Clin Orthop, 1983 Oct, (179), 253 - 65 Bone and serum concentrations of five cephalosporin drugs . Relevance to prophylaxis and treatment in orthopedic surgery; Williams DN et al.; Bone and serum concentrations of five cephalosporins were assayed in 92 patients undergoing elective hip or knee prosthetic joint arthroplasty . One hundred twenty-five bone samples were assayed . Although there was no direct relation between serum and bone antibiotic concentrations, a trend toward increased bone antibiotic concentration for drugs with higher serum levels and longer half-lifes (cefazolin and ceforanide) was noted . Bone antibiotic concentrations were maximal within 60 minutes of drug administration . Although bone antibiotic concentrations following 2-g doses were greater than those following 1-g doses, the differences were not statistically significant . A trend toward higher bone antibiotic concentrations at hip surgery was noted, and this difference achieved statistical significance (p less than 0.05) for cefazolin . As a result of analysis of bone antibiotic concentrations, antimicrobial sensitivities, and cost, administration of 2 g of cefazolin immediately prior to operation, followed by 1 g every eight hours for 24 hours, is recommended in elective prosthetic joint surgery. Br J Urol, 1983 Oct, 55(5), 519 - 21 Review of results of four regimens for treatment of chronic non-bacterial prostatitis; Thin RN et al.; Review of the treatment of chronic non-bacterial prostatitis, defined by the presence of more than 500 leucocytes per mm3 in the expressed prostatic secretion (EPS), showed symptomatic response after 3 months of minocycline, trimethoprim, co-trimoxazole or diazepam . Reduction in the EPS cell count was most marked with minocycline, trimethoprim was less effective and poor results were obtained with co-trimoxazole and diazepam . In the absence of established treatment for chronic non-bacterial prostatitis it is suggested that antimicrobial therapy is worth consideration. Acta Anaesthesiol Scand, 1983 Oct, 27(5), 403 - 9 A comparative evaluation of disposable humidifiers; Mebius C; The performance of four hygroscopic condenser humidifiers (HCH) and two conventional heat and moisture exchangers (HME), all commercially available, have been evaluated in laboratory tests . A clinical study was also made in order to confirm the test results . It was found that the new generation of heat and moisture exchangers, which have hygroscopic properties, are superior to conventional HME units . When dry inspired gases are used, the HCH units, but not the HME units, deliver a moisture level that is comparable to what is produced in the upper trachea during normal breathing the nose . Our clinical experience as well as the extensive body of literature on humidification requirements support the conclusion that in most cases they can be recommended to be used for extended time periods even with dry gases . The humidification efficiency decreases with increasing tidal volume for all units . However, the best units can be used up to tidal volumes of 1000-1500 ml . The dead space of these units varies from 90 ml to 100 ml and the resistances are only about 50 Pa at 0.5 l/s . The weight is in the range 18-40 g . One of the best HCH devices also has distinct antimicrobial properties . The others are found at least not to promote organism growth . This feature added to others such as safety and simplicity in use make an HCH device an attractive alternative to conventional humidification techniques. J Dent Res, 1983 Oct, 62(10), 1062 - 6 A mouthrinse which optimizes in vivo generation of hypothiocyanite; Mansson-Rahemtulla B et al.; We report here the properties of a mouthrinse which enhances one of the natural defense factors in human saliva, the salivary peroxidase system . Concentrations of the antimicrobial agent, the hypothiocyanite (OSCN-) ion, can be increased in vivo to bacteriostatic levels by use of a mouthrinse which is 4 mM (0.014%) in hydrogen peroxide and 1 mM (0.0097%) in potassium thiocyanate at pH 5.5 . The volume of the rinse, the H2O2 concentrations, and the pH were shown to be determinants of the concentration of OSCN- generated by the rinse. Sex Transm Dis, 1983 Oct-Dec, 10(4 Suppl), 366 - 70 Antimicrobial susceptibility and susceptibility testing of Mycoplasma hominis: a review; Bygdeman SM et al.; The determination of the minimal growth-inhibiting concentration (MIC), the minimal metabolism-inhibiting concentration (MMC), and the minimal mycoplasmacidal concentration (MCC) of various antimicrobial compounds for Mycoplasma hominis is influenced by the pH of the test media, the inoculum size, and the incubation time, although each of these factors generally do not affect the minimal concentration more than fourfold . M . hominis is resistant to beta-lactam antibiotics, vancomycin, sulfonamides, trimethoprim, and polymyxin B . There are great differences in the susceptibility of M . hominis to various macrolide antibiotics . Thus the organism is resistant to erythromycin and oleandomycin, moderately resistant to tylosin and spiramycin, susceptible to josamycin as well as to another macrolide drug, labelled M-4365G . M . hominis is also highly susceptible to the macrolide-like compound rosaramicin and to the tetracyclines (although resistant strains occur) . It is susceptible to lincomycin and clindamycin, and moderately susceptible to chloramphenicol and rifampicin . The aminoglycosides have limited activity against M . hominis. Am J Clin Pathol, 1983 Oct, 80(4 Suppl), 622 - 5 Contemporary quality control practices for antimicrobial susceptibility tests: a report from the microbiology portion of the College of American Pathologists (CAP) surveys program; Jones RN et al.; The evaluation of quality control (QC) practices from the College of American Pathologists (CAP) Microbiology Surveys demonstrates a trend away from daily controls similar to that first noted in 1980 . Previous recommendations for more relevant cost-containment oriented weekly QC procedures are discussed, and the 1982 CAP Surveys statistics confirm earlier comparability between the daily and weekly QC participant groups . Each QC practice subgroup (daily or weekly) had nearly identical mean disk inhibitory zone diameters, and the performance accuracy on two 1982 challenge strains were very similar . Generally, disk zone diameter from those laboratories using weekly QC were smaller, but the frequency of minor and major (false-resistant) errors was only slightly increased . The authors recommend the conversion to weekly QC of disk or dilution antimicrobial susceptibility tests after an acceptable daily QC performance has been established (See criteria in discussion). Arch Intern Med, 1983 Oct, 143(10), 1868 - 73 Single daily dose treatment of severe refractory infections with ceftriaxone . Cost savings and possible parenteral outpatient treatment; Baumgartner JD et al.; Ceftriaxone sodium, a new cephalosporin with a very broad spectrum of action and a very long serum half-life, was administered to 127 patients in the treatment of 133 severe infections at our institution in Lausanne, Switzerland . Eighty infections had previously been treated unsuccessfully with other antimicrobials to which the pathogens were most often resistant . Sixty-five episodes were treated with two daily injections until there was an improvement in the patient's clinical condition, while 67 infections were treated from the start by a single daily injection . The results in the two groups were similar . One hundred fifteen infections (86%) were cured or improved, ten (8%) did not respond to therapy or recurred, and eight (6%) were not evaluable . The treatment was well tolerated, even by the 18 patients who received the drug for more than four weeks . The administration of a single daily dose instead of four doses as with standard antibiotic regimens produced a saving of Sfr 84,000 (+42,000) in the 127 patients . The single daily dose also made it possible to treat 25 of the 127 severely ill patients as outpatients, with a saving of Sfr 388,500 (+195,000) with respect to the hospital costs that would have been