (A, 200,000 units; B, 400,000 units; and C, placebo) . At entry, 7 days, 14 days, and at 10 days after cessation of treatment, the clinical condition was evaluated and Gram stain smears and imprint cultures were made and analyzed . The flavored pastille was well accepted by the subjects and both dosages were shown to be effective in significantly reducing or eliminating the Candida organism during active therapy . Data from the 10-day follow-up, however, demonstrated reinfection with the organism . Thus to resolve the condition, effective therapy must include treatment of the etiologic factors of denture stomatitis along with antimicrobial therapy. J Fam Pract, 1989 Jun, 28(6), 713 - 8 Human and animal bite infections; Brook I; Although often innocuous initially, human and animal bites can cause serious local and systemic infections as well as other complications . Bites to a site where joints or bones are close to the skin are especially prone to severe complications . Bites to the hand, therefore, require meticulous radiographic and surgical evaluation if a puncture or a severe laceration has occurred . Since the normal human oral flora harbors more pathogens than that of animals, human bites have a higher incidence of serious infections and complications . The oral flora of both humans and animals is anaerobic-aerobic, and initial empiric treatment requires the most broad spectrum antimicrobial therapy available, in addition to scrupulous wound management and, when required, immunization against rabies and tetanus. Zhonghua Ya Yi Xue Hui Za Zhi, 1989 Jun, 8(2), 74 - 9 {Solvent action of sodium hypochlorite on fresh and formalin fixed tissue: a biochemical approach}; Jeng JH et al.; Debridement of the root canal system has long been recognized as the critical phase of success in endodontic therapy . Because of the morphological complexity of most root canals, complete removal of the pulp tissue during the mechanical preparation of these root canals is often impracticable . Sodium hypochlorite is thus currently favored by most endodontists as the routine irrigant on account of its antimicrobial action and its capacity to dissolve fresh tissue together with necrotic tissues . Formocresol is another common medicament for endodontic treatment and is usually used for pulpotomy, pulpectomy and intracanal medication . Nevertheless, it was empirically believed that formocresol may interrupt the action of sodium hypochlorite in the dissolution of residual tissue . Therefore, the present study was undertaken to testify whether formocresol can substantially retard the solvent action of sodium hypochlorite by comparing the effectiveness of 5% sodium hypochlorite on fresh and formalin-fixed tissues . Connective tissue from the abdominal wall of Sprague-Dawley rats was cut into pieces weighing 0.05 g and measuring about 2 x 10 x 10 mm . A total of 20 pieces of tissue were collected and divided into two groups: 10 pieces were used immediately as the fresh-tissue group; the other 10 pieces were fixed in 10% formalin for 7 days as the fixed-tissue group . Each group was then immersed in 5 ml of 5% sodium hypochlorite for 60 seconds, and 1 ml was aspirated from each for assay . Dialysis was performed using 2 liters of double distilled water for a period of 4 hours with the water changed hourly.(ABSTRACT TRUNCATED AT 250 WORDS) Endod Dent Traumatol, 1989 Jun, 5(3), 147 - 52 The alkalizing properties of calcium hydroxide compounds; Staehle HJ et al.; Calcium hydroxide compounds are available in various forms, such as in aqueous suspensions or as cements, liners, pastes or filled resins . When such compounds are exposed to water, the calcium hydroxide dissociates and the pH value shifts to the basic . In this study the compounds Pulpdent, Dycal, Hydroxyline, Gangraena Merz and Prisma VLC-Dycal were subjected to analysis, including quantitative measurement of the amount and the chronological course of ion release following exposure to water, qualitative analysis of the alkalizing effects at the dentin surface and examination of antimicrobial properties . The results showed that calcium hydroxide compounds differed greatly . The strongest degree of ion release, combined with definite antimicrobial properties, was found for the aqueous calcium hydroxide suspension (Pulpdent) . The cement (Dycal) demonstrated significantly weaker activity . The liner and the paste (Hydroxyline and Gangraena Merz), as well as the calcium hydroxide filled resin (Prisma VLC-Dycal), were largely lacking in both ion release and antimicrobial properties under the experimental conditions. G Ital Dermatol Venereol, 1989 Jun, 124(6), 307 - 9 {Antibiotic treatment of urogenital infections caused by Chlamydia trachomatis . Preliminary