Onkologie, 1987 Feb, 10(1), 57 - 8 Chemoprophylaxis of bacterial infections in granulocytopenic patients with ciprofloxacin; Dennig D et al.; The trial was conducted to evaluate the antimicrobial prophylactic efficacy of ciprofloxacin in reducing the frequency of infections in granulocytopenic patients . The frequency of infections was evaluated in 34 patients with acute non-lymphoblastic leukemia, acute lymphoblastic leukemia, blast crisis of chronic myelogenous leukemia and other malignancies . 46 courses of oral prophylactic treatment with 500 mg ciprofloxacin twice daily were administered . While there was no infection in 61% of treatment courses, fever over 38 degrees C (axillary) occurred in 39% . 6 patients had a fungal pulmonary infection, one patient a supposed viral pneumonia, and only two patients had a documented bacterial infection . There were no severe side effects . We conclude that ciprofloxacin is a potent drug in prophylaxis of bacterial infections in cancer patients with therapy-induced granulocytopenia. J Clin Pharm Ther, 1987 Feb, 12(1), 59 - 63 Drug prescribing for TPN patients at a teaching hospital serving a developing community; Bertram T et al.; Drug prescribing for TPN patients at Ga-Rankuwa Hospital was investigated as part of a larger retrospective survey of TPN products and practices . The medical records of 45 patients who received parenteral nutrition over the period April-August 1985 were examined . Relevant information was transcribed onto survey forms, classified and analysed . The major defined complaints were gastrointestinal (50%) and perinatal (34.5%) . Twelve patients had more than one major complaint . Seventy-three per cent of the patients were admitted to paediatric wards and over 24% to (adult) surgical wards . There was one medical patient in the group . The only drug categories that were prescribed in more than 10% of cases were antimicrobial agents (64.9%) and analgesics (10.4%) . The most frequently used individual drugs were gentamicin (17.5%), penicillin G (14.3%), piperacillin (17%) and aminophylline (11%) . The implications of this pattern of drug use for TPN patient monitoring are discussed. J Antimicrob Chemother, 1987 Feb, 19(2), 193 - 6 In-vitro susceptibility of Pseudomonas species to fifteen antimicrobial agents; Rolston KV et al.; The in-vitro susceptibility of four Pseudomonas spp . (P . aeruginosa, P . fluorescens, P . maltophilia and P . putida) to 15 antimicrobials was determined . Ciprofloxacin had the greatest in-vitro activity . Although the susceptibility of the different species to individual agents was quite variable, they tended to be less susceptible to agents such as amikacin, aztreonam, cefoperazone, ceftazidime and piperacillin, already in clinical use at our institution, than to newer agents, not currently in clinical use. Antibiot Med Biotekhnol, 1987 Feb, 32(2), 122 - 9 {Principles for analyzing the kinetic curves of the antimicrobial effect in dynamic systems simulating the pharmacokinetic profiles of antibiotics}; Firsov AA et al.; Alternative variants of the available methods for estimating the antimicrobial effect kinetics in the in vitro dynamic systems were analyzed . For defining and analyzing the concentration-effect relations in the in vitro dynamic systems it was recommended that two integral parameters characterizing the antimicrobial effect duration (TE) and intensity (IE) irrespective of the recording means be used . TE is defined by the time from the moment of antibiotic administration into the dynamic system till the moment when the count of the microorganisms reaches again its initial level . IE is defined by the area between the curves of the microbial growth kinetics in the presence and absence of an antibiotic . The possible application of TE and IE is exemplified by relation between the sisomicin antimicrobial effect on P . aeruginosa 58, E . coli 93 and K . pneumoniae 5056 and the antibiotic concentration under conditions of sisomicin pharmacokinetic profiles reproduction after intramuscular administration within the levels of the therapeutic doses with an account of individual variability of the aminoglycoside concentration in the blood of humans. Comput Methods Programs Biomed, 1987 Feb, 24(1), 47 - 62 Choice of antimicrobial drugs by the site of infection; Chung SJ et al.; Microcomputer programs are designed in BASIC for the analysis of 1209 positive cultures and 1056 antimicrobial susceptibility tests on clinical specimens from various sites of infection . A list of antimicrobial drugs of choice by the site of infection is determined on the basis of the computer analysis of the data . The list may be useful to clinicians for initial therapy in critically ill patients and for preoperative prophylaxis before the results of cultures and susceptibility tests are reported. Surg Clin North Am, 1987 Feb, 67(1), 57 - 68 Systemic antibiotic treatment in burned patients; Dacso CC et al.; Systemic antibiotics are a valuable therapeutic modality in the burned patient when properly used . Injudicious use, however, may not only fail to be beneficial to the patient but also may produce harmful effects--either through direct toxicity or by contributing to the emergence of resistant strains of micro-organisms . General guidelines and principles for systemic antibiotic use include the following: The burned patient, despite all efforts, will be exposed to microorganisms . No single agent or combination of agents can destroy all the organisms to which the burned patient is exposed . Treatment involves first identifying the organism responsible for clinical sepsis, then choosing appropriate agents . Combinations of antibiotics are not always synergistic or even additive in effect . Multiagent therapy may have the untoward effect of predisposing to superinfection by yeast, fungi, or resistant organisms . Antibiotics should be used for a long enough period to produce an effect, but not long enough to allow for emergence of opportunistic or resistant organisms . Dosages must be adjusted based on serum concentrations when serum assays are available . In general prophylactic systemic antibiotics are indicated in only a few clinical situations including the immediate preoperative and postoperative periods associated with excision and autografting, and possibly in the early phases of burns in children . The penetration of systemic antibiotics into burn eschar remains an area not fully studied; hence, they cannot be the only therapeutic modality used to treat burn wound infection . Systemic dosages of antibiotics in burns will require alteration depending on the clinical status of the patient . The choice of agent requires a thorough knowledge of side effects, toxicity, and potential benefit . Above all, active surveillance and monitoring of the burned patient and the environment in which he or she is being treated is mandatory for effective treatment . The increasing number of new antimicrobial agents has presented a new dilemma to the practicing clinician because many of these agents have not been evaluated thoroughly in the burned population . With further studies, the armamentarium of the burn treatment team will inevitably increase . It is in this manner only that so many of the unanswered questions will be solved, and that infection will start to decline as the major cause of death in the burned population. J Dent Res, 1987 Feb, 66(2), 475 - 9 Antimicrobial factors in saliva: ontogeny and relation to oral health; Tenovuo J et al.; Antimicrobial agents (antibody and non-antibody) present in human saliva protect oral tissues by a variety of mechanisms, such as prevention of bacterial adhesion, agglutination of micro-organisms, and inhibition of multiplication and metabolism . However, studies in which the concentrations of various salivary antimicrobial agents have been correlated to the presence and severity of oral diseases--of dental caries, in particular--have produced controversial data, and it seems evident, also on the basis of the present study, that no single salivary antimicrobial factor (except flow rate) affects oral health to a significant degree . In the present study, we report the levels of some selected salivary antimicrobial agents in predentate and dentate human infants, with a comparison to the levels found in young adults' saliva . Salivary lysozyme, peroxidase, and hypothiocyanite concentrations were already at the adult level at the time when the primary teeth erupt, whereas immunoglobulin (IgA, IgG, and IgM), lactoferrin, myeloperoxidase, and thiocyanate concentrations were significantly lower in children than in adults . Dentate children had more IgG, thiocyanate, and protein in whole saliva than did predentate children. Agents Actions, 1987 Feb, 20(1-2), 77 - 86 Ascorbate and cysteine-mediated selective neutralisation of extracellular oxidants during N-formyl peptide activation of human phagocytes; Anderson R et al.; The effects of sodium ascorbate and cysteine (2.5 X 10(-5) M-2.5 X 10(-4) M) on the intensity and profile of luminol-enhanced chemiluminescence, superoxide generation, extracellular myeloperoxidase (MPO) activity and auto-iodination were measured in purified human polymorphonuclear leukocytes activated by the leukoattractant FMLP in vitro . Chemiluminescence studies were also performed using a whole-blood method . Cysteine (10(-4) M-2.5 X 10(-4) M) and ascorbate (2.5 X 10(-5) M-2.5 X 10(-4) M) caused significant inhibition of the early extracellular peak of FMLP-activated chemiluminescence and increased the intensity of the later occurring intracellular peak in both PMNL and blood . At the same concentrations both agents scavenged superoxide released by FMLP-activated PMNL, inhibited oxidant generation by extracellular MPO and decreased FMLP-induced auto-oxidation of PMNL . Administration of a single 1 gram oral dose of ascorbate to adult human volunteers was associated with significant reduction and enhancement respectively of the extracellular and intracellular luminol-enhanced chemiluminescence responses of FMLP-activated blood . These results show that the water soluble anti-oxidants cysteine and especially ascorbate selectively neutralise the reactivity of harmful reactive oxidants released by phagocytes, whilst the intracellular generation of antimicrobial oxidants remains intact. J Am Dent Assoc, 1987 Feb, 114(2), 217 - 21 The use of sodium bicarbonate and hydrogen peroxide in periodontal therapy: a review; Amigoni NA et al.; The comparative benefits from the use of sodium bicarbonate and hydrogen peroxide over the use of a commercial dentifrice in periodontal therapy is controversial . The consensus of the clinical research indicates that application by patients of sodium bicarbonate and hydrogen peroxide offers no advantage over the preestablished, properly performed home oral hygiene procedures . Any improvements in clinical and microbial parameters generally were attributed to scaling and root planing . The studies that have reported beneficial results with sodium bicarbonate and hydrogen peroxide have used additional antimicrobial agents, concomitant professional application of these substances, and scaling and root planing . In one of these reports, inorganic salts and chloramine-T were delivered subgingivally throughout root-planing procedures, in addition to home application of inorganic salts . Most of these patients also received at least one course of systemic tetracycline therapy . Because this study had no control group, it is impossible to determine whether this program is more effective than are other periodontal therapy programs . A more controlled clinical study involving professional application of sodium bicarbonate, sodium chloride, hydrogen peroxide, and povidone-iodine has shown greater gains in clinical attachment and bone mass than has brushing with toothpaste and water . Again, subgingival scaling and root planing were necessary to attain these results . Because multiple topical agents were applied in both of these reports and systemic antimicrobial agents were used by the Keyes group, it is impossible to determine which agent was responsible for the improvements . Further, professional application may be the crucial factor.