incurred for the same time period. Obstet Gynecol, 1983 Oct, 62(4), 489 - 97 Cefotaxime sodium therapy for endomyometritis following cesarean section: dose-finding and comparative studies; Hemsell DL et al.; One hundred eighteen women who developed endomyometritis after cesarean section in Parkland Memorial Hospital were treated with parenteral cefotaxime sodium . The requirement for additional antimicrobial therapy was significantly higher at an initial daily dose of 3 g/day (16.4%) than when the dose was 6 g/day (4.8%) (P less than .05) . The latter clinical efficacy and the observed in vitro susceptibility of 88% of isolates indicate that cefotaxime is well suited for single-agent parenteral therapy for this polymicrobial pelvic infection . Subsequently, 120 women with the same diagnosis were randomly treated with cefotaxime or clindamycin and gentamicin . Patient populations, surgical variables, in vitro microbiologic data, and side effects were similar for both groups . Clinical success observed was also similar: it was 97.5% for women given cefotaxime and 95% for women given clindamycin and gentamicin. Biochem Biophys Res Commun, 1983 Sep 30, 115(3), 1009 - 14 Production of a monoclonal antibody-bleomycin conjugate utilizing dextran T-40 and the antigen-targeting cytotoxicity of the conjugate; Manabe Y et al.; Bleomycin (BLM), a potent anticancer glycopeptide antibiotic, was linked covalently to murine monoclonal anti-HLA IgG1 antibody (H-1) with the use of dextran T-40 . As determined spectrophotometrically, the conjugate was composed of 57.5 moles BLM per mole antibody . Of the substituted BLM, 18.4% (10.6 moles BLM per mole antibody) exhibited antimicrobial activity . The BLM-(H-1) conjugate showed stronger cytotoxicity than BLM alone against HLA-bearing cells in cultivation after a 30-min exposure to the drugs . In the same experiment, the conjugate was less toxic than BLM against cells lacking HLA. Biochim Biophys Acta, 1983 Sep 13, 759(3), 229 - 35 The effect of trypsin and chymotrypsin on the in vitro antimicrobial and iron-binding properties of lactoferrin in human milk and bovine colostrum . Unusual resistance of human apolactoferrin to proteolytic digestion; Brines RD et al.; The susceptibility of lactoferrin in bovine colostrum and human milk to digestion by trypsin and chymotrypsin has been investigated . Neither enzyme had much effect on the lactoferrin-mediated antimicrobial activity of human milk, and the iron binding capacity of lactoferrin in the milk was only slightly reduced . Likewise both enzymes had only a slight effect on the iron-binding capacity of purified lactoferrin . Although iron-free (apo)lactoferrin was slightly more susceptible to digestion, especially by chymotrypsin, than the iron-saturated form, the difference was much less than has been found in earlier studies with other proteins of the transferrin class . In contrast, trypsin destroyed the antimicrobial activity of bovine colostrum, and, in line with earlier studies, appreciably reduced the iron-binding capacity of both colostrum and purified bovine apolactoferrin . Bovine iron-saturated lactoferrin was more resistant to digestion . The unusual resistance of human apolactoferrin to proteolysis may reflect an evolutionary development designed to permit its survival in the gut of the infant. Yale J Biol Med, 1983 Sep-Dec, 56(5-6), 551 - 6 Role of mycoplasmas in chronic prostatitis; Peeters MF et al.; In 17 out of 102 patients with clinically diagnosed chronic prostatitis the disease could be attributed to known urogenital tract pathogens . Of the remaining 85 patients, Ureaplasma urealyticum was isolated from 38, Chlamydia trachomatis from five, and both organisms together from two . The results of antimicrobial treatment of the patients suggest an etiological relationship between Ureaplasma urealyticum and certain cases of chronic prostatitis . In these cases urethritis seems to be an accompanying symptom (urethro-prostatitis) . No relation could be demonstrated between a favorable outcome of therapy and particular serotypes of ureaplasma . Our study could not establish any pathogenic role for Mycoplasma hominis. Methods Find Exp Clin Pharmacol, 1983 Sep, 5(7), 457 - 60 A critical comment on the use of the plate diffusion test for QSAR considerations; Rehn D et al.; The plate diffusion test is widely used for the screening of possible antimicrobials . Antibiograms play an important role for the selection of suitable antibiotics in the routine treatment of infections . We are able to show with a series of O-acylated 4-hydroxybenzoic acids that the percentage of the dose which did not diffuse into the agar plate depends on physico-chemical parameters of the compounds . The amount of the residue is linearly related both to the lipophilic behaviour expressed by the partition coefficients (log Pf) and the spatial extension expressed as Van der Waals Volumes (Vw) . The plate diffusion test should be used with caution for studies of QSAR and also relative comparisons of activities. Jpn J Antibiot, 1983 Sep, 36(9), 2391 - 4 {Clinical evaluation of latamoxef in perinatal infections}; Ishikawa M et al.; Latamoxef (LMOX) is a new oxacephem antibiotic with a broad spectrum of antimicrobial activity . In vivo transfer and therapeutic efficiency of this drug have studied in perinatal field . The following results have been obtained . Transfer of this drug to umbilical blood was higher than its MIC against majority of Gram-negative pathogens . In the treatment of 5 cases of perinatal infection, the preparation showed excellent efficiency in 2 cases and good efficiency in 3 cases . No side effect was evidenced in any of our patients . In conclusion this drug has satisfactory fetal transfer as well as sufficient safety and excellent efficiency in treatment of perinatal infection cases. Arch Inst Cardiol Mex, 1983 Sep-Oct, 53(5), 435 - 40 {Actinobacillus actinomycetem comitans endocarditis . Report of a case and review of the literature}; Soto Ramirez L et al.; A case of infectious endocarditis caused by Actinobacillus actinomycetem comitans in a young male is presented . The clinical features and the microbiologic data are reviewed as well as the diagnostic and therapeutic procedures including the echocardiographic findings . A review of the literature is presented with 23 cases of endocarditis caused by this bacterium . An analysis of the cases with special emphasis in clinical presentation, predisposing factors, complications and antimicrobial therapy is made . A . actinomycetem comitans could be a cause of blood culture negative endocarditis due to the slow growth of the bacterium and the subacute course of the disease. Acta Anaesthesiol Belg, 1983 Sep, 34(3), 163 - 71 Prophylactic antibiotics in surgery; Naessens A et al.; Prospective double blind studies have demonstrated that brief courses of antibiotics active against major contaminating bacterial pathogens are effective in certain surgical interventions if these agents are given prior to surgery . Administration of antibiotics for long periods after surgery has no beneficial effect on the postoperative infection rate . In addition it may increase the risk of adverse effects and results in widespread emergence of resistant organisms . Until now brief courses of antimicrobial agents have not resulted in an increasing number of resistant bacteria, however surveillance must be continued (Acta anaesth . belg., 1983, 34, 163-171). Pharmazie, 1983 Sep, 38(9), 587 - 9 {Synthesis and antibacterial activity of perchlorylchloramphenicol}; Ziebell G et al.; Starting from p-perchloryl acetophenone we have synthesized the perchloryl analogue of chloramphenicol . The new compound is the first chloramphenicol analogue possessing a higher antimicrobial activity as chloramphenicol itself . It showed an about twofold activity against 18 different microbes in the hole plate diffusion test, compared with the parent compound. J Ethnopharmacol, 1983 Sep, 8(3), 287 - 302 Screening of antimicrobial activity of some plants belonging to the Apocynaceae and Loganiaceae; Verpoorte R et al.; A review is given of the literature on the antimicrobial