study}; Zanetti S et al.; The authors followed 56 patients with clinical signs of urogenital phlogosis, due to Chlamydia trachomatis, treated with one of the following antimicrobial agents: miocamycin, minocycline, doxycycline . The results showed that all the antibiotics used were well tolerated and effective against Chlamydia trachomatis. Boll Soc Ital Biol Sper, 1989 Jun, 65(6), 535 - 41 Studies on heterocyclic compounds: 1,3-thiazolidin-4-one derivatives . III . Biological activity of halogenated 2,3-diaryl-1,3-thiazolidin-4-ones; Piscopo E et al.; In previous communications from these laboratories, thiazolidinone derivatives of general formula (A) were synthesized and screened for antimicrobial activity . (formula; see text) where: X = H, CH3 Ar = phenyl Ar' = fluorinated or chlorinated phenyl The present communication is in part concerned with further extension of these studies to variously halogenated thiazolidinones of general formula (B) . (formula; see text) where: X = H, CH3 R = H, 2-F, 3-F, 4-F, 3-Cl, 4-Cl R' = H, 4-F, 4-Cl These compounds were prepared by the general synthetic procedure previously reported for the 1,3-thiazolidin-4-one derivatives already prepared and screened in this SARs program . The general synthetic approach involves the cyclocondensation of the appropriate Schiff bases with alpha-mercaptoalkanoic acids such as thioglycolic and thiolactic acid . The prepared compounds were tested for their possible activity by a disk-diffusion assay (Kirby-Bauer modified) . The organisms used were: S . aureus, S . beta-haemoliticus, B . subtilis, M . paratuberculosis 607, S . typhi, Kl . pneumoniae, E . coli Bb, Ps . aeruginosa, C . albicans, A . niger, S . cerevisiae . The results of this antimicrobial screening showed that the prepared compounds exhibited varying degrees of activity against Gram-positive, Gram-negative bacteria, and fungi . The second half of this report deals with the structure-activity relationships in all the compounds prepared and studied in this research program . For comparison of antimicrobial activity, the growth inhibitory activity of all the halogenated thiazolidinones of type (A) and (B), prepared and screened in this SARs study, were tabulated.(ABSTRACT TRUNCATED AT 250 WORDS) J Am Osteopath Assoc, 1989 Jun, 89(6), 806 - 10 Epidural abscess and subdural empyema; Sellick JA Jr; Epidural abscess and subdural empyema are serious intracranial infections that result in significant morbidity and mortality . Frequently, they are secondary to sinusitis or middle ear disease, and the bacteria involved are inhabitants of the upper respiratory tract . Symptoms may be mild and mimic the symptoms of the underlying infection . However, especially with subdural empyema, alteration in the level of consciousness and focal neurologic deficits are common . Morbidity and mortality are minimized by early diagnosis, which is best made with computed tomography scanning, and proper therapy, which consists of surgical drainage and administration of appropriate antimicrobials . It is important that primary care physicians be aware of the clinical features of these potentially fatal complications of common infections. Pathol Biol (Paris), 1989 Jun, 37(5 Pt 2), 585 - 90 {Bacteriostatic and bactericidal study of rifabutine and clofazimine in combination against Mycobacterium avium-intracellulare and Mycobacterium xenopi}; Gevaudan MJ et al.; The authors have tested the sensibility to rifabutine and clofazimine of seventeen strains of M . avium and eleven strains of M . xenopi . They compared the ability of these and other antimicrobial agents ciprofloxacin, amikacin and erythromycin alone or in combinations to inhibit the growth of strains of the M . avium complex and of M . xenopi . The purpose of this investigation was also to examine the bactericidal action of these antimicrobial agents and to determine the ability of combinations to kill strains of M . avium and M . xenopi. J Surg Res, 1989 Jun, 46(6), 588 - 92 Mechanisms of cytoplasmic pH recovery in acid-loaded macrophages; Swallow CJ et al.; In the acidic microenvironment of an abscess, efficient antimicrobial function is dependent upon the phagocyte's maintenance of its physiological intracellular pH . To determine the mechanisms by which macrophages recover from an intracellular acid load, the cytoplasmic pH of murine peritoneal macrophages was measured using the pH-sensitive cytoplasmic fluorescent dye bis(carboxyethyl)-5(6)-carboxyfluorescein . These studies showed that pH recovery was primarily mediated by a Na+/H+ antiport in the plasma membrane which exchanged intracellular H+ for extracellular Na+ . The proportion of pH recovery mediated by this exchanger was determined by measuring the rate of acid extrusion