(ABSTRACT TRUNCATED AT 250 WORDS) Arch Surg, 1987 Feb, 122(2), 197 - 203 Neutrophil function in a rat model of endotoxin-induced lung injury; Simons RK et al.; Polymorphonuclear neutrophil leukocytes (PMNs) are known to cross the alveolar-capillary barrier and enter the alveolus in acute adult respiratory distress syndrome (ARDS) . The pathogenic role of PMNs in both the acute lung injury and subsequent infectious susceptibility in ARDS is not clear . In the present study we investigated the functional status of various neutrophil populations using a chronic, endotoxemia-induced ARDS model . Rats infused with Escherichia coli endotoxin for three days develop an acute lung injury with a histologic picture closely resembling human ARDS . The PMNs recovered from the circulation and by bronchoalveolar lavage were compared with normal rat PMNs . In endotoxemic animals, superoxide production was markedly enhanced in circulating PMNs, indicating production of high levels of potentially cytotoxic oxygen intermediates, while myeloperoxidase activity was decreased in both circulating and lavage PMNs, indicating depressed myeloperoxidase-dependent antimicrobial activity. Pharmacol Toxicol, 1987 Feb, 60(2), 100 - 3 Antibacterial effect of four phenothiazines; Kristiansen JE et al.; Various types of phenothiazines were examined for antibacterial effect on 61 Gram-positive and Gram-negative bacterial strains in vitro . The investigated phenothiazines were two neuroleptic drugs, fluphenazine and chlorpromazine, and two antihistaminic drugs, alimemazine and promethazine . All four drugs have antibacterial effects in vitro, the phenothiazines being more potent against the Gram-positive microorganisms . The antibacterial potency of the drugs was measured as IC50: Fluphenazine 29 microM (15 micrograms/ml), alimemzaine 49 microM (37 micrograms/ml), promethazine 88 microM (28 micrograms/ml) and chlorpromazine 92 microM (29 micrograms/ml) . The antibacterial potency of the drugs was linked neither to the neuroleptic nor the antihistaminic potency of the drugs, which is in agreement with results of earlier stereoisomeric investigations . Thus, the known phenothiazines may represent a pool of potentially new antimicrobial drugs . A therapeutic application of these results, however, requires additional in vitro an in vivo testing in an animal model . The bacterial model might be of value as a model system in the study of the interaction of neuropharmacological agents and other membrane active compounds on biological membranes. J Immunol, 1987 Jan 15, 138(2), 491 - 5 In vivo and in vitro activation of alveolar macrophages by recombinant interferon-gamma; Black CM et al.; In vivo administration of recombinant interferon-gamma (rIFN-gamma) was previously shown to result in activation of the microbicidal activities of peritoneal macrophages (PM phi) . Because macrophages at different anatomical sites vary in their functional capacities, we considered it of interest to determine whether administration of murine rIFN-gamma, either in vitro or in vivo, can enhance the microbicidal activity of resident alveolar macrophages (AM phi) and to compare the effects of rIFN-gamma on AM phi and PM phi . After incubation in vitro with rIFN-gamma, the antimicrobial activities of both murine AM phi and PM phi were enhanced, as assessed by their ability to inhibit replication of the intracellular parasite, Toxoplasma gondii . This effect was dose dependent for AM phi over a range of 0.1 to 1 U/ml and for PM phi over a range of 0.5 to 1000 U/ml . In this assay, the minimum dosage required for in vitro activation of AM phi was one-half that required for activation of PM phi, suggesting a greater sensitivity of AM phi to the in vitro activity of rIFN-gamma . Macrophages from both anatomical sites were also activated when rIFN-gamma was administered in vivo . This effect was dose dependent over a range of 10(3) to 10(5) U/mouse . Freshly harvested AM phi and PM phi from mice injected 24 hr earlier with 10(4) U rIFN-gamma by either the i.v . or i.p . routes markedly inhibited intracellular multiplication of Toxoplasma . In contrast, AM phi and PM phi from control mice permitted fourfold to ninefold increases in numbers of intracellular Toxoplasma . The anti-toxoplasma activity of AM phi and PM phi gradually diminished over a period of 3 days when assayed at successive 24 hr periods after a single i.v . injection of rIFN-gamma . At 3 days after injection, a substantial loss of anti-toxoplasma activity was observed with PM phi as compared with controls; residual anti-toxoplasma activity was still demonstrable in AM phi at 3 days . These results demonstrate that in vitro as well as in vivo treatment with rIFN-gamma confers on AM phi an enhanced antimicrobial activity . These findings provide a rationale for evaluating rIFN-gamma in the treatment of pulmonary infections, especially those due to opportunistic pathogens against which AM phi play a major role in host defense. Z Hautkr, 1987 Jan 15, 62(2), 125 - 35 {Therapy of chronic venous insufficiency--the domain of dermatologic ambulatory care}; Lohfink HD; By means of a graded test system for external medicaments, we optimized and standardized the local therapy of chronic venous insufficiency (CVI) in our out-patient department: allergological tests; subjective sensitivity tests of ulcus cruris venosum; comparison of ointments with powder in the therapy of ulcus cruris venosum, objective findings, applicability of the dry therapy (Heede); comparison of external drugs containing antimicrobial chemotherapeutics with those not containing these additives in the therapy of ulcus cruris venosum; comparison of ointments containing heparinoid with lipoid-in-water emulsions without admixtures in plebological therapy . We report on the therapeutic standard . Clinically 63,8% of all patients attending our dermatologic out-patient department showed CVI (stages I to IV); 38,7% were graded "venously ill" (stages III and IV) . Stage I of CVI is characterized by varicous veius without discomfort . Problems of eczema are both dermatological and phlebological problems . The therapy of CVI, however, is the dermatologist's business. Can J Hosp Pharm, 1987 Feb, 40(1), 6 - 11 Intravenous metronidazole: a drug utilization review in a community hospital; Nessim D; The recent release, relatively high cost and extensive usage of intravenous metronidazole, in a 690-bed community hospital, prompted a drug utilization review of this antimicrobial agent . The review was retrospective and occurred over the period of October 25, 1984, to April 10, 1985 . All patients started on intravenous metronidazole were assessed . The quality of use of intravenous metronidazole was determined on the basis of pre-established criteria, which were developed from the literature and in consultation with the hospital's Medical Microbiologist . These criteria were approved by a peer review committee of medical staff . Drug utilization was assessed as either appropriate or inappropriate . Appropriate therapy implied compliance with all of the criteria for appropriate intravenous metronidazole use with respect to indication, dose, dosage frequency, timing of perioperative prophylaxis, duration of use, and concurrent antimicrobial drug use, when metronidazole was prescribed for prophylaxis, empiric treatment or treatment of a documented infection (documented treatment) . Inappropriate use implied non-compliance with one or more of the criteria . Fifty-four courses of intravenous metronidazole in fifty in-patients were reviewed . Of the total usage of intravenous metronidazole, 50%, was judged to be inappropriate . Although the Surgical Services accounted for 56% of the total usage, only 13% of the total intravenous metronidazole use was for surgical prophylaxis . Of these cases, 57% were inappropriate . Seventy percent of the total intravenous metronidazole use was for empiric treatment; 53% of these cases were considered inappropriate . The reasons cited most frequently for inappropriate prophylactic or empiric use were inappropriate indication and inappropriate dosage frequency.(ABSTRACT TRUNCATED AT 250 WORDS) Gan No Rinsho, 1987 Jan, 33(1), 89 - 96 {Acute squamous metaplasia of the whole lung after combined radiation and chemotherapy in advanced lung cancer}; Miyamoto T et al.; Two patients with advanced lung cancer, histologically diagnosed as adenocarcinoma and squamous cell carcinoma, respectively, were treated with a combination of radiation and anticancer drugs (aclacinomycin-A, bleomycin, mitomycin) . The lung tumors responded remarkably to this combined modality . However, the patients succumbed to pneumonia-like disease, being refractory to various antimicrobial treatments . Histologic examination revealed that the outstanding squamous metaplasia developed diffusely in the terminal bronchioles and the alveoli in all lobes of the lungs . Compared with their clinical courses and the resultant detailed pathological findings, the pathogenesis of the conditions was discussed. J Am Acad Dermatol, 1987 Jan, 16(1 Pt 2), 238 - 42 Cutaneous botryomycosis in a patient with acquired immunodeficiency syndrome; Patterson JW et al.; A patient with acquired immunodeficiency syndrome presented with multiple pruritic papules and nodules over the trunk and extremities . Biopsy specimens from two of these lesions contained granules within abscesses of the papillary dermis . There were numerous gram-positive cocci within the granules . Culture of one lesion failed to produce growth . A mouse inoculated with tissue from a lesion revealed no evidence of sepsis or organ involvement . The skin lesions showed no obvious response to systemic antimicrobial therapy but gradually resolved after treatment had been discontinued . Such lesions should be clinically distinguished from other cutaneous manifestations of acquired immunodeficiency syndrome, such as Kaposi's sarcoma. J Trauma, 1987 Jan, 27(1), 45 - 8 Natural course of the human bite wound: incidence of infection and complications in 434 bites and 803 lacerations in the same group of patients; Lindsey D et al.; Human bites and common lacerations are frequent in certain residential groups in institutions for the care of developmentally disabled individuals . We screened the records of such an institution and studied the course and outcome of 434 human bite wounds and 803 lacerations in the same group of clients . Infection developed in 13.4% of the lacerations, and 17.7% of the bite wounds (chi 2 = 3.474; p greater than 0.06) . Prophylactic antibiotics were administered after 14.0% of the bite wounds, and 3.2% of the lacerations . Infection supervened after prophylactic antibiotics in 29.5% of the bites and 34.6% of the lacerations . No patient with a bite wound required debridement, initial or subsequent surgical intervention other than wound closure, admission to hospital, or intravenous antibiotics . There is no recorded instance of a bite wound complication other than immediate loss of tissue . These data substantiate a higher incidence of infection in human bite wounds, but they are scant support for admonition that such wounds are indication for routine antimicrobial prophylaxis or aggressive surgical intervention. Obstet Gynecol, 1987 Jan, 69(1), 127 - 30 Abbreviated antibiotic therapy for the treatment of postpartum endometritis; Soper DE et al.; Standard antimicrobial therapy for postpartum endometritis usually consists of several days of intravenous antibiotics followed by up to ten days of oral therapy . In an effort to decrease the length of hospitalization and duration of antibiotic use, 54 patients were placed on an abbreviated antibiotic protocol . Therapy consisted of intravenous gentamicin and clindamycin until the patient's temperature remained lower than 99.5F for 24 hours, at which time intravenous antibiotics were discontinued and the patient was discharged immediately without oral medication . No morbidity secondary to the abbreviated regimen was observed . Further, the duration of hospitalization and antibiotic therapy of the study group were significantly shorter than similar data from a group of historic controls . These observations suggest that an abbreviated course of antibiotics, based upon the patient's "therapeutic response," may be a safe and cost-effective alternative to the currently practiced therapeutic regimen. Rev Argent Microbiol, 1987 Jan-Mar, 19(1), 27 - 31 {Resistance to antibiotics in strains of Azospirillum sp.}; Alonso M et al.; A total of 32 strains of Azospirillum mainly isolated from rhizosphere of grasses and soils of Argentina were examined for susceptibility to 9 antimicrobial agents (trimethoprim, ampicillin, carbenicillin, streptomycin, spectinomycin, chloramphenicol, kanamycin, nalidixic acid and tetracycline) . Many of the strains were sensitive to tetracycline, kanamycin, chloramphenicol and nalidixic acid, and resistant to ampicillin (more than 50 mg/l) and carbenicillin (more than 200 mg/l) . In spite of this general pattern, for most of the strains it was possible to obtain an antibiotype . Such antibiotype could be useful for identification of the strains in field experiments or in genetic transfer experiments. J Hyg Epidemiol Microbiol Immunol, 1987, 31(3), 335 - 41 Drug resistance and pathogenicity of S . aureus isolated from patients; Vymola F et al.; Over the period 1983-1985, investigators from the Institute of Hygiene and Epidemiology, Prague, and the Central Research Institute of Epidemiology, USSR Ministry of Public Health, Moscow, carried out a joint study of drug resistance in S . aureus strains in relation to their enterotoxigenic properties and phage group specificity . Altogether 277 strains were explored which had been isolated at random from the clinical material from infant and adult inpatients . Most of the isolated strains featured multiple resistance to antibiotics: PNC (77.9%), CMP (52.7%), TET (21.6%), ERY (17.6%) and LIN (11.9%) . The strains isolated from infants were most frequently resistant to TET and ERY . No correlation was found between the incidence of antimicrobial drugs resistance and toxigenic properties of the isolated strains. Toxicon, 1987, 25(8), 899 - 909 A low molecular weight protein with antimicrobial activity in the cutaneous 'venom' of the yellow-bellied toad (Bombina variegata pachypus); Barberio C et al.; The cutaneous 'venom' was collected from dorsal skin fragments of the yellow-bellied toad Bombina variegata pachypus by means of stimulation with noradrenaline . Light and electron microscope observations gave evidence that the 'venom' corresponds to the secretory products of both serous gland types (i.e . with small or large granules) characteristic of this genus, which had discharged their contents upon stimulation . The serous 'venom', when tested for antimicrobial activity, inhibited the growth of several bacterial strains . Heat treatment, dialysis, protease digestion and SDS-PAGE electrophoresis showed that the antimicrobial activity was thermostable and associated with a low molecular weight protein . This protein was purified and homogeneity determined by CM-cellulose chromatography and SDS-PAGE electrophoresis . The purified protein has a molecular weight of 6700, displays antibacterial properties and appears different from the antimicrobially