activity of various indole alkaloids . The data are briefly discussed . A screening was performed of a series of plants belonging to the indole alkaloid rich plant families Apocynaceae and Loganiaceae, 25 materials representing 14 Apocynaceae species and 54 materials representing 41 Strychnos species were investigated . No activity against the yeast or the fungus, used as test organisms was found . A number of extracts showed activity against the gram-positive test organisms, 4 species showed activity against gram-negative bacteria. Farmaco {Sci}, 1983 Sep, 38(9), 630 - 9 Pyrrolnitrin analogues . VIII - Synthesis and antibacterial activity of new 1,4- and 1,5-diarylpyrroles; Filacchioni G et al.; From ethyl 1-aryl-2-methyl-4-(4-nitrophenyl)pyrrole-3-carboxylates new 1-aryl-2-methyl-4-(4-nitrophenyl)pyrrolderivatives wer prepared . These compounds and some previously reported 1,4- and 1,5-diarylpyrroles were subjected to in vitro antimicrobial screenings . Namely some 1-aryl-2-methyl-4-(4-nitrophenyl)pyrrole-3-carboxylic acids and its 5-chloroderivatives are the most potent . The results obtained are discussed on the basis of structure-activity relationships. J Clin Microbiol, 1983 Sep, 18(3), 449 - 51 Evaluation of the BACTEC antimicrobial removal system for detection of bacteremia; McGuire NM et al.; The BACTEC 16B resin medium was developed to detect bacteremia in patients receiving antimicrobial therapy . Over a 9-month period, we compared the efficacy of the BACTEC 16B bottle to the conventional aerobic BACTEC 6B bottle . Of a total of 1,524 sets of blood cultures, 79 yielded presumed pathogens . Of these 79 sets, 42 (53.2%) were positive in both the 16B and 6B bottles, 23 (29.1%) were positive only in the 16B bottle, and 14 (17.7%) were positive only in the 6B bottle . For patients receiving antimicrobial drugs, 33 of 34 (97.1%) sets were positive for pathogens in the 16B bottle, but only 15 of 34 (44.1%) were positive in the 6B bottle . In 19 (55.9%) of the 34 sets, only the 16B bottle yielded growth . The resin bottle was more useful for patients with gram-positive bacteremia than for those with gram-negative bacteremia . The BACTEC 16B resin medium increases the recovery of organisms from bacteremic patients receiving antimicrobial agents and should be used in addition to the standard BACTEC aerobic bottle for such patients. Contact Dermatitis, 1983 Sep, 9(5), 397 - 401 Bronopol allergic contact dermatitis; Peters MS et al.; Bronopol (2-bromo-2-nitropropane-1, 3-diol) is an antimicrobial compound widely used as a preservative, primarily in cosmetic formulations . Analysis of patch tests performed on our patients revealed an incidence of 12.5% relevant positive results to 0.5% and/or 0.25% bronopol . This result reflects a history of prolonged use of bronopol-containing lubricants in our referral population of patients with different types of severe, extensive dermatitis . Contact sensitization to bronopol in this population is probably facilitated by abnormal cutaneous barrier function . Our findings emphasize the need for further clinical study of the potential for bronopol to produce contact sensitivity, and suggest caution with regard to its use in patients with dermatitis. Ann Otol Rhinol Laryngol, 1983 Sep-Oct, 92(5 Pt 1), 525 - 7 Osteomyelitis of the clavicle; Krespi YP et al.; Osteomyelitis of the clavicle is rare; however, it may occur following head and neck surgery . Risk factors include radiation, long-standing tracheitis, disruption of the periosteum or the cortical bone with interruption of the blood supply to the clavicle . Proper management includes early diagnosis, surgical debridement of soft tissue and bone, appropriate antimicrobial therapy, and coverage of the defect with a myocutaneous flap to protect the great vessels of the upper mediastinum. Am J Kidney Dis, 1983 Sep, 3(2), 106 - 10 Antimicrobial therapy in patients with impaired renal function; Aronoff GR; In order to formulate a thoughtful and rational approach to drug dosing in renal failure, the nephrologist must consider several features that influence drug disposition in uremia . Drug bioavailability is generally adversely influenced in patients with renal disease . Drug distribution is frequently altered to an unpredictable degree . Drug protein binding is affected not only by changes in the amount of circulating binding protein but also by the accumulation of endogenous toxins . Renal failure frequently affects drug biotransformation . Drug-dosing tables and nomograms are important; however, they are not a substitute for an encompassing clinical approach and sound clinical judgment. Surg Gynecol Obstet, 1983 Sep, 157(3), 265 - 8 A comparative study of surgical skin preparation methods; Geelhoed GW et al.; Analysis of a randomized study of preoperative skin preparation techniques in thoracic and general surgical patients revealed that the use of a one minute alcohol cleansing and application of an antimicrobial film provides equivalent bactericidal activity to a five minute iodophor scrub and paint . Initial bacterial kill is greater with a one minute alcohol cleansing than a five minute iodophor scrub . There were fewer patients with high bacterial counts at the time of closure in the groups treated with the antimicrobial film than in the traditional iodophor scrub group . Saving in preoperative operating room time can be achieved using a one minute alcohol cleansing plus application of an antimicrobial film with equal antibacterial efficacy to that of conventional methods. Surg Gynecol Obstet, 1983 Sep, 157(3), 197 - 200 The importance of early diagnosis and surgical treatment of necrotizing fasciitis; Miller JD; Necrotizing fasciitis is a severe infection with a mixed bacterial population involving a single tissue plane . It is best diagnosed by the history of minor trauma, extreme toxicity, anesthesia of the skin and roentgenologic evidence of soft tissue gas . Initial treatment consists of antibiotics, intravenously administered fluids, blood transfusions, calcium and general patient support . Surgical procedures include extensive debridement as soon as possible and as needed for continued necrosis, secondary closure and skin grafting . The mortality of this disease has not been altered by antimicrobials . Only early recognition and surgical treatment will improve the prognosis. Arch Neurol, 1983 Sep, 40(9), 596 - 7 Acute toxoplasmic encephalitis in a normal adult; Bach MC et al.; Acute encephalitis associated with an impressive skin rash developed in an otherwise healthy man . Brain biopsy findings were not diagnostic, but serologic data confirmed the diagnosis of acute toxoplasmosis . The patient improved after antimicrobial therapy with pyrimethamine and sulfadiazine, but he was left with neurologic deficits. Rev Infect Dis, 1983 Sep-Oct, 5(5), 843 - 53 A reevaluation of the roles of the O2-dependent and O2-independent microbicidal systems of phagocytes; Elsbach P et al.; In recent years the bactericidal and cytotoxic actions of phagocytes and particularly neutrophils have been attributed mainly to O2-dependent systems that depend on the accumulation of chemically reactive derivatives toxic to the bacteria . This view has been reexamined in the light of new observations on the properties and potency of O2-independent bactericidal proteins that have been purified from neutrophils . These proteins include several enzymes as well as a granule-associated protein that acts specifically against certain gram-negative bacteria . Exposure of susceptible bacteria to this latter protein produces three effects: loss of ability to multiply, a discrete increase in permeability of the outer membrane of the envelope, and activation in the bacterial envelope of degradative enzymes that act on phospholipids and peptidoglycan . It is concluded that effective antimicrobial activity rests on the coexistence of O2-independent bactericidal proteins that are highly specific for certain microbial species and O2-requiring systems that nonspecifically attack all cells. J Clin Periodontol, 1983 Sep, 10(5), 487 - 514 Microbiological and clinical effects of topical subgingival antimicrobial treatment on human periodontal disease; Rosling BG et al.; This study was undertaken to evaluate the microbiological and clinical effects of a subgingivally applied mixture of H2O2-NaCl and NaHCO3 followed by subgingival irrigation with 1% Betadine in the treatment of periodontal disease . 