in the presence of the Na+/H+ antiport inhibitor, amiloride . Mean rate of acid extrusion (in mM/min) was reduced from 4.4 +/- 0.2 in control cells to 1.6 +/- 0.2 in the presence of amiloride (mean +/- SEM, n = 8, P less than 0.01), demonstrating the presence of a second mechanism for pHi recovery . Inhibition of this residual recovery both by the sulhydryl reagent N-ethylmaleimide and by ATP depletion suggested that the additional mechanism was an ATP-dependent proton extrusion pump . Thus, macrophages have at least two efficient mechanisms for maintaining physiological pH when exposed to an intracellular acid load . Since the Na+/H+ antiport is inhibited at low extracellular pH, the maintenance of physiological cytoplasmic pH, and of normal cell function, within the acidic milieu of a tumor or abscess may depend on the alternate mechanism of pH recovery demonstrated here. Anasth Intensivther Notfallmed, 1989 Jun, 24(3), 177 - 80 {Adult respiratory distress syndrome in legionella pneumonia--successful treatment with extracorporeal CO2 elimination procedures}; Muller E et al.; We report on successful treatment of an 46-year-old patient with ARDS (Adult Respiratory Distress Syndrome), caused by legionella-pneumophilia-pneumonia . The treatment with conventional artifical mechanical ventilation had failed . The new method of extracorporeal CO2-Elimination and low frequency positive pressure ventilation (ECCO2-R-LFPPV), introduced by L . Gattinoni (2) was in that case of severest ARDS very helpful . Supported by antimicrobial therapy with Erythromycin and Rifampicin the lung function could be improved to "restitutio ad integrum" . Changes in chest radiographs, clinical parameters of ventilation, gas exchange and haemodynamics as well as the results of sequential pulmonary studies are demonstrated and discussed. Otolaryngol Head Neck Surg, 1989 Jun, 100(6), 568 - 72 Antibiotic iontophoresis in the treatment of burn perichondritis of the rabbit ear; Macaluso RA et al.; Perichondritis of the pinna is a serious late infection of burns involving the ear . The avascular nature of this injury renders systemic antibiotic therapy ineffective in delivering adequate levels of drug to the area to provide antimicrobial activity . Treatment has traditionally been surgery in some form, resulting in further disfigurement of the damaged cartilagenous framework . Iontophoresis, a method of dispersing charged particles through a relatively impermeable membrane by a light electrical field, appears to be a feasible method of antibiotic delivery . This initial pilot study investigated the development of perichondritic-like burns in ten rabbit ears, and techniques for gentamicin iontophoresis and assay in devitalized cartilage . Five rabbits, with ear burns simulating perichondritis, were treated with gentamicin iontophoresis on one ear and gentamicin-soaked gauze on the other . Resulting assays of the ear cartilages, after four treatments over a 2-day period, demonstrated a nearly twenty-fold increase in gentamicin levels in the iontophoresis-treated ears, compared to low levels in the soaked ears . Systemic absorption was negligible in all rabbits. J Antibiot (Tokyo), 1989 Jun, 42(6), 903 - 12 19-Deformyl-4'-deoxydesmycosin (TMC-016): synthesis and biological properties of a unique 16-membered macrolide antibiotic; Fujiwara T et al.; 19-Deformyl-4'-deoxydesmycosin was synthesized by the following synthetic route: 19-Deformylation of desmycosin, 3,2',4''-tri-O-trimethylsilylation, 4'-O-sulfonylation, 4'-iodination, reductive deiodination and 3,2',4''-tri-O-detrimethylsilylation . Deformylation of the aldehyde group at the C-19 position was achieved by two different methods: A) A simple one-step deformylation using Wilkinson's catalyst ((Ph3P)3RhCl) . B) Reductive decarboxylation of the 19-carboxyl derivative following NaClO2 oxidation of the aldehyde . 19-Deformyl-4'-deoxydesmycosin showed very strong antimicrobial activity in vitro and in vivo. Rev Prat, 1989 May 25, 39(16), 1399 - 402 {Nosocomial infections in surgery}; Wysocki M et al.; Nosocomial infections affect about 5 p . 100 of surgical patients, and postoperative infections of the operative wounds or sites account for the major part of these infections . A knowledge of the potential organisms causing such infections and which vary according to the site and type of the surgical procedure is the most important guide to prophylaxis . Perioperative antimicrobial prophylaxis has made it possible to achieve a substantial reduction of surgical wound infection rates, and the basis for its use in each of the major surgical settings is reviewed. Biochim Biophys Acta, 1989 May 19, 981(1), 130 - 4 Magainin 1-induced leakage of entrapped calcein out of negatively-charged lipid vesicles; Matsuzaki K et al.; Effects of magainin 1, a novel antimicrobial peptide, on the permeability of lipid vesicles were investigated by using calcein as a trapped fluorescent marker . Magainin 1 induces the leakage of calcein specifically out of negatively-charged vesicles . The peptide binds to bovine brain phosphatidylserine sonicated vesicles according to the Langmuir isotherm with a binding constant of 3.8.10(5) M-1 and a binding-site number of 0.10 per lipid molecule . The leakage seems to occur at a critical binding number of approx . 