active peptides previously isolated from the 'venom' of the toad. Scand J Infect Dis, 1987, 19(4), 483 - 4 Infective aortitis due to Brucella melitensis; Aguado JM et al.; Infective aneurysms caused by Brucella sp . are extremely rare . B . suis and B . abortus have been implicated in a few cases but to our knowledge, B . melitensis has not been reported as a cause of mycotic aneurysm of the abdominal aorta . We here report the first case of this described in the English literature . The patient was successfully treated with resection of the infected aneurysm, placement of an axillo-bifemoral graft, and prolonged antibiotic treatment (doxycycline and streptomycin) . Extended antimicrobial therapy and extra-anatomical bypass grafting procedures are advisable in the management of brucella infections of the abdominal aorta. J Arthroplasty, 1987, 2(3), 215 - 7 Triple antibiotics for the treatment of infected joint replacements . Case report and commentary; Shaw JA; Combination antibiotics are frequently used in the treatment of infected joint arthroplasties to achieve synergistic activity against the infecting organisms . A case is presented in which triple antibiotic therapy was used in the treatment of an infected hip arthroplasty . The antibiotic combination proved to have an antagonistic effect despite documented sensitivities to the individual drugs . Serum antimicrobial assays are recommended in the treatment of all prosthetic joint infections. Respiration, 1987, 51(4), 285 - 91 Mycobacterium malmoense--report of a case in Switzerland; Leuenberger P et al.; Mycobacterium malmoense was isolated in four different sputum samples of a 45-year-old alcoholic smoker . The biochemical and culture characteristics of this species are described and compared with a reference strain (ATCC 29571) . The isolated strain was sensitive in vitro to rifampicine, ethionamide, kanamycine and erythromycin . Therapy consisted of right-upper-lobe lobectomy and a two-year antimicrobial therapy . There was no sign of relapse at the end of the treatment period. Nahrung, 1987, 31(5-6), 507 - 17 Colonization resistance of the digestive tract--mechanism and clinical consequences; van der Waaij D; Potentially pathogenic bacteria and yeasts meet a number of resistance factors . These colonization resistance (CR) determining factors control the growth density of potentially pathogenic microorganisms in the various parts of the alimentary canal . The CR of the digestive tract is to be seen partially of host origin but to a greater extent due to direct and indirect activity of the (anaerobic) indigenous microflora . This implies that the CR mechanism is vulnerable to antibiotics which affect the indigenous flora during treatment . A decreased CR enhances colonization by microorganisms that are resistant to the antibiotic(s) used for therapy . Increased population densities of potentially pathogenic bacteria ("overgrowth") may correlate with invasion of the mucosal tissues often followed by translocation to remote lymphatic organs . Overgrowth also may correlate with development or acquisition of resistance to the antibiotic applied . By screening in experimental animals antibiotics have been selected which do not affect the CR . Such antimicrobial drugs have successfully been used to selectively eliminate potentially pathogenic bacteria and yeast in neutropenic patients. Ann Med Interne (Paris), 1987, 138(4), 296 - 7 {Severe pneumopathy and acute renal insufficiency disclosing Chlamydia psittaci infection: resistance to the treatment with erythromycin}; Garo B et al.; The authors report one case of psittacosis with acute respiratory distress syndrome, acute tubulo-interstitial nephropathy and jaundice . Erythromycin therapy was uneffective but recovery was obtained with minocycline and rifampicin treatment . Early diagnosis of Chlamydia psittaci infection is mandatory in order to prevent severe complications and to institute appropriate antimicrobial therapy. Ann Med Interne (Paris), 1987, 138(4), 287 - 8 {Legionnaires' disease in hairy cell leukemia . 2 new cases}; Voiriot P et al.; We report the cases of two patients who developed legionnaires' disease during the course of hairy cell leukaemia . The clinical features are described with special emphasis on the severity of illness in one patient and marked jaundice in both . These cases demonstrate the enhanced susceptibility to Legionella pneumophila infections in patients with hairy cell leukaemia . We therefore suggest a reevaluation of empiric antimicrobial treatment of pneumonia in such patients. Drugs Exp Clin Res, 1987, 13(3), 161 - 6 Enhancement of antibiotic antibacterial activity by experimental pleural exudates; Miglioli PA et al.; The aim of this research was to study the synergistic effect of experimental pleural exudates and antimicrobial drugs on various microorganisms . The antibacterial activity of different pleural exudates alone and in the presence of sub-MIC amounts of antibiotics was studied by a continuous recording turbidimetric method . Synergistic action between the antibiotics and the exudates was demonstrated . This phenomenon can be explained by the presence of heat-labile substances that themselves possess only slight antibacterial activity but are able to increase the effect of sub-MIC antibacterial drugs. Zentralbl Gynakol, 1987, 109(7), 450 - 8 {Choriocarcinoma: neutropenia--acute emergency}; Briese V et al.; A patient aged 21 with metastatic choriocarcinoma was treated with Methotrexate . After twice application a severe neutropenia developed . The treatment of the febrile granulocytopenic cancer patient receiving antineoplastic therapy was performed by human gammaglobulin, transfer factor, leucocyte transfusion and selective antimicrobial modulation. Vet Hum Toxicol, 1987, 29 Suppl 1, 54 - 7 Aquaculture in Europe; Brown LA; The major aquatic species farmed in Europe are Atlantic salmon, rainbow trout and carp . Eels, flat-fish, mussels, oysters and crayfish are also produced . Northern Europe, with more temperate climates, centers its production around the salmonidae; further south and east eels and various species of carp are farmed . Farm systems vary from extensive fishing lakes to highly intensive tank units . Drugs and chemicals appear to be reasonably available in Europe to fish farmers . Three antimicrobials are currently licensed for use in food fish . Current legislation on the use of chemicals on fish farms does not adequately cover the present situation and so, almost any chemical which does not have to be given by a veterinarians prescription is available for a fish farmer . The constraints on future development of medicines for aquaculture industry are discussed together with the problems of generic prescribing. Dev Pharmacol Ther, 1987, 10(4), 278 - 91 Epidemiological evaluation of anti-infective drug prescribing for children in outpatient practice; Stanulovic M et al.; In comparison with other regions in Yugoslavia, in the District of Novi Sad a high prescribing rate for antimicrobial drug were previously found . The aim of this study was to determine whether this high rate applies also to pediatric patients up to the age of 7 years, to define the prescribing pattern of physicians, and ultimately, to direct educational and other measures toward improving the therapeutic practices . The sample consisted of all prescriptions for 1 month for 26,652 children, comprising 8.9% of the total population . The method was based on a drug dose statistics concept, where the most frequently prescribed amount of the active substance, determined by convention as the defined daily dose (DDD), was used as a unit of measurement . The number of such statistical or average doses were expressed per 1,000 children per day . It was found that the prescribing rate in the District exceeds all other regions for which comparable data exist . In the prescribing pattern, the high usage of tetracyclines contributed to final removal of tetracyclines in syrup formulation from the market in Yugoslavia. Clin Ther, 1987, 9(4), 420 - 8 Antimicrobial management of surgically treated gangrenous or perforated appendicitis: comparison of cefoxitin and clindamycin-gentamicin; Sirinek KR et al.; Patients with gangrenous or perforated appendicitis were treated with cefoxitin or a combination of clindamycin and gentamicin for a minimum of five post-operative days . Septic complications developed in four of the 54 patients receiving cefoxitin: one was an intraabdominal abscess requiring surgery and three were wound infections . Of the 51 patients receiving clindamycin-gentamicin, two had septic complications: one was an intra-abdominal abscess requiring surgery and one was a wound abscess requiring drainage . The differences in the septic complications in the two treatment groups were not statistically significant . The cost to the patient of combined therapy with clindamycin and gentamicin was 36% higher than the cost of cefoxitin alone . The results demonstrate that cefoxitin alone is comparable to the "gold standard" of clindamycin-gentamicin in the treatment of patients with gangrenous or perforated appendicitis. Zentralbl Mikrobiol, 1987, 142(2), 175 - 8 Characterization of an antimicrobial substance, produced by Streptomyces violaceorectus; el-Gammal AA; Streptomyces violaceorectus produces a yellow-brown antimicrobial substance when cultivated on starch-potassium nitrate medium . The purified antimicrobial substance was active against Gram-positive, Gram-negative bacteria, and fungi . The solubility, characteristics, Rf values, minimum inhibiting concentrations, UV and IR spectra were studied . Elemental analysis was: carbon 37.94%, hydrogen 6.97%, nitrogen 7.50%, and oxygen 47.58%. Neurochirurgie, 1987, 33(2), 142 - 7 {Cerebral aspergillosis . Apropos of 4 cases}; Hajjar J et al.; Four patients with aspergillosis of the central nervous system collected in less than two years are reported . Three patients had hematologic malignancies (acute myelogenous leukemia, Hodgkin's disease) and were treated with corticosteroids and chemotherapy . One patient received antimicrobial agents fort a post operative meningitis (after acoustic neuroma surgery) . Analysis of these cases and review of literature available us to point out the increased frequency of invasive and cerebral aspergillosis particularly in immunocompromised hosts treated by cytotoxic drugs or broad spectrum antibiotic therapy . Diagnosis is very difficult because: --there are non specific radiologic features for aspergillus granuloma, abscess, aneurysm or meningitis, --blood and cerebrospinal fluid cultures are invariably negative, --serologic tests have limited value in immunosuppressed patients (poor capacity to elaborate antibodies) . Diagnosis can be made only by surgical biopsy who isolate fungal elements . However diagnosis in greatest cases is only made at autopsy . Treatment consist by antifungal drugs administered intravenously and surgery when it is possible . Prognosis of cerebral aspergillosis is very poor and mortality rate very high about 70%. Acta Anaesthesiol Belg, 1987, 38(1), 117 - 22 Bronchopulmonary superinfections in the critically ill; Vincent JL et al.; Bacterial colonization of the airways can lead to nosocomial respiratory infections . The emergence of Gram-negative bacteria in the upper airways is usual in critical conditions . Antimicrobial therapy and especially bacterial adherence to the airways mucosa have been incriminated in the selection of Gram-negative bacteria becoming ultimately multiresistant . Transmission of bacteria by the hands of the ICU-personnel and aspiration of bacteria represent two important factors in the airway colonization . Bacterial clearance can simultaneously be impaired by debility and altered mental state . Pulmonary infections are especially common in peritonitis or after abdominal surgery . In a series of 30 patients who had a complicated course after abdominal surgery, we observed that in all patients with acute respiratory failure, sputum cultus yielded at least one microorganism also recovered from cultus of the abdominal secretions . Acute respiratory failure was most commonly due to respiratory infection and carried a worse prognosis . Aspiration of bacteria from the gastrointestinal tract appears to represent the most common source of nosocomial bronchopulmonary superinfection in the critically ill. Clin Ther, 1987, 9(2), 167 - 73 Effective perioperative prophylaxis with a single dose of cefotaxime in transurethral prostatectomy; Nielsen PB et al.; In a prospective, observer-blind study, the authors assessed the efficacy of cefotaxime (2 gm IV) as auxiliary therapy to the currently used antimicrobial prophylaxis in transurethral prostatectomy . Cefotaxime was administered to 48 patients . From these, 188 blood specimens were drawn and eight blood cultures from eight patients were positive . From an untreated control group of 50 patients 196 specimens were drawn . Thirty-one of these specimens (from 17 patients) were positive (P less than 0.05) . This significant reduction was due mainly to fewer pathogen isolates (1 versus 16) . The number of postoperative complications was reduced from 21 in 15 patients to 12 in 10 patients (P less than 0.05) . It is concluded that a single IV dose of 2 gm of cefotaxime protects against the immediate perioperative complications. Med Pediatr Oncol, 1987, 15(1), 7 - 13 Randomised study of ticarcillin, cefamandole with or without tobramycin in febrile, neutropenic patients with solid tumors; Page JP et al.; A prospective randomised study was conducted comparing the efficacy and toxicity of the antibiotics ticarcillin and cefamandole (TC) with or without tobramycin (TCT) in 100 febrile neutropenic patients with solid tumours