20 adults with moderate to severe periodontal disease were included in a split mouth design study . All patients were given oral hygiene instruction and were subjected to supragingival scaling in all 4 quadrants, and subgingival scaling and root planing of half the dentition . 10 patients were instructed to use the chemical antimicrobial mixture twice a day instead of dentifrice, and also received professional application of the mixture once every 14 days for 3 months in connection with reinstruction in oral hygiene procedures . The remaining 10 patients received oral hygiene instructions combined with professional tooth cleaning without use of chemicals once every 14 days during a 3-month period . The effect of treatment was evaluated by monitoring the subgingival microflora, clinical periodontal parameters, and by computer assisted subtraction analysis of serial standardized radiographs to determine changes in mass of the supporting alveolar bone . The present study revealed that subgingival debridement combined with mechanical plaque control resulted in decreased numbers of subgingival microorganisms including spirochetes and motile rods, and arrested the progressive breakdown of the periodontal tissues . Topical antimicrobial agents used in combination with subgingival scaling further reduced the subgingival microflora and substantially improved early periodontal healing including gain of probing attachment level and gain in radiographic alveolar bone mass during the 12 months of observation . No clinical improvement but a tendency to further periodontal breakdown was found in the unscaled quadrants, even in those which were subjected to a personal application of the topical antimicrobial mixture . This study indicates that professional and personal subgingival application of a mixture of H2O2-NaCl and NaHCo3 will significantly enhance the microbiological and clinical effects of periodontal scaling and root planing . These agents, and the topical mode of antimicrobial therapy seem promising in the management of human periodontal diseases. J Antibiot (Tokyo), 1983 Sep, 36(9), 1228 - 35 Inhibition of nucleic acid biosynthesis in procaryotic and eucaryotic cells by cyanocycline A; Hayashi T et al.; Cyanocycline A was cytotoxic against Meth A cells in vitro, and also showed marked activity against the same cell line grown as an experimental ascites tumor . This antibiotic inhibited nucleic acid synthesis in Escherichia coli and Meth A cells . The antimicrobial activity of the antibiotic was reversed by addition of exogenous herring sperm DNA . Cytofluorometric analysis of cyanocycline A-treated Meth A cells showed an unusual pattern of the relative content of DNA and RNA per cell . These results suggested that cyanocycline A binds to DNA, and that it inhibits nucleic acid synthesis. Rev Infect Dis, 1983 Sep-Oct, 5 Suppl 4, S806 - 22 Microbial interactions with neutrophils; Spitznagel JK; Bacterial pathogenesis is heavily dependent on the capacities of microbial cells to avoid activating or to resist antimicrobial mediators of neutrophil polymorphonuclear granulocytes, the first line of phagocytic defense against infection . These capacities can but be understood in terms of the cell biology of neutrophils . The relevant microbial mechanism largely reside in the biochemical structures of their cell surfaces and their secretions . These factors are reviewed, and the importance of biochemical genetic analysis in seeking new solutions to old and new problems is stressed. J Antibiot (Tokyo), 1983 Sep, 36(9), 1097 - 100 Aculeximycin, a new antibiotic from Streptosporangium albidum . II . Isolation, physicochemical and biological properties; Ikemoto T et al.; A new larvicidal antibiotic, aculeximycin, was found in the culture broth of an actinomycete identified as Streptosporangium albidum . Aculeximycin was isolated from the culture filtrate by adsorption on a Diaion HP-20 column and successive elution with acidic aqueous acetone . It was extracted from the concentrated active fraction with 1-butanol and subjected to column chromatography on a Sephadex LH-20 column . Aculeximycin exhibited strong larvicidal activity against mosquito larvae as well as antimicrobial activities against Gram-positive and Gram-negative bacteria, yeasts and molds. Schweiz Med Wochenschr, 1983 Aug 20, 113(33), 1112 - 7 {The role of complement and specific antibodies in the development and defense mechanism of sepsis and septic shock}; Nydegger U; Sepsis, abscess formation or development of purulent exudates in closed cavities expresses insufficient host defense against pyogenic infections . An attempt is made to analyse the reasons for diminished host resistance and/or increased virulence of the invading microbes . While the role of cellular defense mechanisms is not considered, a number of humoral components, such as lysozymes glycolipids, lactoperoxidase, fibronectin, esterases and haptoglobin, participate in efficient defense . Special emphasis is placed on serum complement, both with regard to its unspecific but nevertheless efficient alternative pathway, and with respect to its phylogenetically much more recent classical pathway . Recognition of bacteria by either mechanism of complement activation leads to C3b deposition on the microbial surface for efficient opsonization, while the juxtaposition of at least two molecules of antibodies contained in the immunoglobulin fraction of plasma safely leads to complement activation via the classical pathway . Therefore, specific recognition of bacteria by immunoglobulin-antibodies remains the core of anamnestic antimicrobial defense, the more so since some antibodies may also confer on the bacterial surface the capacity to activate the alternative pathway . The recent description of monoclonal antibody directed at bacteria relevant in sepsis opens perspectives in the near future when such components will eventually be used for therapeutic purposes, along with antibodies also directed towards the pathogenetic bacterial products endo- and exotoxin. Am J Clin Pathol, 1983 Aug, 80(2), 182 - 9 Cefuroxime, cefamandole, cefoxitin, and cephalothin in vitro susceptibility tests: reassessment of the "class representative" concept, confirmation of disk interpretive criteria, and proposed quality control guidelines; Barry AL et al.; The relationship of cefuroxime in vitro susceptibility tests to similar cephalosporins (cefamandole, cefoxitin, and cephalothin) was evaluated using 396 recent clinical isolates . The previously published interpretive criteria of greater than or equal to 18 mm (less than or equal to 8.0 micrograms/mL) = susceptible and less than or equal to 14 mm (greater than or equal to 32 micrograms/mL) = resistant for each drug were considered appropriate . The results of all study methods demonstrated cefuroxime to be slightly less active than cefamandole against most species, yet both drugs possessed nearly identical antimicrobial spectra . Cephalothin and cefoxitin were confirmed to have spectra significantly different from cefamandole and from each other, thus requiring separate testing . The application of the "class representative" concept to cefuroxime and cefamandole seems justified . Use of a 30-micrograms cefuroxime disk yielded the best predictive results and minimized the number of false-susceptible (very major) interpretive errors . Quality control guidelines are presented in a tentative form for cefuroxime, and modifications in the cephalothin and cefamandole zone limits are suggested. Obstet Gynecol, 1983 Aug, 62(2), 151 - 4 Perioperative antimicrobials for cesarean delivery: before or after cord clamping? Cunningham FG, Leveno KJ, DePalma RT, Roark M, Rosenfeld CR. To determine neonatal risk of exposure to intrapartum antimicrobials given to reduce maternal infection following cesarean delivery, 642 mother-infant pairs