0.03 per lipid molecule . A circular dichroism study revealed that magainin 1 conforms mainly to an unordered structure both in an aqueous solution and in the presence of egg yolk phosphatidylcholine vesicles, whereas to an amphiphilic helix with the phosphatidylserine vesicles . In conclusion, magainin 1 interacts with acidic lipids through electrostatic interactions followed by hydrophobic interactions to form an amphiphilic helix, inducing the leakage. Experientia, 1989 May 15, 45(5), 478 - 80 The use of 5-fluorocytosine and ketoconazole in the culture of the erythrocytic stages of Plasmodium falciparum and some tumor cell lines; Roth EF Jr et al.; In vitro culture systems are often contaminated by bacteria and fungi . It is therefore often necessary to supplement culture media with agents such as penicillin/streptomycin, gentamycin or amphotericin B . The latter cannot be used in the in vitro culture of erythrocytic stages of P . falciparum, and thus anti-fungal agents have not been regularly used in this system . We describe the prophylactic use of 5-fluorocytosine (5-FC) and ketoconazole (KTZ) in tissue cultures at concentrations up to 300 and 10 micrograms/ml respectively which have no effect on the growth of P . falciparum (FCR-3 strain) . A melanoma cell line (C32) and a line of uterine carcinoma (C41) were also unaffected by similar concentrations of 5-FC and KTZ . When dissolved in complete culture medium (RPMI 1640) with 10% human plasma, the minimum inhibitory concentration of 5-FC for a susceptible strain of Candida remained below 2 micrograms/ml . These experiments suggest that 5-FC (at 50 micrograms/ml) alone or in combination with KTZ (at 1 microgram/ml) is a useful addition to the armamentarium of antimicrobials available to the tissue culture biologist for a variety of cell culture systems. J Am Vet Med Assoc, 1989 May 15, 194(10), 1467 - 73 Clinical, radiographic, and bronchial cytologic features of cats with bronchial disease: 65 cases (1980-1986); Moise NS et al.; Medical records, radiographs, and bronchial cytologic abnormalities of 65 cats with bronchial disease were reviewed . Bronchial disease was defined as abnormality of the lower airways to the exclusion of disease originating or mainly involving the alveoli, interstitium, vasculature, or pleura . Cats with bronchial disease were more likely to be female and older . Siamese cats were overrepresented and had more chronic disease . In order of frequency, the following clinical signs were reported: coughing, dyspnea, occasional sneezing, wheezing, and vomiting . Radiography revealed prominent bronchial markings, with some cats having collapse of the middle lobe of the right lung (n = 7), overinflation of the lungs (n = 9), or aerophagia (n = 13) . Of 65 bronchial washes, 58 were considered exudative, with the predominant cell type being eosinophil in 24%, neutrophil in 33%, macrophage in 22%, and mixed population of cells in 21% . Cultures for bacteria were considered positive in 24% of the cats . Circulating eosinophilia was not helpful in predicting the predominant cell type in bronchial cytologic exudates . Hyperproteinemia without dehydration was present in a third of the cats, indicating an immunologic response . Half the cats had resolution of clinical signs, whereas half the cats required continuing medication with bronchodilators, antimicrobial agents, or corticosteroids. Agressologie, 1989 May, 30(5), 269 - 72 {Infections caused by central venous catheterization at intensive care units}; Schmit JL et al.; All different types of catheters can induce localized (subcutaneous) or systemic sepsis . Infection rates of 7 to 20% have been reported in the literature; catheter infection results from bacterial colonization of the skin, colonization of the line or may be secondary to blood born seeding . In a one year prospective study of 56 catheters in our unit, the rate of systemic infection was 5.3%, insertion site infection 3.6%, and contamination without infection 25% . No catheter with less than 10(2) colonies on a semi-quantitative culture method was infected . Prevention of catheter related sepsis needs strict aseptic protocols, and short duration