undergoing conventional chemotherapy . In this study, neutropenia less than 100/microliter was noted in 31% of 106 evaluable infectious episodes and neutrophil counts less than 1,000/microliter persisted for a median 4 days . Infection was microbiologically documented in 42% of episodes (bacteremia 24%) with gram-negative organisms responsible for 63% of bacterial isolates . Overall, 65% of episodes responded to TC and 76% to TCT (p greater than 0.05) . Patients with initial shock bacteremia, pulmonary infection, or gram-negative sepsis responded relatively poorly . Neutrophil nadir and pathogen susceptibility did not influence outcome . Antibiotic toxicity was minimal with no tobramycin-related nephrotoxicity . These results are broadly comparable to those observed with leukemic patients, but the relatively short duration of neutropenia in the solid-tumour patients appears to minimize the need for additional antibiotics provided there is adequate antimicrobial coverage with the initial choice of antibiotics. J Antibiot (Tokyo), 1987 Jan, 40(1), 1 - 6 Identification of novel erythromycin derivatives in mother liquor concentrates of Streptomyces erythraeus; Kibwage IO et al.; The identification of five novel compounds, pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-N-demethylerythromycin A-6,9-hemiketal, 5-O-beta-D-desosaminylerythronolide A and 15-nor-erythromycin C, in mother liquor concentrates of Streptomyces erythraeus is described . The pseudo-erythromycin derivatives are characterized by a 12-membered macrocyclic ring as a result of C13----C11 trans-lactonization . The five compounds have very little antimicrobial activity. Stat Med, 1987 Jan-Feb, 6(1), 91 - 7 Maximum likelihood estimation and likelihood ratio test for square tables with missing data; Shih WJ; Missing data complicate the analysis of paired categorical data . This paper considers with the use of the EM algorithm, the maximum likelihood estimation and likelihood ratio test for incomplete square tables with missing data . An example involving the susceptibility of micro-organisms to antimicrobial drugs illustrates the procedure. Rev Infect Dis, 1987 Jan-Feb, 9(1), 214 - 9 After empiric therapy: what to do until the granulocyte comes back; Pizzo PA; The prompt initiation of empiric broad-spectrum antibiotic therapy when a granulocytopenic patient becomes febrile has become standard practice and has resulted in a significant reduction in the early morbidity and mortality associated with infection . Granulocytopenic patients, however, are at risk for multiple infectious episodes, particularly when the duration of neutropenia is prolonged . Accordingly, the addition of one or more antimicrobial agents to the initial empiric antibiotic regimen is often necessary to deal effectively with these second infections and to help maximize the patient's chance for survival . An organized plan that incorporates modifications of the primary antibiotic regimen (e.g., the addition of another antibiotic or an antifungal agent) into the overall management of the febrile neutropenic patient is important, especially when neutropenia lasts for more than a week. Rev Infect Dis, 1987 Jan-Feb, 9(1), 189 - 93 The white cells: use of granulocyte transfusions; Quie PG; Since serious infections are major complications in patients with fewer than 200 phagocytic cells per microliter or in patients with dysfunctional phagocytes, granulocyte transfusions have been used in an attempt to improve clinical outcome . After two decades of trial and clinical use, the role of granulocyte transfusions for therapy of serious infections has not been clearly established . The methods of harvest, storage, and transfusion of granulocytes are acceptable; however, the quantities that are obtained from donors restrict numbers of cells that may be transfused . Limited clinical response has diminished enthusiasm for the use of granulocyte transfusions as therapy, and their use as prophylaxis has been ineffective . Reported clinical data suggest that patients with persisting granulocytopenia with sepsis due to gram-negative bacteria and patients with chronic granulomatous disease with life-threatening infections unresponsive to aggressive antimicrobial therapy may benefit from granulocyte transfusions. Drugs, 1987, 34 Suppl 1, 56 - 61 A preliminary report on the pharmacokinetics of ofloxacin, desmethyl ofloxacin and ofloxacin N-oxide in patients with chronic renal failure; White LO et al.; The in vitro activities of ofloxacin, desmethyl ofloxacin and ofloxacin N-oxide were determined and a specific high performance liquid chromatography (HPLC) assay for these 3 compounds was devised as part of a study of the pharmacokinetics of ofloxacin and its metabolites in patients with impaired renal function . Desmethyl ofloxacin had significant antimicrobial activity but less than that of the parent drug . In 2 patients with chronic renal failure, specific HPLC assay indicated an extended half-life for ofloxacin (approximately 13 hours) and the appearance in serum of low concentrations of both metabolites after 10 hours, persisting until the last blood sample was taken (32 hours) . Further studies using specific assays are needed, particularly in patients undergoing haemodialysis and after administration of multiple doses. Arch Inst Pasteur Madagascar, 1987, 53(1), 217 - 26 {Antibacterial action of essential oils extracted from Madagascar plants}; Ramanoelina AR et al.; The following aromatherapy study reports the antimicrobial activity of eight Malagasy essential oils by the determination of their respective M.I.C . (Minimal Inhibitory Concentration) on enteropathogenic and spoilage bacteria strains . The aromatic plants used were taken from the Labiatae family (Thymus vulgaris, Ocimum gratissimum), the Myrtaceae family (Eugenia caryophyllata, Melaleuca viridiflora) and the Compositae (Helichrysum lavanduloides, H . bracteiferum, H . gymnocephalum, Psiadia altissima) . Their inhibitory effect were tested on eight referied strains commonly used for antibiotic measurements and also on twelve others enteropathogenic bacteria strains . The results showed that three oils from Thymus vulgaris, Ocimum gratissimum and Eugenia caryophyllata were particularly efficient with a large spectra action . We noticed that the essential oil of Melaleuca viridiflora had also a high inhibitory effect especially on Gram positive bacteria. Vet Med Nauki, 1987, 24(10), 21 - 7 {Preclinical research on drug forms containing rifamycin SV intended for intramammary use}; Pashov D et al.; It was established, that LD50 of rifamycin SV--sodium salt, produced by the Research Institute on Microbiological Industry--Razgrad (People's Republic of Bulgaria)--RM, at p.o . applying on albino mice, albino rats and broilers is correspondingly greater than 4100.0 mg/kg m., greater than 5740.0 mg/kg m . and 1951.6 (1355.5 divided by 2810.1) mg/kg m . and at s . c . introducing into albino mice--815.9 (756.9 divided by 879.9) mg/kg m . From the prepared on the basis of RM-4 intramammary medicaments--RM-1, RM-2 and RM-3 for lactating cows and RM-4 for cows in the dry period, a good bearing have RM-1, RM-3 and RM-4 . RM-1, RM-2 and RM-3, applied intracisternally a single time on lactating cows, and RM-4 on cows in the dry period, create antimicrobial levels with duration correspondingly 168, 72 and 48 h, and 35 days . RM almost does not penetrate in the neighbouring not treated quarters . Appropriate medicament for the lactating cows with average duration of emission is RM-3 (term of action 96 h) and for cows in the dry period RM-4 when applied 35 days before the calving. Arch Immunol Ther Exp (Warsz), 1987, 35(2), 97 - 101 Microbial transformation of azacarbazoles . II . Conversion of methyl-substituted alpha-carbolines to corresponding alpha-iso-carbolines by Kitasatosporia setae strain; Peczynska-Czoch W; alpha-Carboline derivatives substituted with methyl groups at C-2, C-4, C-2,4, C-6 and C-8 position were subjected to N-1 methylation performed by Kitasatosporia setae . The yield of formed corresponding alpha-iso-carbolines varied, depending on the position of methyl substituent . It has been observed that the methyl group introduced in position C-2 and C-6 of alpha-carboline molecule markedly diminishes the susceptibility of nitrogen for enzymic attack in comparison with methylation reaction performed with methyl iodide . On the contrary, derivatives possessing methyl groups in positions C-4 and C-8 are methylated by chemical and microbial means with approximately the same yield . The obtained alpha-iso-carbolines appeared to be toxic to the transforming Kitasatosporia setae strain at the concentration range of 0.2-2.5 microM/ml . Taking into account that the MIC values of parent alpha-carbolines estimated for Kitasatosporia setae were much higher than 2.5 microM/ml, this finding seems to be out of the accordance with the general belief that the microbial conversion of xenobiotics is only a detoxification process . Apparently, 4-methyl and 2 -dimethyl substituted alpha-iso-carbolines besides of their antimicrobial properties, displayed strong cytotoxic activity against KB cells line at the concentration range 0.03-0.05 microM/ml. Arch Immunol Ther Exp (Warsz), 1987, 35(2), 129 - 37 Microbial transformation of azacarbazoles . VII . Antitumor properties of benzo-alpha-iso-carbolines formed by Kitasatosporia setae strain from corresponding benzo-alpha-carbolines; Peczynska-Czoch W; 2,3-Benzo-alpha-carboline, 7,8-benzo-alpha-carboline and their 4-methyl derivatives were subjected to microbial conversion yielding corresponding benzo-alpha-iso-carbolines . All obtained products showed significant antimicrobial and cytotoxic properties . ID50 values were found to be at range 0.01-0.001 microM/ml, regarding in vitro KB tumor cells system data . It has been found that introduction of methyl group at para-position to the nitrogen of pyridine nucleus strongly increases cytotoxic and microbial activity of benzo-alpha-iso-carbolines . Apparently it has been indicated that antitumor activity of benzo-alpha-iso-carbolines is strongly dependent on shape and size of the molecule . Of all the compounds tested only 2,3-benzo-1,4-dimethyl-alpha-iso-carboline increases life span of leukemia P388 bearing mice up to 160%. Acta Med Austriaca, 1987, 14(5), 112 - 4 {Possibilities and limits of the H2 breath test}; Hay U et al.; The hydrogen breath test has been introduced as a non-invasive and reproducible test for the detection of milk intolerance, bacterial overgrowth and intestinal motility disorders . In our hands the semiquantitative assessment of mucosal lactase activity and the non-invasive monitoring of antimicrobial treatment in bacterial overgrowth were further attractive facettes of this test. Fundam Clin Pharmacol, 1987, 1(4), 283 - 96 Immunopharmacology of the immunotherapy of cancer, infection, and autoimmunity; Hadden JW; The current status and future prospects of the immunotherapy of cancer, infection, and autoimmunity are reviewed briefly . Progress in treating the immunodeficiency of cancer with thymic hormones and drugs such as levamisole and lentinan has produced some degree of remission stabilization . Interferon, interleukin II, and LAK cells have inhibited active, progressive cancer . New approaches with monoclonal antibodies, immunotoxins, tumor necrosis factors, and so on are under rapid development . Future prospects focus on combined approaches yielding synergy . Treatment of infections in animals and man either prophylactically or therapeutically, with thymic hormones, interferons, and thymomimetic drugs such as levamisole and isoprinosine, demonstrate the efficacy of this approach . The use of these agents in conjunction with antimicrobial therapy in immunosuppressed hosts is warranted . In immunodeficiency associated with AIDS virus infection, interleukin II, thymic hormones, isoprinosine, and imuthiol have shown effect in partially restoring immune function, although with little clinical benefit . Their use with antiviral therapy is advocated . Finally, thymic hormones, isoprinosine, levamisole, and other sulfur-containing compounds have ameliorated murine and human autoimmune disease presumably through effects in improving cellular immune function . Continued development of this type of therapy is warranted . The continued progress of immunopharmacology as the science of immunotherapy portends the future successful development of many therapeutic approaches to these diseases. Acta Neurochir (Wien), 1987, 89(3-4), 112 - 6 Post-operative aseptic meningitis; Blomstedt GC; Neurosurgical patients with post-operative meningitis often present with negative bacterial cultures . The symptoms and signs as well as laboratory findings are identical to those with verified bacterial meningitis . The aim of this study was to find out whether we are dealing with a sterile reaction, and antimicrobial treatment can safely be stopped . 