were evaluated . In 464, the mother was given an initial dose of antimicrobial(s) before cord clamping, whereas in the remaining 178 administration of these drugs was not begun until after delivery . Despite the facts that all infants were at equivalent risk for infection and that none were proved to have bacteremia, 28% of those exposed to intrapartum maternal antimicrobials were evaluated for sepsis whereas only 15% of those not exposed were evaluated (P less than .001) . Excess hospital charges for infants in whom sepsis workup was initiated was $127 greater than that for infants not suspected of having sepsis (P less than .025) . Of 305 women given three-dose perioperative antimicrobial therapy, 255 were given the initial dose before cord clamping and 24% experienced a subsequent uterine infection . This was not significant when compared with a uterine infection rate of 22% in 50 women in whom three-dose therapy was not initiated until after cord clamping . As maternal benefits that accrue from such intrapartum therapy are equivalent regardless of the timing of three-dose treatment, and as fetal exposure to these drugs has significant clinical and economic impacts, it is concluded that antimicrobials given to these women at high risk should be withheld until after cord clamping. J Antibiot (Tokyo), 1983 Aug, 36(8), 1034 - 9 Synthesis and in vitro activity of a new carbapenem, RS-533; Miyadera T et al.; The synthesis and in vitro antimicrobial activity of a new synthetic carbapenem, (5R,6S)-6-{(R)-1-hydroxyethyl}-2-{(S)-1-acetimidoylpyrrolidin -3-ylthio}-1-carbapen-2-em-3-carboxylic acid (RS-533), are described . The MIC values of related penems and carbapenems are also given for comparison with those of the new carbapenem. J Antibiot (Tokyo), 1983 Aug, 36(8), 1020 - 33 Cephalosporin antibiotics . Synthesis and antimicrobial activity of 7 beta-{2-(5-amino-1,2,4-thiadiazol-3-yl)-2-oxyiminoacetamido}cephalosporin derivatives; Csendes I et al.; Cephalosporins with a 7 beta-{2-(5-amino-1,2,4-thiadiazol-3-yl) -2-oxyiminoacetamido} side chain were synthesized and their in vitro inhibitory potency was established . The compounds exhibit a strong antibacterial activity against various Gram-positive and Gram-negative bacteria . The antimicrobial activity is related to the oxime-substituent R1 and the C-3 substituent R2 . Selected amino-1,2,4-thiadiazolyl-cephems 1 show a prolonged half-life in mice. Z Kardiol, 1983 Aug, 72(8), 476 - 80 {Prosthesis endocarditis with embolization of a Smeloff-Cutter aortic valve prosthesis . Diagnosis, surgical management, clinical and hemodynamic course to 3 years' postoperative follow-up}; Horstkotte D et al.; In a 47-year-old man a late postoperative chronic infective prosthetic valve endocarditis became evident 8 years after implantation of a Smeloff-Cutter aortic valve prosthesis . Signs and symptoms of valve endocarditis increased rapidly, so that within 12 months a total valve embolization was found intraoperatively . Three years after emergency reoperation and implantation of a Bjork-Shiley prosthesis, good clinical and hemodynamic results were established . Thus, even in prosthesis valve endocarditis with severe consecutive hemodynamic impairment, immediate surgical treatment seems to be mandatory and can be performed successfully with good long-term results if the diagnosis is made in time and if effective antimicrobial therapy is begun. J Antimicrob Chemother, 1983 Aug, 12(2), 133 - 9 Susceptibility of penicillin-resistant pneumococci to eighteen antimicrobials: implications for treatment of meningitis; Tweardy DJ et al.; The minimal inhibitory concentrations (MICs) of 18 antibiotics including 16 beta-lactam antibiotics were determined by agar dilution on 70 strains of pneumococci (25 penicillin sensitive, 18 intermediate resistant and 27 resistant) . The antimicrobials tested were penicillin G, ampicillin, carbenicillin, ticarcillin, piperacillin, mezlocillin, cephalothin, cefoxitin, cefamandole, latamoxef (moxalactam), cefotaxime, cefoperazone, ceftazidime, ceftriaxone, N-formimidoyl thienamycin, SCH 29482, chloramphenicol and vancomycin . Of these agents, only cefotaxime demonstrated greater activity than penicillin against intermediate penicillin-resistant strains while cefoperazone, ceftriaxone, N-formimidoyl thienamycin and vancomycin as well as cefotaxime demonstrated activity superior to penicillin against penicillin-resistant strains . Comparison of the MIC90s of these agents with the achievable cerebrospinal fluid levels suggests that meningitis caused by penicillin-resistant pneumococci should respond to treatment with cefotaxime, cefoperazone, ceftriaxone and vancomycin. Hoppe Seylers Z Physiol Chem, 1983 Aug, 364(8), 1003 - 9 Purification and spectral characterization of seminalplasmin, an antimicrobial protein from bull semen; Theil R et al.; A new method for the purification of seminalplasmin, an antimicrobial protein from bull semen, was developed . The last step of the procedure involved preparative high performance liquid chromatography on a reversed phase column . Highly purified seminalplasmin was characterized by CD, absorption, fluorescence spectroscopy, double immunodiffusion and biological activity . Analytical ultracentrifugation revealed a molecular mass of 6300 Da . Amino-acid analysis of the protein preparation indicated the absence of sulfur-containing amino acids cysteine and methionine. Am J Hematol, 1983 Aug, 15(1), 57 - 63 Acute leukemia and infections: perspectives from a general hospital; Balducci L et al.; The incidence and etiology of infections in 210 acute leukemics at the University of Mississippi Medical Center between 1962 and 1978 were reviewed . Infections episodes occurred 269 times in 148 patients . In 193 infections, potential pathogens were cultured . Infection was a contributing cause of death in 89 patients . E . Coli, S . aureus, K . pneumoniae, and P . aeruginosa accounted for 58% of the isolates . No unusual patterns of antimicrobial resistance were observed . The outcome of the infections was related to the absence or resolution of neutropenia . Among 48 patients febrile on first admission, four cases of gram-negative pneumonia, two cases of fungal pneumonia, and two cases of pseudomonas cellulitis were diagnosed . We conclude that the etiology of infections was similar to that of cancer centers; multidrug-resistant gram-negative organisms were not prevalent; absence or resolution of neutropenia indicates a good prognosis for outcome of infection; and untreated acute leukemics may acquire opportunistic infections. J Clin Endocrinol Metab, 1983 Aug, 57(2), 402 - 9 Chemiluminescence and superoxide anion production by leukocytes from diabetic patients; Shah SV et al.; Stimulated neutrophils exhibit a burst of oxidative metabolism which results in the formation of superoxide anion and other oxygen species that participate in bacterial killing . Chemiluminescence is also produced and is a sensitive measure of oxidative metabolism and correlates well with antimicrobial activity . Since infection is an important cause of morbidity and mortality in diabetic patients we examined chemiluminescence and superoxide production by leukocytes from diabetics in the resting state and in response to a soluble (phorbol myristate acetate) and to a particulate stimulus (opsonized zymosan) . No significant difference in the resting chemiluminescence was observed . However, the resting superoxide anion production by patients' leukocytes was significantly higher in autologous serum; when patients' leukocytes were placed in normal serum, a significant reduction in the resting superoxide anion production was observed . Using phorbol myristate acetate as a stimulus, leukocytes from diabetic patients had a markedly reduced chemiluminescence response {controls 388 +/- 48, n = 22, patient 220 +/- 37, peak cpm X 10(3)/10(6)P leukocytes, n = 22, (P less than 0.01)} and reduced superoxide anion response {controls 30.1 +/- 3.8, n = 16, patients 13.3 +/- 2.6 nmol/15 min/10(6)P leukocytes, n = 16 (P less than 0.001)} . Significantly reduced chemiluminescence response (P less than 0.05) and