of catheterization, antiseptic wrapping of the line; antimicrobial filtersets may further reduce the infection risk. Vestn Khir Im I I Grek, 1989 May, 142(5), 10 - 2 {Antibacterial threads in surgery of the lungs}; Polous IuM et al.; Antibacterial threads "Kapromed DKh" were used in experiments and clinic for the formation of lung sutures in combination with the antimicrobial film ESBADKh with the cyanacrylate glue . The application of polymers exerts a positive effect upon the regeneration of the lung wound and reduces the frequency of postoperative complications associated with the disturbed hermetic property of the suture and the development of the inflammatory process. Mikrobiol Zh, 1989 May-Jun, 51(3), 48 - 52 {Quantitative "structure-antimicrobial activity" relations of the new azole derivatives}; Patratii VK et al.; New azole derivatives are synthesized and examined with the purpose of searching antimicrobic drugs and of determining the quantitative structure--activity relationships . Their antifungal and antibacterial activity is fixed . Certain regularities of the relationships between the chemical structure of compounds and their activity are determined by the Free-Wilson model . The influence of aryl and alkyl radicals in 1.2 and 5 positions of azoles on antimicrobial properties is discussed . Prospects for the further studies of this group of chemicals are shown. Am J Med Sci, 1989 May, 297(5), 328 - 30 Pneumomediastinum complicating Pneumocystis carinii pneumonia in a patient with AIDS; Villalona-Calero MA et al.; The destructive potential of Pneumocystis carinii infection in patients with AIDS has been amply documented . This report describes a homosexual man with P . carinii pneumonia (PCP) complicated by pneumatocoeles and pneumomediastinum . The pneumomediastinum almost completely resolved with successful antimicrobial therapy . Pneumomediastinum, like pneumothorax, should be anticipated in patients with AIDS and PCP. J Nat Prod, 1989 May-Jun, 52(3), 629 - 33 Isolation of flavonoids and a chalcone from Helichrysum odoratissimum and synthesis of helichrysetin; Van Puyvelde L et al.; 3,5-Dihydroxy-6,7,8-trimethoxyflavone, 3-O-methylquercetin, and helichrysetin were isolated from the flowers of the Rwandese medicinal plant, Helichrysum odoratissimum . Because of inconsistencies of the mp of the latter chalcone, a synthesis of helichrysetin was developed . 3-O-Methylquercetin was shown to be an active principle as it displayed antimicrobial activity. Microb Pathog, 1989 May, 6(5), 369 - 80 Neutrophil-macrophage cooperation in the host defence against mycobacterial infections; Silva MT et al.; CD-1 mice inoculated intraperitoneally with Mycobacterium avium, M . bovis, M . microti or M . kansasii showed a persistent peritoneal granulocytosis (above 10(6) cells, i.e . more than 15% of total cells) throughout the 3 month period of infection studied . By contrast, in mice inoculated with the non-pathogenic M . aurum or with heat-killed M . avium the number of granulocytes decreased progressively after the first 15 days . No mycobacteria were found in granulocytes except in the first 2 days of infection . The mycobacteria-induced chronic granulocytosis was accompanied by phagocytosis of granulocytes by macrophages . Throughout the 3 months of infection, macrophages were found to contain intracellular lactoferrin . Macrophages with lactoferrin were also found in subcutaneous infection caused by M . marinum and in systemic infection caused by M . avium or M . kansasii . The in vitro activity of mouse peritoneal macrophages against M . avium and M . microti was increased after ingestion of granulocyte material by macrophages . These results lead us to propose that granulocytes participate in the host response to mycobacterial infections, not as phagocytes but rather through an indirect mechanism, as a source for the macrophages of molecules involved in antimicrobial mechanisms (e.g., lactoferrin and myeloperoxidase) lacking in the mature macrophage. Zentralbl Hyg Umweltmed, 1989 May, 188(1-2), 188 - 93 {Octenidine dihydrochloride, properties of a new antimicrobial agent}; Harke HP; The chemical, antimicrobial and toxicological properties of Octenidine dihydrochloride - a compound belonging to the bipyridines - are briefly described . Already low concentrations (0.1% and less) of the substance are bactericidally and fungicidally effective . It is remarkable that this effect is practically as strong against grampositive as against gram negative germs . The compound is not absorbed by the skin . A systemic effect cannot be observed upon oral application within large of dosage scales . As active component in antiseptics the remanent effect has particularly to be emphasized even against