24 patients with post-operative meningitis with negative bacterial cultures were randomized into two groups . Both were initially treated with chloramphenicol until the results of the bacterial cultures were available . Treatment was then withdrawn in one group and continued in the other . Chloramphenicol had no effect on the outcome and can therefore safely be stopped when adequate bacterial cultures are reported negative. Chemotherapy, 1987, 33(6), 419 - 27 In vitro evaluation of difloxacin (A-56619), A-56620, and other 4-quinolones against isolates from cancer patients; Rolston KV et al.; The in vitro activity of two new quinolones, difloxacin and A-56620, was compared with that of other quinolones against isolates obtained from bacteremic cancer patients . Both agents had a broad antimicrobial spectrum which included both gram-positive and gram-negative organisms . A-56620 had lower MIC values against most organisms tested than difloxacin, and its activity was comparable to that of ciprofloxacin. Nephrologie, 1987, 8(6), 287 - 92 {Functions and metabolism of polynuclear neutrophils in patients under chronic hemodialysis}; Paul JL et al.; Clinical evidence indicates that infection is still a cause of morbidity and mortality in patients undergoing hemodialysis . The major role played by the polymorphonuclear cells in antimicrobial response by the host explained considerable study of several aspects of granulocyte functions in chronic hemodialysis patients . It is now well documented that hemodialysis induces the sequential activation of the complement components of the alternative pathway and may provide a mechanism for initiating leukoaggregation and sequestration of granulocytes . This complement activation could also explain the profound leukopenia observed shortly after the initiation of hemodialysis . It has been also assumed that the sequestration of granulocytes is dependent on a temporarily altered cell function and leads to a depressed chemotaxis, an impairment of phagocytic and bactericidal capacities . Moreover, a significant defect in the oxidative metabolism was observed before and during the course of the dialysis session . This article summarizes research that has been done on the function of neutrophils from chronic hemodialysis patients. Drugs, 1987, 34 Suppl 1, 131 - 3 Antimicrobial prophylaxis in immunocompromised patients; Hartlapp JH; The results of a randomised, prospective trial to investigate the efficacy of prophylactic treatment with ofloxacin during granulocytopenia after cytostatic treatment are presented . 42 patients with metastasised testicular germ-cell tumours entered the study . Cytostatic treatment consisted of at least 4 courses, 2 of which were succeeded by prophylactic treatment with ofloxacin . Three patients undergoing prophylactic treatment developed fever . Fever occurred in 16 patients during control phases (no ofloxacin prophylaxis) of cytostatic treatment . Seven of the 19 infections could be documented microbiologically . No side effects that related to ofloxacin were noted . In conclusion, ofloxacin was highly effective in the prevention of infection and, therefore, should be given prophylactically to patients with granulocytopenia. ORL J Otorhinolaryngol Relat Spec, 1987, 49(3), 152 - 6 Antimicrobial prophylaxis in head and neck surgery; Panosetti E et al.; In this random study, 60 patients were given either cefotaxime, or ceftriaxone as a prophylactic measure in cervicofacial surgery . Each antibiotic was administered during a 48-hour period starting 1 h before the operation . Twenty-three patients underwent major cervicofacial surgery including opening of the pharynx or the buccal cavity by the cervical route . Only a single postoperative infection was observed as a result of a salivary fistula on the 2nd postoperative day . The two antibiotics have turned out to be very efficient as short-term prophylactic treatment in cervicofacial surgery . In other respects, the much longer half-life of ceftriaxone means that a single daily dose can be given . Finally, the cost of the prophylactic treatment is smaller using ceftriaxone than cefotaxime. J Exp Zool Suppl, 1987, 1, 53 - 63 Vitamin-binding proteins in the nutrition of the avian embryo; White HB 3rd; Nutrients required for the growth and development of an avian embryo must be present when the egg is laid . Many, if not most, of the nutrients in eggs are transferred from the blood plasma of the hen into the yolk of the oocyte as specific nutrient-protein complexes . Egg yolk contains vitamin-binding proteins for thiamin, riboflavin, biotin, cobalamin, retinol, and cholecalciferol . The biochemical details of how these plasma vitamin-protein complexes are recognized by and deposited in the oocyte and subsequently dissociated for use by the embryo are not known . Niacin and ascorbic acid are synthesized by the embryo from other compounds deposited in the egg . Pantothenic acid, which is abundant in the egg, is not bound tightly to a specific protein . Binding proteins for thiamin, riboflavin, biotin, and cobalamin are also present in egg white . Because they are usually not saturated with respect to their ligand, these binding proteins are able to scavenge nutrients and thereby are thought to protect the embryo from infection by microbes that require the ligands . In the albumen of a few species, nutritionally significant amounts of bound riboflavin or biotin are present, suggesting both nutritional and antimicrobial functions for their binding proteins . It is postulated that differences in the amounts of various nutrient-binding proteins correspond to differences in the nutrient contents among the eggs of various species and reflect differences in the nutrient needs of the contained embryos . Mutations that inactivate nutrient-binding proteins arrest development before hatching and are dependent solely on the maternal genotype. Int J Clin Pharmacol Res, 1987, 7(3), 215 - 7 Cefoperazone therapy of bacterial meningitis: a preliminary report; Cristiano P et al.; Eleven hospitalized patients with bacterial meningitis were treated with cefoperazone at daily dosage ranging between 3 and 8 g intravenously . Seven patients had proven Gram-negative bacterial infections, but in four patients the aetiological agent remained unknown . Eight patients completely recovered from infection and the pathogens were eradicated, in one patient the treatment failed and in two patients only some improvement was registered . Furthermore in five patients cefoperazone serum and cerebrospinal fluid levels were determined four times in the first week of treatment (1st, 3rd, 5th and 7th day) . No side-effects were recorded . Cefoperazone can be considered as effective antimicrobial agent in the therapy of bacterial meningitis. Immunopharmacol Immunotoxicol, 1987, 9(4), 489 - 510 Halothane anesthesia decreases human monocyte hydrogen peroxide generation . Protection of monocytes by activation with gamma interferon; Stevenson GW et al.; In an effort to determine the impact of halothane anesthesia on certain human cell-mediated immune functions, normal, purified human monocytes and lymphocytes were exposed to halothane in vitro at varying concentrations for up to 8 hours . Subsequently, these human effector cells were analyzed for their ability to function in several cell-mediated immunologic assays . Natural killer cell activity against K-562 was unaffected by halothane in most of the donors tested . Similarly, the ability of purified monocytes to inhibit MBL-2 tumor cell growth was unchanged . Halothane appeared to decrease the proliferative response of lymphocytes to phytohemagglutinin (PHA) in approximately 50% of the normal donors tested . In contrast, the ability of monocytes to lyse antibody-coated red cell targets (ADCC) was unaffected by even maximal exposure to halothane . Of interest was the finding that human monocytes exposed to as low as 2% halothane anesthesia for 4 hours displayed a dramatic down-regulation of hydrogen peroxide (H2O2) release . Since it is known that hydrogen peroxide and other incompletely reduced forms of oxygen secreted by monocytes can play a major role in the antimicrobial, antitumor, and inflammatory functions of these cells, this finding may help explain the enhanced susceptibility of post-operative patients to infections. Folia Microbiol (Praha), 1987, 32(5), 421 - 5 Antimicrobial properties of aromatic compounds of plant origin; Zemek J et al.; The antimicrobial action of 11 compounds involving guaiacyl- and syringyl-like structures (low-molecular-weight part of lignin), gallic acid and its derivatives, cinnamic acid and its derivatives, veratric acid, anisic acid and crotonic acid (a total of 25 compounds) against bacteria, yeast-like organisms and protozoa was examined . Aromatic compounds modified in the C-side chain and aldehydes were effective preferentially against Trichomonas vaginalis, whereas against bacteria and yeast-like organisms eugenol was the most effective inhibitor. Toxicol Pathol, 1987, 15(3), 333 - 7 Interleukin 1 and interferon-gamma: cytokines that provide reciprocal regulation of macrophage and T cell function; Schultz RM; Interactions between macrophages and T cells are symbiotic, since optimal functions of both cell types require interchange of soluble mediators . Upon activation, macrophages release interleukin-1 (alias lymphocyte activating factor, leukocytic endogenous mediator, and endogenous pyrogen), a family of molecules with multivarious biological effects, ranging from induction of fever and the acute phase response to lymphocyte activation and concomitant release of interleukin-2 . Interleukin-2 induces activation and replication of several subsets of precursor lymphocytes, including cytotoxic T cells, lymphokine-activated killer (LAK) cells, and natural killer (NK) cells, and enhances their cytotoxic activity for tumor cells . Both interleukin-2 and leukotrienes enhance production of immune interferon (interferon-gamma) by activated T cells . Aside from antiviral activity, interferon-gamma produces a number of immunomodulatory effects, including macrophage activation (Ia induction, antimicrobial effector function, and activation of oxidative metabolism) and augmentation of NK function . Expression of Ia on accessory cell membranes is required for the initiation of many antigen-specific, T-dependent immune responses . Interferon-gamma also synergizes with a variety of microbial agents to augment macrophage tumoricidal function and enhance interleukin-1 secretion . The production of interferon-gamma appears to have a critical role in feeding back the cascade of interleukins in a loop of amplification . Both interleukin-1 and interferon-gamma modulate release of arachidonate metabolites in various cells . This cascade of cytokines, in collaboration with arachidonate oxygenation products, regulates immunity and sets the stage for many of the events underlying inflammation . Various anti-inflammatory drugs and immunopotentiators appear to act by modulating cytokine pathways. J Toxicol Clin Toxicol, 1987, 25(4), 255 - 72 Properties of the extract and spicules of the dermatitis inducing sponge Neofibularia mordens Hartman; Flachsenberger W et al.; Skeletal components and the exudate of the sponge Neofibularia mordens, as well as four fractions of the extract were investigated . Possible causes, and management, of the contact dermatitis resulting from application of extract fractions were studied . Antimicrobial activity of the sponge extract fractions, together with their effect on small crustaceans, was determined . Two fractions exhibited strong neuroactivity on guinea-pig isolated intestine, octopus-arm nerve-muscle and crustacean cheliped nerve-muscle preparations. Folia Microbiol (Praha), 1987, 32(4), 329 - 33 Antimicrobial effects of some mono- and bishydrazones; Valent M et al.; Antibacterial, antifungal and antiprotozoal effects of nine mono- and bishydrazones of glycolaldehyde, glyoxal, methoxyacetaldehyde and glutaraldehyde were studied using eight model organisms . It was found that bishydrazones are much more efficient antimicrobial agents than monohydrazones in the case of all model microorganisms. Pediatr Infect Dis J, 1987 Jan, 6(1), 24 - 8 Review of 59 patients hospitalized with animal bites; Feder HM Jr et al.; We reviewed the charts of 59 pediatric and adult patients hospitalized because of animal bites (46 dog bites, 10 cat bites, 3 monkey bites) . The bites of 40 of the 59 patients were infected at the time of admission . Gram-stained specimens correctly predicted the infecting bacteria in only 5 of 20 cases . Eighty-three percent of the bacterial isolates were penicillin-susceptible . Before admission 14 patients had received outpatient antibiotic prophylaxis and the infections in 11 of these 14 patients were caused by bacteria susceptible to the prophylactic antibiotic . Complications were more common if antimicrobial therapy had not been altered according to susceptibility testing results . Of the 59 patients 19 were admitted immediately after being bitten because of severe uninfected bites . Of these 19 patients 18 received prophylactic antibiotics and none developed a serious complication. Intensive Care Med, 1987, 13(2), 106 - 13 Prevention of colonization and respiratory infections in long-term ventilated patients by local antimicrobial prophylaxis; Unertl K et al.; In a randomized clinical trial the prophylactic effects of locally administered antimicrobials on quantitative colonization and respiratory infections were studied in intubated patients with an expected period of mechanical ventilation of greater than 6 days . Nineteen patients received 50 mg of polymyxin B and 80 mg of gentamicin distributed among nose, oropharynx and stomach at 6-h intervals, as well as 300 mg of amphotericin B in the oropharynx . Twenty untreated patients served as controls . In the control group colonization by respiratory pathogens was more common (oropharynx 19 vs 6 patients (p less than 0.001); trachea 19 vs 11 (p less than 0.01)), and the number as well as the count of the colonizing species was usually higher . Fourteen patients of the control group developed respiratory infections, including nine cases of pneumonia, as compared to four patients with prophylaxis, including one case of pneumonia (p less than 0.01) . Pneumonia-associated deaths were prevented with prophylaxis; however, the overall mortality remained unchanged . Respiratory infections in the prophylaxis group were associated with organisms resistant to the agents used, but the overall occurrence of