superoxide production (P less than 0.05) by leukocytes from diabetic patients were also observed using opsonized zymosan as a stimulus . No significant effects on chemiluminescence or superoxide response to phorbol myristate acetate were observed with cross-incubation studies in which patients' leukocytes were placed in normal serum or control leukocytes in patient serum . In vitro addition of insulin (25 microU; 100 microU/ml) had no significant effect on patient cell response; similarly increasing the glucose concentration from 100 mg/dl to 200 mg/dl and 400 mg/dl had no significant effect on control cell response . Glucagon in a lower concentration (200 pg/ml) had no significant effect; only at a higher concentration (400 pg/ml), it caused an inhibition of the phorbol stimulated chemiluminescence and superoxide response of control leukocytes . These results show an impaired oxidative burst by leukocytes from diabetic patients which may contribute to impaired bacterial killing and may explain, in part, the morbidity and mortality in diabetic patients suffering from infection. Am J Med, 1983 Jul 28, 75(1B), 31 - 6 Resin-process methods for improved isolation of organisms from blood and other body fluids; Hansen SL et al.; Two resin-based processes and conventional culturing methods were compared in isolating organisms from blood specimens of patients given antimicrobial agents . Of 20 patients whose specimens were found to contain clinically relevant organisms, one or both of the resin-process methods isolated organisms in eight after conventional culturing was unsuccessful . Conventional cultures were successful in five cases in which the resin-process methods did not work, and both resin-process and conventional culturing were successful in seven cases . In eight cases in which other body fluids were cultured, only a resin-process method was successful in four, although they are intended for use only with blood specimens . Data indicate that resin-process methods should be used along with conventional culturing methods when patients have already been given an antimicrobial . A review of the literature shows that the devices improve the recovery of organisms but does not establish that detection time is decreased. Arch Biochem Biophys, 1983 Jul 15, 224(2), 494 - 505 Detoxification of the phytoalexin pisatin by a fungal cytochrome P-450; Matthews DE et al.; The fungus Nectria haematococca, a pathogen of garden pea (Pisum sativum), can demethylate pisatin, an antimicrobial compound synthesized by infected pea tissue . The phenolic product is less toxic than pisatin to many microorganisms . Cell extracts catalyzing pisatin demethylation were obtained from N . haematococca, and the properties of the reaction were examined . The enzyme activity was greatest in the high-speed pellet fraction, in which rates up to 20 nmol/min/mg protein were observed . The Km for pisatin was relatively low, less than 5 microM . The reaction was dependent on NADPH, which could not be replaced by any other cofactor tested . However, in the presence of NADPH, NADH increased the rate of demethylation . Oxygen uptake by the enzyme was stimulated by addition of pisatin, the increment of oxygen utilization being approximately equimolar with pisatin added . Formaldehyde was a product of the reaction . The effects of various inhibitors were tested to determine whether this reaction is mediated by cytochrome P-450 . The respiratory inhibitors KCN (1 mM) and antimycin A strongly inhibited the demethylation of pisatin by intact cells of the fungus, but not by the NADPH-supplemented enzyme . The cytochrome P-450 inhibitors SKF 525-A and 1-(2-isopropylphenyl)imidazole inhibited demethylation both in whole cells and in the enzyme preparation, though the latter compound was effective only at high concentrations . Most other cytochrome P-450 inhibitors tested had little effect . However the reaction was quite sensitive to CO, and this inhibition was readily reversed by light at wavelengths near 450 nm . It is concluded that pisatin demethylase is a cytochrome P-450 monooxygenase. Am J Vet Res, 1983 Jul, 44(7), 1378 - 81 Effect of C31G, an antimicrobial surfactant, on healing of incised guinea pig wounds; Michaels EB et al.; An anti-infective surfactant composition (C31G) promoted healing of infected and noninfected wounds in guinea pigs . In this animal model, histologic features of wounds treated topically with C31G revealed an increased rate of wound closure associated with decreased inflammatory response and increased C31G fibroblast infiltration and epithelialization . The effect of C31G on fibrin formation, the initial event of wound healing, was compared with effects of anionic and cationic surfactants that delay healing . The surfactants had different effects on clotting time, platelet activation, and cross-linkage of the stabilized clot . Seemingly, C31G increased the protein cross-linking of fibrin in clots containing fibronectin. Am Rev Respir Dis, 1983 Jul, 128(1), 173 - 5 Melioidosis: recrudescence with a strain resistant to multiple antimicrobials; Shaefer CF et al.; We describe a recent case of melioidosis presenting classically in a young Vietnam veteran . The case demonstrates extensive antibiotic resistance in this isolate and failure of ceftriaxone, despite its in vitro efficacy . Other multiple antimicrobial regimens also failed . Melioidosis remains a concern in patients who have previously lived in endemic areas . A high level of diagnostic suspicion is required, especially in patients with a febrile illness or tuberculosis-like presentations . Early detection of Pseudomonas pseudomallei and rational treatment of adequate duration are critical in successful management. J Exp Med, 1983 Jul 1, 158(1), 234 - 9 Lymphokine enhances oxygen-independent activity against intracellular pathogens; Murray HW et al.; To determine if mechanisms other than the generation of toxic oxygen intermediates are active against intracellular pathogens, oxidatively deficient mouse L cells and monocyte-derived macrophages from patients with chronic granulomatous disease were stimulated with soluble lymphocyte products . Despite no enhancement in oxidative activity, these cells displayed effective microbistatic activity against both T . gondii and C . psittaci . These results suggest a potential role for nonoxidative mechanisms in the mononuclear phagocyte's activity against intracellular pathogens, and indicate that lymphokines can regulate both oxygen-dependent and oxygen-independent antimicrobial responses. Surg Gynecol Obstet, 1983 Jul, 157(1), 82 - 8 Topical therapy and the development of silver sulfadiazine; Fox CL Jr; Topical therapy is a selective approach to the prevention and treatment of infection in burns and other surgical wounds . Effective compounds possess certain chemical and physical properties . Prerequisites include low solubility, slow absorption, nonreactivity with wound exudates, proteins and ions and ability to achieve prolonged antimicrobial activity in the wound . These compounds yield much higher levels in the zone of infection than can be achieved by diffusion into the wound after systemic administration . The wide spectrum of antibacterial activity, the low toxicity, minimal tissue reaction, ease of application suggest that topical silver sulfadiazine therapy can safely be extended to other wound infections, wound covers and certain transplant materials. J Lab Clin Med, 1983 Jul, 102(1), 78 - 87 Fluid spaces in normal and osteomyelitic canine bone; Quinlan WR et al.; When cortical bone is afflicted by an infectious process, significant alterations in the physiology and anatomy occur at the cellular level . Included in these alterations are modulations of the various fluid spaces of cortical bone . Volume of distribution studies with 14C-labeled sucrose and 99Tc-labeled red blood cells in an animal model of acute, subacute, and chronic osteomyelitis of the tibia were performed to quantitate the various fluid spaces in cortical bone . Additionally, the studies were performed in cortical bone from the radius and tibiae (following sham operations) to allow comparison with