transient germs reaching the skin after disinfection. Arzneimittelforschung, 1989 May, 39(5), 618 - 9 Lung tissue concentrations of ciprofloxacin following intravenous administration in patients; Forst H et al.; Serum and corresponding lung tissue concentrations of ciprofloxacin (Ciprobay) were investigated in 25 patients undergoing open lung surgery for pulmonary malignancies . Drug levels were measured at various times (50-240 min) after completion of a single i.v . dose of 200 mg by bioassay and HPLC . Lung tissue concentrations peaked within one hour after dosing (bioassay: 3.2 micrograms/g, HPLC: 4.5 micrograms/g) . Tissue levels exceeded corresponding serum level 3- to 4fold throughout the observation period . The results demonstrate excellent penetration properties of this new antimicrobial compound into lung tissue . Ciprofloxacin was concentrated in the lung and thus by far exceeded known minimum inhibitory concentrations for most nosocomial respiratory pathogens. Antimicrob Agents Chemother, 1989 May, 33(5), 771 - 2 Antimicrobial susceptibility of Bordetella avium and Bordetella bronchiseptica isolates; Mortensen JE et al.; Two veterinary pathogens, Bordetella bronchiseptica and Bordetella avium, were tested for their antimicrobial susceptibilities . Of the 20 antimicrobial agents tested, both species were consistently resistant to penicillin and cefuroxime but susceptible to mezlocillin, piperacillin, gentamicin, amikacin, and cefoperazone. Antimicrob Agents Chemother, 1989 May, 33(5), 700 - 4 Penetration of antibiotics into the surgical wound in a canine model; Rosin E et al.; The dose and timing of antimicrobial agents given for surgical wound prophylaxis should be based on the concentration-time profile of the drug in tissue at the site of contamination . However, concentrations of antimicrobial agents in surgical wounds are difficult to determine accurately . Since a surgical wound is a unique extravascular compartment with increased vascular permeability and a high surface area/volume ratio, antibiotic concentrations in sera and surgical wounds should be similar . To test this hypothesis, the pharmacokinetics of single intravenous doses of cefazolin (40 mg/kg) and gentamicin (4 mg/kg) in sera and surgical wounds in a clinically relevant surgical model using dogs were compared . Drug concentrations were determined in interstitial fluid in muscle biopsies taken randomly from wound surfaces and serial wound fluid samples collected after the incisions were closed . Protein binding of cefazolin and gentamicin in sera and wound fluids was low (less than or equal to 29 +/- 9%) in this canine model . Cefazolin and gentamicin equilibrated rapidly (less than or equal to 30 min) between serum and the surgical wound, and concentrations in the two sites declined in parallel . Values for the area under the concentration-time curve, mean residence time, and terminal half-life in serum and the surgical site for each drug were similar . Cefazolin concentrations in serum underestimated the time during which concentrations in surgical wounds exceeded the susceptibility breakpoint MIC for important pathogens by an average of 58 min (range, 26 to 109 min; P = 0.036); for gentamicin, the underestimation averaged 30 min (range, 10 to 60 min; P = 0.036) . These data support the concept that the concentration-time profiles of antimicrobial agents in serum may prove valuable clinically as guides to determining the and timing of antibiotic administration necessary for effective antimicrobial prophylaxis in surgery . Further studies are needed to determine the surgical wound pharmacokinetics of highly protein-bound antibodies. Antimicrob Agents Chemother, 1989 May, 33(5), 653 - 6 Fluorometric measurement of ofloxacin uptake by human polymorphonuclear leukocytes; Pascual A et al.; A fluorometric assay, based on the natural fluorescence of the quinolone nucleus, was used to determine the uptake of ofloxacin by human polymorphonuclear leukocytes . The ratio of cellular concentration to extracellular concentration (C/E) at 20 min and 37 degrees C was 7.2, using an extracellular concentration of 5 micrograms/ml . Uptake was rapid and was not affected by pH (5 to 9), but required elevated environmental temperature and cell viability . The metabolic inhibitors sodium fluoride and sodium cyanide significantly decreased the uptake of ofloxacin . The penetration of ofloxacin was not affected by the presence of glucose or adenosine, but was decreased by L-amino acids (lysine, leucine, and glycine) . These results suggest that ofloxacin could be transported via an amino acid transport system and that the fluorometric assay is a useful method for determining the intracellular penetration of fluoroquinolones, avoi