resistance was not increased, as compared to the control group . We conclude that unrestrained upper airway colonization by respiratory pathogens and respiratory tract infection were causally related . Local antimicrobial prophylaxis proved to be a highly effective strategy for the prevention of potentially life-threatening pneumonias in critically ill patients, but in the present study the host setting appeared to be the major determinant of outcome. Antimicrob Agents Chemother, 1987 Jan, 31(1), 27 - 31 Inactivation of enveloped viruses and killing of cells by fatty acids and monoglycerides; Thormar H et al.; Lipids in fresh human milk do not inactivate viruses but become antiviral after storage of the milk for a few days at 4 or 23 degrees C . The appearance of antiviral activity depends on active milk lipases and correlates with the release of free fatty acids in the milk . A number of fatty acids which are normal components of milk lipids were tested against enveloped viruses, i.e., vesicular stomatitis virus, herpes simplex virus, and visna virus, and against a nonenveloped virus, poliovirus . Short-chain and long-chain saturated fatty acids had no or a very small antiviral effect at the highest concentrations tested . Medium-chain saturated and long-chain unsaturated fatty acids, on the other hand, were all highly active against the enveloped viruses, although the fatty acid concentration required for maximum viral inactivation varied by as much as 20-fold . Monoglycerides of these fatty acids were also highly antiviral, in some instances at a concentration 10 times lower than that of the free fatty acids . None of the fatty acids inactivated poliovirus . Antiviral fatty acids were found to affect the viral envelope, causing leakage and at higher concentrations, a complete disintegration of the envelope and the viral particles . They also caused disintegration of the plasma membranes of tissue culture cells resulting in cell lysis and death . The same phenomenon occurred in cell cultures incubated with stored antiviral human milk . The antimicrobial effect of human milk lipids in vitro is therefore most likely caused by disintegration of cellular and viral membranes by fatty acids . Studies are needed to establish whether human milk lipids have an antimicrobial effect in the stomach and intestines of infants and to determine what role, if any, they play in protecting infants against gastrointestinal infections. Antimicrob Agents Chemother, 1987 Jan, 31(1), 117 - 20 Therapeutic implications of inhibition versus killing of Mycobacterium avium complex by antimicrobial agents; Yajko DM et al.; Patients with the acquired immune deficiency syndrome (AIDS) with disseminated Mycobacterium avium infection have responded poorly to treatment with rifabutine (Ansamycin) and clofazimine, in spite of the good in vitro response of M . avium to these antimicrobial agents . We compared the ability of these and other antimicrobial agents to kill versus the ability to inhibit the growth of strains of the M . avium complex isolated from patients with AIDS . Killing curve experiments showed that the concentrations of rifabutine and clofazimine needed to kill two log units of M . avium are at least 32 times greater than the concentrations needed to inhibit growth . Little or no killing occurred at concentrations of these antimicrobial agents that are achievable in serum . In contrast, five of seven strains tested were killed by ciprofloxacin at concentrations that can be achieved in serum . Ciprofloxacin should be studied further for possible use in the treatment of M . avium infections. Clin Ther, 1987, 9(3), 273 - 80 Clinical and bacteriological evaluation of tetracycline and erythromycin in acne vulgaris; Al-Mishari MA; A clinical and bacteriological comparison of tetracycline and erythromycin was carried out in 40 patients with papulopustular acne vulgaris . Twenty patients received 250 mg of tetracycline BID and 20 received 250 mg of erythromycin BID for four months . Clinically, 19 (95%) of patients treated with tetracycline and 17 (85%) of those treated with erythromycin had improvement ranging from moderate to very good . Both drugs also reduced the microflora both in the pustules and on normal skin from the same patients . Three patients given tetracycline and one given erythromycin reported mild side effects . Thus both antimicrobial agents were effective and safe in treating acne vulgaris. Antimicrob Agents Chemother, 1987 Jan, 31(1), 100 - 1 In vitro activity of A-56268 (TE-031) and four other antimicrobial agents against Chlamydia trachomatis; Segreti J et al.; The in vitro activity of A-56268 (TE-031), a new macrolide antibiotic, against 11 strains of Chlamydia trachomatis was determined and compared with that of four other antibiotics . A-56268 was the most active drug tested . Doxycycline, trimethoprim-sulfamethoxazole, and erythromycin had good activity but were less active in vitro than A-56268. Sex Transm Dis, 1987 Jan-Mar, 14(1), 37 - 40 Symptomatic response to therapy of men with gonococcal urethritis: do all need posttreatment cultures? Schmid GP, Johnson RE, Brenner ER. Because the large majority of men with gonorrhea respond to antimicrobial therapy with the rapid disappearance of signs and symptoms, it was hypothesized that a symptomatic response to therapy would predict successful treatment . The records of 4897 men with gonorrhea, of whom 183 (3.7%) were treatment failures on days 3-7 after treatment were studied, and the clinical response to therapy with microbiologic outcome was correlated . Before therapy, 4662 men (95.2%) had dysuria and/or urethral discharge . Of the 582 men who remained symptomatic, 103 (17.7%) had a positive culture after treatment, as compared with only 78 (1.9%) of 4080 men who became asymptomatic (P less than .01) . The conclusion was that men who are initially symptomatic and become asymptomatic after therapy have a small chance (one of 50) of being infected at the posttreatment visit . However, because of its very large size, this group contributed almost one-half of all treatment failures (78 of 183; 42.6%). Br J Neurosurg, 1987, 1(2), 179 - 83 Subdural empyema: a rational management plan . The case against craniotomy; Shearman CP et al.; A review of the management of 34 patients with subdural empyema treated at the Derbyshire Royal Infirmary has been undertaken . It is concluded that craniotomy has little part to play in the management of patients with this condition . With modern, improved antimicrobials and prompt burr hole lavage complete recovery should be obtained in the majority of cases . The treatment of the severely ill patient is discussed. J Infect, 1987 Jan, 14(1), 71 - 8 Cutaneous infection with Mycobacterium gordonae; McIntyre P et al.; A case of cutaneous infection with Mycobacterium gordonae and other reports of extrapulmonary infection due to this organism are reviewed . This case confirms the pathogenic potential of M . gordonae which must now be included among the scotochromogens capable of causing cutaneous disease . Isolates of this organism should be tested against a full range of antimicrobial agents since traditional antituberculous therapy may be of limited efficacy . Pending the results of in vitro susceptibility testing, amikacin, ethambutol, rifampicin and co-trimoxazole are suggested as empirical therapy for infections caused by this organism. J Hyg Epidemiol Microbiol Immunol, 1987, 31(3), 307 - 12 Comparative investigation of PMN leucocyte antimicrobial potential in animals of different species susceptibility to the plague agent; Isin ZhM et al.; The present work was aimed at a comparative study of oxygen-dependent metabolism (OM) and myeloperoxidase (MPO) activities as well as the content of bactericidal cationic proteins (BCP) in polymorphonuclear leucocytes (PMNL) from mammals and birds with different susceptibility to plague (mice, guinea pigs, rats, great and miday gerbils, rabbits, dogs, pigeons and man) . The experimental finding of an association between infectious susceptibility and functioning of the major PMNL bactericidal systems (OM activity and BCP content) indicates that the magnitude of antimicrobial potential of professional phagocytes is a factor determining species susceptibility to plague . The intermediate and high levels of MPO activity detected in all the species studied except in pigeons suggest involvement of the MPO-H2O2-halide cytocidal system of PMNL in destroying Y . pestis. J Antibiot (Tokyo), 1986 Dec, 39(12), 1724 - 35 Preparation and evaluation of 3,4''-ester derivatives of 16-membered macrolide antibiotics related to tylosin; Kirst HA et al.; A large group of ester derivatives of tylosin-related macrolides was prepared in which the hydroxyl groups at C-3 and C-4'' were acylated by either chemical or biochemical methods . Most of the derivatives exhibited excellent in vitro antimicrobial activity . However, only the 3,4''-diacyl derivatives of tylosin and macrocin showed any significant improvements of in vivo efficacy against experimental infections in rodents. Antimicrob Agents Chemother, 1986 Dec, 30(6), 958 - 60 Relevance of in vitro antimicrobial susceptibility of Brucella melitensis to relapse rate in human brucellosis; Ariza J et al.; The in vitro susceptibility of Brucella melitensis was examined vis-a-vis the clinical outcome in 75 patients with brucellosis . The initial MICs for Brucella isolates from patients who relapsed and from those who did not were similar . Furthermore, the MICs for isolates from patients whose infections relapsed were no different from those for original isolates . Our results clearly showed that neither initial nor subsequent antibiotic susceptibility plays a role in the likelihood of relapse of patients with brucellosis. Antimicrob Agents Chemother, 1986 Dec, 30(6), 874 - 6 Pharmacokinetics of cefoperazone in the parturient; Gonik B et al.; Limited pharmacokinetic data for cefoperazone are available from the parturient . Because cefoperazone has a dual excretory pattern, primarily via the biliary system and secondarily via the kidney, pregnancy-induced physiologic alterations can influence its deposition and clearance . Twelve term parturients receiving cefoperazone prophylaxis after cesarean section were selected for study . After 2 g of cefoperazone was administered for 1 h intravenously, serial blood samples were assayed by high-pressure liquid chromatography . Plasma protein binding of cefoperazone was studied in vitro . The mean peak cefoperazone concentration +/- standard deviation was 169.9 +/- 60.4 micrograms/ml . The mean half-life was 152 min . Total serum clearance was 80.8 +/- 30.8 ml/min . The steady-state volume of distribution was 14.2 +/- 6.0 liters . All subjects had detectable trough levels at the end of the dosage interval, with a mean value of 6.5 +/- 5.2 micrograms/ml . Protein binding of cefoperazone for parturients was 74.3 +/- 10.9%, compared with 87.7 +/- 3.2% in nonpregnant controls (P less than 0.05) . These data suggest that cefoperazone deposition can be greatly influenced by pregnancy . However, unlike several other new antimicrobial agents whose excretions are mainly renal, the cefoperazone half-life and thus trough concentration for the parturient more closely resemble that for the nonpregnant subject. Am J Hosp Pharm, 1986 Dec, 43(12), 3008 - 13 Effect of pharmacist interventions on drug therapy costs in a surgical intensive-care unit; Miyagawa CI et al.; The effect of interventions by a clinical pharmacist on the cost of drug therapy in a 14-bed surgical intensive-care unit (SICU) was evaluated . The SICU pharmacist provides both distributive and clinical services from a modified satellite pharmacy five days each week . During a 13-week study period that comprised 65 days, the pharmacist documented all interventions that resulted in a discontinuation of or change in drug therapy, all nonformulary-drug requests, the detection and avoidance of problems related to drug therapy, and the enrollment of patients in investigational drug studies (for which the pharmacy department received monetary remuneration) . The effect of these interventions on the costs of drug therapy was calculated using drug acquisition costs and, for i.v . preparations, the cost of the i.v . fluid and the cost of preparing and checking the product . A total of 332 interventions during the study period represented $18,030 in potential cost avoidance, which would extrapolate to an annual cost avoidance of $72,122 . The majority of interventions involved discontinuations of or changes in drug therapy, most often involving antimicrobials . This pharmacist had a positive impact on the cost of drug therapy in the SICU. Chemioterapia, 1986 Dec, 5(6), 385 - 7 In vitro antimicrobial activity in comparison with tonsillar tissue penetration of mezlocillin; Martinetto P et al.; The aim of this study was to determine the role of mezlocillin, a new acylureidopenicillin, in otorhinolaryngology . One hundred and forty-four bacterial strains were isolated from 100 patients suffering from infections of the oropharyngeal tract . Among the isolates only 10 (6.9%) resulted in being mezlocillin-resistant by the agar diffusion method . Minimum inhibitory and minimum bactericidal concentrations were also determined . Pharmacokinetic parameters e.g., diffusion in tonsillar tissue and serum concentrations, were studied . Mean mezlocillin tonsillar levels of 3.5 micrograms/g and 1.8 micrograms/g and serum concentrations of 60.2 micrograms/ml and 10.6 micrograms/ml, 1 h and 4 h respectively after administration, were found. Obstet Gynecol, 1986 Dec, 68(6), 789 - 94 Puerperal pelvic thrombophlebitis: impact on diagnosis and treatment using x-ray computed tomography and magnetic resonance