normal and control values . The total exchangeable water, vascular, and interstitial fluid spaces were increased in all three types of osteomyelitic bone . With one-way analysis of variance and Duncan's multiple range test, the alterations observed in each type of osteomyelitic bone (acute, subacute, or chronic) were statistically different from those observed in normal bone (p = 0.001) and controls (p less than or equal to 0.01) . The differences of the mean values observed among the three types of osteomyelitic bone were not statistically significant (p greater than 0.05) . These pathophysiologic alterations in osteomyelitic bone must be considered when one studies the ability of various antimicrobials to reach bactericidal concentrations in the interstitial fluid space, the primary site of drug-microorganism interaction. Pediatr Med Chir, 1983 Jul-Aug, 5(4), 179 - 84 {Neonatal septic osteoarthritis}; Menchini M et al.; The Authors report their experience related to 15 cases of neonatal osteo-arthritis which have occurred in the last seven years in the neonatal intensive care unit . Besides the traditional clinical picture, it is stressed that neonatal osteo-arthritis has recently acquired new interest for an etiologic shift of the pathogens and for the availability of new antimicrobial agents . The rational antibiotic treatment and the role of the coordinated medical and orthopedic therapy have been essential for the benign clinical course and for the long-term prognosis . It is concluded that in order to reduce this serious disease it is necessary to avoid every potential risk factor, to operate in rigorous aseptic conditions and to improve the environmental conditions of the neonatal intensive care units. J Infect, 1983 Jul, 7(1), 31 - 8 The value of initial laboratory investigations in the management of meningitis; Nye FJ; The results of cerebrospinal fluid (CSF) examination and other initial laboratory investigations have been analysed in one hundred and forty-nine patients with meningitis . The CSF differential leucocyte count clearly distinguished between bacterial and viral meningitis in 92 per cent of patients evaluated: CSF glucose and protein concentrations were less predictive by comparison . CSF glucose values were particularly unreliable because of hyperglycaemia in patients with bacterial meningitis and predictive accuracy increased when CSF levels were expressed as a percentage of blood glucose concentration . Results were not influenced by the age of the patients, and laboratory evidence of bacterial infection did not appear to be masked by prior antimicrobial therapy . A management algorithm based on the results of initial tests was applied retrospectively to the patients in whom Gram-stained CSF did not reveal bacteria . The algorithm indicated immediate antimicrobial therapy for all thirty patients with pyogenic infections, and for only one of sixty-three patients with a final diagnosis of viral meningitis. Farmaco {Sci}, 1983 Jul, 38(7), 488 - 97 Synthesis of some 2- and 4-methoxyacetylaminobenzenesulphonylamino acid derivatives and their antimicrobial activity; El-Naggar AM et al.; The synthesis of a series of 3-acetylamino-4-methoxy-,2-acetylamino-4-methoxy- and 2-methoxy-5-acetylaminobenzenesulphonylamino acids, methyl esters, hydrazides and dipeptide methyl esters (IV-LXI) is described . Some o-, m- and p-anisidine and 2-aminopyridine derivatives have also been prepared by analogous procedure . Twenty of various by substituted acetylaminomethoxybenzenesulphonylamino acid and dipeptide derivatives were found to possess specific antimicrobial activities towards different microorganisms. J Clin Periodontol, 1983 Jul, 10(4), 422 - 32 Antibiotic susceptibility testing of subgingival plaque samples; Walker CB et al.; The in vitro inhibitory effect of several antimicrobial agents was determined against dispensed dental plaque samples taken from periodontally diseased sites as an aid in the selection of antibiotics for adjunctive use in periodontal therapy . 2 groups of patients were sampled . 1 group of 10 patients with severely advanced disease had received periodontal treatment which included the frequent adjunctive use of an antibiotic . The second group consisted of 15 individuals with less severe periodontal disease; only 4 individuals had been previously treated with antibiotics for their periodontal disease . Bacterial samples of subgingival plaque were taken from each patient and tested against a battery of antibiotics to determine which agent was the most effective in suppressing bacterial growth . Each antibiotic was incorporated into Trypticase-soy blood agar at a concentration equivalent to that achieved in either gingival fluid or blood following recommended oral dosages . The inhibitory effect was determined by comparing the number of bacterial recovered on the antibiotic-containing medium to the total number of bacteria recovered on the basal medium . Penicillins, with the exception of cloxacillin, were the most effective in inhibiting bacterial growth . Benzylpenicillin consistently inhibited the growth of 90% of the isolates recovered on media free of antibiotics while ampicillin and amoxicillin frequently inhibited 99% or more of the bacteria recovered . Tetracycline was generally inhibitory for at least 90% of the isolates if the patients had not been previously treated with this agent . However, resistance to this drug was common in samples taken from patients previously treated with tetracycline . Doxycycline, a tetracycline derivative, did not inhibit significantly more isolates than tetracycline . Clindamycin was inhibitory for 90% or more of the organisms in most of the samples; and, was usually effective in inhibiting isolates in samples which exhibited large numbers of isolates resistant to tetracycline . Erythromycin was relatively ineffective against the isolates recovered from samples from the severely diseased group but was inhibitory to isolates in some samples taken from the more moderately diseased group . Metronidazole, at the concentration tested, was largely ineffective against the isolates in bacterial samples from both groups . No single antimicrobial agent was found to be inhibitory for greater than 90% of the bacteria recovered from all of the subgingival plaque samples with the possible exception of some penicillins. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Jul, 255(1), 39 - 43 Heat treatment as an aid for the isolation of Legionella pneumophila from clinical and environmental samples; Groothuis DG et al.; The isolation of legionella's from clinical as well as environmental samples is hindered by the overgrowth of legionella's by the accompanying bacterial flora, which could not be sufficiently suppressed by adding antimicrobial drugs to the BCYA alpha . The effect of heat treatment on clinical samples and on water samples concentrated by filtration was investigated . Treatment of the samples for 30 minutes at 50 degrees C reduced the number of cfu of the accompanying flora by a factor 10(1.6)-10(3.9) depending on the number of contaminants, whereas the number of cfu of legionella was reduced only by a factor 1.05-1.44 . Higher or lower temperatures resulted in a too high reduction of the number of legionella's or an insufficient elimination of the accompanying flora respectively . The described method is less laborious and less critical than the earlier described low pH-treatment. Mutat Res, 1983 Jul, 121(1), 53 - 7 The micronucleus test with mouse spleen cells; Shindo Y et al.; The results of this study show that the micronucleus test can be carried out with mouse spleen cells as well as with cells from bone marrow . Polychromatic erythrocytes occurred in the spleen at a frequency of about 9% of the whole spleen cells compared with about 13% in the bone marrow . 