imaging; Brown CE et al.; The clinical diagnosis of puerperal pelvic thrombophlebitis was confirmed by x-ray computed tomography in 11 women, and further documented in six by magnetic resonance imaging . Venous thrombi were demonstrated in ovarian, iliofemoral, and inferior vena caval vessels . In six women with ovarian vein involvement and no evidence of iliofemoral thrombophlebitis, resolution followed intravenous antimicrobial therapy alone, and in three of these, resolution was confirmed by x-ray tomography . In contrast, three of five women with symptomatic iliofemoral thrombophlebitis had a prolonged febrile course despite antimicrobial and heparin therapy . The clinical courses of these 11 women were consistent with the observation that pelvic thrombophlebitis is associated with pelvic infection . Disease manifested within a few days after parturition was more likely due to ovarian vein involvement, whereas disease with later onset of symptoms was more likely due to iliofemoral thrombosis, with or without vena caval extension . Through the use of x-ray computed tomography and magnetic resonance imaging, the natural course of pelvic thrombophlebitis can be better elucidated and therapeutic regimens more clearly evaluated. J Clin Microbiol, 1986 Dec, 24(6), 1100 - 1 Isolation of two strains of Kingella kingae associated with septic arthritis; Raymond J et al.; Two new cases of infection, a presternal abscess and a spondylodiscitis caused by the recently classified bacterium Kingella kingae, are reported . The main bacteriological characteristics and the susceptibility of the two isolates to antimicrobial agents are described . The pathology of K . kingae, particularly among children, is reviewed. Antibiot Med Biotekhnol, 1986 Dec, 31(12), 917 - 20 {Experimental and clinical study of the use of lysozyme in combination with chemotherapeutic agents}; Bukharin OV et al.; Antimicrobial effect of lysozyme in combination with a wide set of antimicrobial drugs (38) was studied with respect to 74 bacterial cultures . It was shown that synergism of the antimicrobial effect in the presence of lysozyme was variable for drugs differing in the mechanism of their action and depended on the pathogen species . The most pronounced synergistic effect was observed with respect to grampositive bacteria with the use of many drugs such as benzylpenicillin, ampiox, morphocycline, erythromycin and others . The potentiation effect of lysozyme was less pronounced with respect to Coli bacteria and Pseudomonas . Combination of lysozyme with aminoglycosides such as gentamicin, tobramycin, sisomicin and amikacin resulted in increasing antimicrobial effect with respect to practically all the microbial cultures tested . The clinical trials of the efficient combinations of the antibiotics and lysozyme studied experimentally proved their high efficacy in combined therapy of patients with pneumonia and pyelonephritis of bacterial genesis . Thus, in children with acute pneumonia (92 observations) it resulted in more rapid elimination of the temperature reaction, toxic and cardiorespiratiry syndromes, cough and physical signs of the disease . In treatment of 83 children with pyelonephritis complete clinico-laboratory remission was observed in 81 per cent of the cases against 56.4 per cent in the patients treated with the antibiotics without lysozyme. Comput Methods Programs Biomed, 1986 Dec, 23(3), 217 - 23 A microcomputer-assisted analysis of drug resistance in bacteria; Moller JK; A software package for analysis of antimicrobial drug resistance traits has been developed . It is written in PASCAL and implemented on a microcomputer . The microbiological data to be analysed is reduced to the different patterns of drug resistance found and the associated numbers of isolates . Based upon these patterns of drug resistance, the incidence of resistance to individual drugs and combinations is calculated . Furthermore, the extent and nature of the multiple drug resistance within a group of microorganisms is examined by looking at various aspects of the statistical association of drug resistance traits. Clin Perinatol, 1986 Dec, 13(4), 741 - 54 Septic shock in obstetrics; Gonik B; Septic shock in the obstetric population remains an uncommon yet potentially lethal complication of infection . Effective therapy mandates early recognition and aggressive intervention . Although numerous similarities exist in comparison to the nonobstetric patient, differences in potential pathogens and alterations in physiologic parameters should be kept in mind . In addition, the antepartum subject carries with her another potentially viable human being who deserves consideration . Optimal therapy should be directed at reestablishing an effective intravascular volume, maintaining adequate oxygen delivery to peripheral and central tissues, and the initiation of appropriate broad-spectrum antimicrobial agents to eradicate the causative pathogens. J Urol, 1986 Dec, 136(6), 1290 - 1 Acute renal failure in a solitary kidney due to bacterial pyelonephritis; Weinstein T et al.; Deterioration of renal function after acute bacterial pyelonephritis is rare . We report on 2 patients with a solitary functioning kidney in whom acute renal failure developed in the setting of acute bacterial pyelonephritis . Following antimicrobial treatment kidney function returned to baseline values . This finding suggests that patients with a solitary functioning kidney are more prone to have renal dysfunction after acute bacterial pyelonephritis. Eur J Clin Microbiol, 1986 Dec, 5(6), 634 - 8 Influence of antibiotics on intestinal mucin in healthy subjects; Carlstedt-Duke B et al.; To determine the effect on microbial breakdown of intestinal mucin healthy volunteers were treated orally with ten different antibiotics . The most pronounced effects were seen after administration of bacitracin, clindamycin or vancomycin: the electrophoretic mucin pattern in faeces changed from a normal conventional pattern to a specific pattern similar to that found in germ-free rats . Disturbed patterns were also observed in some of the subjects treated with ampicillin, doxycycline, erythromycin, metronidazole or nalidixic acid . In most cases the electrophoretic mucin pattern normalized within five weeks after the end of treatment . There were no effects on the microbial breakdown of intestinal mucin in the groups treated with ofloxacin or trimethoprim/sulfamethoxazole . Thus, administration of antimicrobial drugs in clinically recommended doses may cause long-term disturbances in one microflora-associated characteristic, the breakdown of intestinal mucin. Aust N Z J Med, 1986 Dec, 16(6), 761 - 5 Serological investigations in the diagnosis and management of infective endocarditis; Roberts-Thomson PJ et al.; In a retrospective study of 39 patients with infective endocarditis (IE) all had elevated concentrations of C reactive protein (CRP) at presentation, patients with the acute variety having significantly higher values than patients with the subacute variety . In addition, the majority of patients with subacute bacterial endocarditis had elevated concentrations of circulating immune complexes (CICs) and rheumatoid factor (RF), both of which were absent in all but one of nine patients with acute bacterial endocarditis . Two patients with subacute and one with acute bacterial endocarditis had low values of C3 and C4 . Measurement of CRP, CICs, and RF did not distinguish between patients with and without extracardiac manifestations . Sequential analysis of patients revealed that a successful response to antimicrobial treatment was indicated by a striking and rapid decline in CRP, with less striking declines in CICs, RF, and IgM . Antibiotic failure was indicated by the persistence of high concentrations of CRP and CICs . We conclude that the measurement of C reactive protein is of some value in the diagnosis and management of infective endocarditis . A normal CRP concentration excludes this diagnosis . The measurement of CRP alone appears sufficient for monitoring most cases of infective endocarditis with the sequential measurement of rheumatoid factor and circulating immune complexes adding no useful information except where the CRP remains elevated despite treatment . In this latter instance, persisting high levels of CRP and circulating immune complexes together herald an ominous course. Arch Latinoam Nutr, 1986 Dec, 36(4), 725 - 33 Potentialization of the lactoperoxidase system for preservation of raw milk in the tropics; Aparicio MA et al.; The antimicrobial ability of the lactoperoxidase system was increased by the addition of larger amounts of the thiocyanate and hydrogen peroxide at levels above those suggested by other authors . Results of laboratory and field trials revealed that the potentialized system was able to preserve poor-quality raw milk for longer periods of time, at "tropical" temperatures, than when used as recommended previously . It was possible to preserve some milks at 20 degrees C for more than one day, without diminishing their overall quality . At 36 degrees C, the milks did not show acidity development for about 10 hours . Tests conducted under real collection and transportation conditions validated these findings . It was therefore proved that the system can be used practically and that its bactericidal/bacteriostatic effect on the spoilage flora of milk can be increased in order to overcome the particularly adverse conditions of milk handling in the tropics. Acta Pathol Microbiol Immunol Scand {B}, 1986 Dec, 94(6), 393 - 8 The antibacterial effect of selected phenothiazines and thioxanthenes on slow-growing mycobacteria; Kristiansen JE et al.; The aim of the present investigation was to illustrate the antibacterial effect of various phenothiazine and thioxanthene derivatives on mycobacteria in vitro . It was demonstrated that clopenthixol is about twice as potent as chlorpromazine (CPZ) and levomepromazine-maleate is about half as potent as CPZ, measured by the inhibitory effect on the growth of the mycobacterial strains . Measured in the same way the stereoisomeric compounds of flupenthixol are shown to be more potent than the stereo-isomeric compounds of clopenthixol and chlorprothixen . The two last-named compounds are equal in potency . The stereo-isomeric analogs of the thioxanthene derivatives are equal in antibacterial potency against the slow-growing mycobacteria . The mycobacterial strains investigated show no difference in sensitivity between the cis (Z)--and and trans (E)--compounds of the thioxanthenes . It seems particularly promising that also the more resistant mycobacteria other than Mycobacterium tuberculosis, e.g . M . avium and M . intracellulare, are sensitive in the concentration range investigated . Considered as a whole, these results might be a stimulus to investigate the antimicrobial effect of the thioxanthenes in vivo. J Pharm Sci, 1986 Dec, 75(12), 1180 - 4 Synthesis and antimicrobial activities of N4-(2-acetoxyethoxymethyl)thiosemicarbazones and N3-(2-acetoxyethoxymethyl)thioureas; Foye WO et al.; A series of thiosemicarbazones and thioureas having an open-chain analogue of the ribosyl group, the 2-acetoxyethoxymethyl moiety, has been synthesized . Significant growth inhibitory activity versus gram-positive and gram-negative organisms, a yeast, and a mold has been found with the 2-acetoxyethoxymethyl derivatives of N-alkyl-, aryl-, and heteroaryl-thiosemicarbazones and thioureas . The molecules may function as inhibitors of ribonucleotide reductase or in utilization of the carbamyl group in pyrimidine biosynthesis. Antibiot Med Biotekhnol, 1986 Dec, 31(12), 905 - 9 {Comparative study of the surface-active properties of gramicidin S and its derivatives by polarography}; Korolev PN et al.; Gramicidin S and its derivatives by the free amino groups of the ornithine moieties were studied with respect to their effect on interface tension of mercury and the polarographic background for comparative estimation of the surface active properties of these compounds . The same way as the compounds preserving their main properties, the neutral and acid derivatives lowered the polarographic maximum . No correlation between the level of the antimicrobial and membrane activity and the surface active properties of the tested compounds was observed . It is likely that the direct cause of the induced biological effect is not connected with the surface active properties responsible for possible interaction of the tested substances with the cell (protoplast). Biochim Biophys Acta, 1986 Nov 6, 862(1), 211 - 9 Relationship between antimicrobial activity and amphiphilic property of basic model peptides; Lee S et al.; Several cationic model peptides of the prepiece moieties of mitochondrial protein precursors were found to be active against Gram-positive bacteria, but inactive against Gram-negative bacteria . The CD spectra of the model peptides in the presence of phospholipid liposomes demonstrated that antimicrobial activity was generally in parallel with the content of the alpha-helical amphiphilicity . The results indicate that appropriate positioning of cationic and hydrophobic groups in the stable alpha-helical structure of the peptides is important to exhibit antimicrobial activity . These peptides also have an ability to leak carboxyfluorescein from acidic and neutral phospholipid vesicles, suggesting that the peptides interact with the bacterial membrane to perturb it. Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi, 1986 Nov, 19(4), 289 - 94 {Fatal septicemia due to Chromobacterium violaceum}; Wu SH et al.; A 2-year old boy was suffered from an infection caused by Chromobacterium violaceum . This is the first case of C . violaceum infection reported in Taiwan . The boy was treated with chloramphenicol and gentamicin but died after one month of illness due to the incooperation of patient's family . The causative agent was isolated from patient's blood and scar . Complete bacteriologic characteristics and antimicrobial susceptibility pattern of this isolate are reported. Res Vet Sci, 1986 Nov, 41(3), 386 - 90 Chemotherapy and pharmacokinetics of some antimicrobial agents in healthy dwarf goats and those infected with Ehrlichia phagocytophila (tick-borne fever); Anika SM et al.; The therapeutic efficacy and pharmacokinetics of oxytetracycline (10 mg kg-1), ampicillin (20 mg kg-1) and a combination (TSS) of trimethoprim (20 mg kg-1), sulphadimidine (50 mg kg-1) and sulphamethylphenazole (50 mg kg-1) were investigated in normal dwarf goats and in those infected with Ehrlichia phagocytophila . Goats given oxytetracycline or TSS intravenously showed improvement, whereas ampicillin was ineffective . The infected goats had significantly prolonged elimination half-life values for sulphadimidine and oxytetracycline . The disposition kinetics of ampicillin and sulphamethylphenazole showed no marked differences between the healthy and infected animals . The tick-borne fever model used in the present study can be of value in testing the therapeutic efficacy and pharmacokinetics of chemotherapeutic agents in rickettsial infections. Antimicrob Agents Chemother, 1986 Nov, 30(5), 739 - 42 In vitro susceptibility of Capnocytophaga species to 29 antimicrobial agents; Rummens JL et al.; A hemoglobin-supplemented medium composed of Columbia agar base supplemented with 1% hemoglobin and 1% Polyvitex was used to investigate the in vitro activity of 29 antimicrobial agents against Capnocytophaga species . Clindamycin was the most active agent, with all strains being inhibited by 0.06 microgram/ml or less . Amoxicillin-clavulanic acid and imipenem were the most active among the beta-lactam antibiotics (MIC for 90% of strains tested {MIC90}, 0.50 microgram/ml); other very active drugs were BMY 28142, cefpirome, cefotaxime, ceftazidime, and ceftriaxone (MIC90, 0.06 to 0.50 micrograms/ml), although at least one strain showed resistance to each of these antibiotics (MIC, greater than or equal to 16 micrograms/ml) . Ciprofloxacin was the most active among the quinolones, with all strains being inhibited by 0.50 microgram/ml . The MICs of the other four drugs ranged from 0.12 to 4 micrograms/ml . Ampicillin, penicillin G, ticarcillin, aztreonam, and temocillin were moderately active (MIC90, 1 to 8 micrograms/ml; MIC range, less than or equal to 0.03 to greater than 128 micrograms/ml) . All strains were uniformly resistant to the aminoglycosides, polymyxin B, vancomycin, trimethoprim, and amphotericin B . Three strains produced beta-lactamase . No significant difference was found between the susceptibility of strains isolated from various sources or patients. Zh Mikrobiol Epidemiol Immunobiol, 1986 Nov, (11), 99 - 102 {Analysis of the possible mechanisms of the action of socioeconomic factors on the epidemic process whose biological base is an open parasitic system}; Zaritskii AM; The mechanism of action of socioeconomic factors on the epidemic process have been analyzed on the basis of the study of the influence, exerted on the biological properties of infective agents by environmental factors resulting from human activities, and the theory of the self-regulation of the parasitic system . Such mechanisms can be subdivided into the mechanisms affecting the epidemiological triad (the source of infection, the mechanism of transfer, and the susceptibility of the population) and the mechanisms facilitating the formation of infective agents with selective advantages (decreased virulence, resistance to antimicrobial preparations, etc.) under the influence of environmental factors resulting from human activities . The former mechanisms suppress and tend to localize the epidemic process, while the latter ones activate this process under the conditions becoming more complicated for the spread of the infective agent. J Antibiot (Tokyo), 1986 Nov, 39(11), 1551 - 6 Synthesis and antimicrobial activity of a new penem, sodium (5R,6S)-2-(2-fluoroethylthio)-6-{(1R)-1-hydroxyethyl}penem-3- carboxylate; Kawamoto I et al.; The synthesis and in vitro antimicrobial activity of a new penem antibiotic, sodium (5R,6S)-2-(2-fluoroethylthio)-6-{(1R)-1-hydroxyethyl}penem-3-ca rbo xylate (1), are reported . The MIC values of 1 are compared with those of some related 2-haloalkylthio penems prepared in this work, and also Sch 29482 and thienamycin. Am J Dis Child, 1986 Nov, 140(11), 1186 - 90 Clinical and nasopharyngeal isolates of unusual multiply resistant pneumococci; Klugman KP et al.; Routine surveillance of pneumococcal isolates for resistance to antibiotics has revealed the emergence of an unusual pattern of multiple antimicrobial resistance in South Africa . Thirty-nine pneumococcal isolates, including 21 from clinical specimens, showed resistance to tetracycline, erythromycin, clindamycin, trimethoprim, and a combination product of trimethoprim and sulfamethoxazole sodium (co-trimoxazole), yet susceptibility to penicillin G . Multiple resistance has to date been almost invariably associated with resistance to beta-lactam antibiotics . A survey of nasopharyngeal carriage revealed carriage of an additional 21 isolates of multiply resistant pneumococci, representing 7.9% of children investigated in Johannesburg, but these organisms were not found in children in Soweto or four rural villages . We present the minimum inhibitory concentrations of 15 antimicrobial agents against 15 of these 21 strains . These findings are discussed in relation to exposure of these populations to antibiotics and to the treatment of local and systemic pneumococcal disease . Of all 60 isolates of multiply resistant pneumococci isolated to date, those fully characterized serologically belong to serotypes 6B, 14, or 19F. Pharmazie, 1986 Nov, 41(11), 761 - 9 Synthesis of alkyloxybenzamide derivatives as potential antimicrobial agents; Habib NS et al.; Three series of alkyloxybenzamido derivatives have been prepared . The first comprises N1-{4-(4-alkyloxybenzamido)benzoyl}-N2-substituted alkylidene hydrazine, the second involves 1-{4-(4-alkyloxybenzamido)benzoyl}-4-alkyl, aryl, or aralkyl-3-thiosemicarbazides, and the third includes 1-substituted-5-{4-(4-alkyloxybenzamido)phenyl}-1,3,4-triazole-2-t hione . Representative samples of the prepared compounds were tested for their in-vitro antimicrobial activity. Jpn J Antibiot, 1986 Nov, 39(11), 3094 - 109 {A nationwide study of the antimicrobial susceptibility of clinical isolates of Escherichia coli in Japan}; Igari J et al.; We studied the antimicrobial susceptibility of E . coli isolated in 1983 and 1984 and also the yearly changes of the susceptibility of E . coli from 1980 to 1984 isolated in 103 hospitals in Japan . Antibiotics used for MIC determination were ampicillin (ABPC) as a penicillin, cefazolin (CEZ) as a cephalosporin, cefmetazole (CMZ) as a cephamycin and gentamicin (GM) as an aminoglycoside . Numbers of isolates tested were 2,321 strains in 1983 and 1,965 strains in 1984 . CMZ was the most effective agent among the 4 antibiotics tested, followed by GM and CEZ in this order . A large number of the isolates were inhibited by 1.56 micrograms/ml on CMZ and GM and by 6.25 micrograms/ml of CEZ . About two-thirds of the isolates were inhibited at a concentration of 12.5 micrograms/ml or less of ABPC . The susceptibility of E . coli against the 4 antibiotics changed little year by year and the tendency of the appearance of resistant strains did not increase in the last 5 years. Infection, 1986 Nov-Dec, 14(6), 261 - 7 Empiric antimicrobial therapy in febrile granulocytopenic patients . Randomized prospective comparison of amikacin plus piperacillin with or without parenteral trimethoprim/sulphamethoxazole; Menichetti F et al.; In a prospective randomized trial parenteral trimethoprim/sulphamethoxazole was added to amikacin plus piperacillin in order to compare triple-drug antibiotic combination with a standard regimen as empiric therapy of fever in patients with granulocytopenia . One hundred and sixty-one episodes were evaluated; 74 episodes with amikacin plus piperacillin and 87 episodes with amikacin plus piperacillin plus trimethoprim/sulphamethoxazole . The overall response to therapy (63% vs . 84%) as well as the response of microbiologically documented infections (60% vs . 82%) was significantly better in patients treated with the triple-drug combination (p less than 0.05) . However, no statistically significant differences in response to antibiotics at different infection sites or with regard to any single pathogen was found between the two groups . Trimethoprim/sulphamethoxazole seemed to be responsible for additional toxicity (nausea and vomiting) when added to amikacin plus piperacillin, but these side-effects were clearly related to the rate of infusion of trimethoprim/sulphamethoxazole . The findings of this study support the use of a three-drug versus a two-drug combination as empiric antibiotic regimen in febrile granulocytopenic patients. Antimicrob Agents Chemother, 1986 Nov, 30(5), 659 - 63 Modulation of bacteriolysis by cooperative effects of penicillin-binding proteins 1a and 3 in Escherichia coli; Tuomanen E et al.; Escherichia coli characteristically lyses upon treatment with most beta-lactam antimicrobial agents . In contrast, an investigational aminothiazole cephem, CGP 31523A, produced a new combination of antibacterial effects: it was highly bactericidal without causing cell wall degradation or lysis . Killing was associated with the formation of vacuolated filaments . Because the compound bound to penicillin-binding proteins (PBPs) 1a and 3, we investigated the role of PBP 3 in modulation of lysis caused by inhibition of PBP 1a . A temperature-sensitive mutant with a nonfunctional PBP 3 lysed when treated with CGP 31523A . The combination of a PBP 1 inhibitor (cefsulodin) and a PBP 3 inhibitor (aztreonam) also caused filamentation and death without lysis of wild-type cells over a narrow concentration range . We conclude that cooperative effects between PBPs in E . coli can lead to a dissociation of bacterial killing and lysis. J Clin Periodontol, 1986 Nov, 13(10), 965 - 74 Modes of application of anti-plaque chemicals; Newman HN; Because interdental and subgingival sites are relatively inaccessible to mouthrinsing, they necessitate alternative methods of application of anti-plaque chemicals . These include routine oral hygiene aids, surfactants to enhance uptake and retention of antimicrobials, gels and periodontal dressings . The principal modes of application that have received attention recently, apart from the systemic route, are syringe and pulsated jet irrigation and slow release compounds . Slow release devices currently receiving attention may be classified as membrane diffusion, solution of drug in polymer and solid drug dispersed in polymer matrix . The most widespread dental instance of a slow release device appears to be the use of varnishes and resins to carry fluoride . Recent attempts at devising improved methods of antimicrobial application include the testing of materials for their biodegradability or for their potential to adhere to mucosal surfaces . It is concluded that the potential exists for antimicrobials applied directly to the site of intended action to contribute significantly to dental health, particularly when employed as components of practical oral hygiene regimes. J Clin Periodontol, 1986 Nov, 13(10), 957 - 64 Chlorhexidine compared with other locally delivered antimicrobials . A short review; Addy M; Based on the association of bacterial plaque with the initiation of chronic gingivitis and progression of chronic periodontitis, chemical antiplaque agents have been employed both in prevention of periodontal disease and its treatment . In supragingival plaque control regimens, chlorhexidine has not been superceded as a chemical anti-plaque agent, although other compounds have been shown to be useful . The local side-effects of chlorhexidine and other cationic antiseptics, however, limit their long-term use for prevention . Extrinsic tooth staining in particular remains the greatest problem . Short-term anti-plaque uses for chlorhexidine include as an adjunct to mechanical cleaning in the initial oral hygiene phase of treatment, in situations where mechanical oral hygiene is difficult, including postsurgery, intermaxillary fixation, fixed orthodontic therapy, physically and mentally handicapped individuals, systemic diseases with oral manifestations such as leukaemia . More recent interest in chlorhexidine has resulted from the delivery of compounds subgingivally in the treatment of chronic periodontitis . Such methods have extended the use of chlorhexidine into areas inaccessible to the action of antimicrobial drugs delivered locally by conventional means, such as tooth brushing or mouth rinsing . Available evidence suggests that chlorhexidine may not be as effective as some antimicrobial drugs whose activity is more specific for those organisms considered particularly pathogenic to the periodontal tissues. Am J Trop Med Hyg, 1986 Nov, 35(6), 1129 - 33 Giardia lamblia: a culture method for determining parasite viability; Hill DR et al.; A simple, quantitative method has been developed to assess the viability of Giardia lamblia trophozoites after exposure to a potentially lethal agent . This method utilizes the ability of trophozoites which remain viable to replicate and multiply . In this study, the percent dead trophozoites after incubation in 20% fresh human serum was determined first by morphologic criteria and then by the ability of par