3 test compounds were used to compare the frequency of micronuclei in cells from the 2 tissues . Mitomycin C and cyclophosphamide induced micronucleated polychromatic erythrocytes in both spleen and bone marrow . Fosfomycin, an antibiotic having a broad spectrum of antimicrobial activities, did not induce micronucleated erythrocytes in either organ. J Immunol, 1983 Jul, 131(1), 384 - 7 Suppression of macrophage antimicrobial activity by a tumor cell product; Szuro-Sudol A et al.; Medium conditioned by tumor cells (TCM) and certain nonmalignant cells contains a trypsin-sensitive factor that suppresses macrophage oxidative metabolism . Because the killing of intracellular pathogens such as Toxoplasma gondii and Leishmania donovani by macrophages is largely oxygen-dependent, we tested the effect of TCM on the antiprotozoal activity of mouse peritoneal macrophages . After 24 hr of cultivation with TCM, in vivo and in vitro activated macrophages could no longer kill toxoplasmas or inhibit their replication . In vivo administration of TCM resulted in similar impairment . The leishmanicidal activity of resident and activated macrophages, when measured 6 hr after infection, was markedly suppressed by in vitro exposure to TCM . The addition of exogenous H2O2 in the form of glucose-glucose oxidase reconstituted the capacity of TCM-exposed macrophages to kill L . donovani promastigotes as quickly as control cells . Thus, TCM appears to deactivate macrophages by the functional criteria of suppressed antitoxoplasmal and antileishmanial activity, as well as by the biochemical criterion of suppressed oxidative metabolism. Vet Q, 1983 Jul, 5(3), 127 - 30 Keratoconjunctivitis infectiosa ovis (KIO), 'pink eye' or 'zere oogjes' (a survey); Konig CD; The occurrence of keratoconjunctivitis infectiosa ovis (KIO) in the Netherlands was reported by Hofland et al . in 1969 for the first time . At present the disease is well known in the Netherlands . Nevertheless there are still questions about the causative agent and the most effective and easiest therapy . Most authors suppose that the disease is caused by Colesiota conjunctivae, although others mention infections by other chlamydia, Mycoplasma conjunctivae, Mycoplasma ovipneumoniae, Acholeplasma oculi and a wide variety of bacteria . The diagnosis can be made on the basis of the symptoms and the detection of the agent in conjunctival scrapings . The bacilliform bodies can be found in conjunctival smears in the cytoplasm (Giemsa, Stamp) . Many therapies are used topically, parenterally or orally . Locally used eye-ointments must be effective against Colesiota; antimicrobial drugs administered by injection must be effective against the latter and also provide a sufficient cell tissue penetration with excretion into the lacrimal fluids . Injections have proved to be easier to administer, especially in serious outbreaks, but such outbreaks are exceptional (18) . Some therapies have been evaluated in small scale experiments (28) as well as in field trials (17). J Nat Prod, 1983 Jul-Aug, 46(4), 532 - 6 Studies on iridoid-related compounds, II . The structure and antimicrobial activity of aglucones of galioside and gardenoside; Ishiguro K et al.; Enzymatic hydrolysis of galioside (1) and gardenoside (2), epimer of 1 at C-8 position, provided the antimicrobially active aglucone (3) and the inactive 6(a,b), while acid treatment of 2 gave scandoside methylester (8), deacetylasperulosidic acid methylester (9) and 10-dehydogeniposide (10). J Clin Microbiol, 1983 Jul, 18(1), 43 - 8 Detection of bacteremia in patients receiving antimicrobial therapy: an evaluation of the antimicrobial removal device and 16B medium; Doern GV et al.; A total of 1097 blood specimens obtained from patients receiving antibacterial antimicrobial agents were processed by three blood culture systems: standard aerobic and anaerobic radiometric media, resin-containing radiometric medium (16B; Johnston Laboratories, Cockeysville, Md.), and aerobic and anaerobic radiometric media inoculated with blood processed in an Antimicrobial Removal Device (Marion Laboratories, Kansas City, Mo.) . A total of 73 cultures, representing 45 unique septic episodes, yielded 81 clinically significant organisms . Forty-six organisms (28 septic episodes) were recovered in standard radiometric medium . 16B medium yielded 63 organisms (37 septic episodes) . Sixty-nine organisms (42 septic episodes) were isolated from radiometric blood cultures inoculated with Antimicrobial Removal Device-processed blood . Contamination rates were not significantly different among the three systems . In comparison with standard radiometric blood cultures, the length of time to detection of positive blood cultures was shorter with both 16B medium and with Antimicrobial Removal Device-processed cultures . Comparison of the latter two systems suggested enhanced recovery of clinically significant organisms in radiometric blood cultures inoculated with blood processed in the Antimicrobial Removal Device . There was no difference in the length of time to detection of positive blood cultures. Int J Clin Pharmacol Ther Toxicol, 1983 Jul, 21(7), 325 - 38 Chemotherapeutic agents: aspects of their activity on natural mechanisms of defense against infections; Fietta A et al.; This review summarizes the experience gained on interactions between antimicrobial agents and some reactions of the host defense system (adherence, chemotaxis, phagocytosis, microbicidal activity of leukocytes, complement system, antibody production, cell-mediated immunity) and attempts a critical evaluation . The data collected from the literature are often conflicting and there seem to be differences of behavior among derivatives belonging to the same family of antibiotics . Therefore it is quite difficult to draw a correct conclusion from these data . So far it has not been possible to understand the impact that the interference of antibiotics in natural and immunologic reactions of the host defense has on the outcome of chemotherapy, mainly in patients with some degree of immunodepression . In this instance, in fact, the interference with certain immunologic reactions could influence the therapeutic activity of specific antibiotics that are endowed with inhibitory activity . However, so far no controlled study or clear demonstration has shown that antibiotics with different activity on the immunologic reactions can have different efficacy in immunodepressed patients. J Antimicrob Chemother, 1983 Jul, 12 Suppl A, 71 - 6 Perioperative use of ceftazidime as a prophylactic agent in transurethral surgery; Childs SJ et al.; Sixty-eight patients undergoing transurethral surgery were randomly assigned to receive either a single dose of ceftazidime (31 patients) preoperatively, or three doses of cefotaxime (34 patients) perioperatively, as prophylaxis . In this study, only 1/20 male patients (5%), and none of the female patients, developed an infection . We conclude that single-dose prophylaxis, with a safe, broad-spectrum antimicrobial, provides adequate protection against postoperative infection in genitourinary surgery. J Clin Invest, 1983 Jul, 72(1), 32 - 44 Killing of intracellular Leishmania donovani by human mononuclear phagocytes . Evidence for oxygen-dependent and -independent leishmanicidal activity; Murray HW et al.; Human peripheral blood monocytes were cultivated for 1-30 d before assay for H2O2 release or challenge with Leishmania donovani promastigotes (LDP) or amastigotes (LDA) . 1-d cells readily generated H2O2 in response to both phorbol myristate acetate triggering (1,013 +/- 58 nmol/mg protein . 90 min) and LDP ingestion, and killed 50% of LDP within 6 h, and 90% by 24 h . In contrast, the same cells released little H2O2 during LDA ingestion, killed no LDA at 6 h and less than 30% by 24 h, and supported intracellular LDA replication . Monocyte-derived macrophages (cells first cultivated for greater than or equal to 7 d) generated less than 125 nmol H2O2/mg . 90 min after phorbol myristate acetate triggering, killed neither LDP nor LDA, and permitted both forms to replicate . The addition of mitogen- or antigen-stimulated lymphokines, however, prevented the decline in monocyte oxidative capacity, enhanced macrophage H2O2 release by more than sixfold, and, in parallel, induced 1-d monocytes to kill LDA and cultivated macrophages to display both promastigocidal and amastigocidal activity . In comparison to 1-d monocytes and lymphokine-activated macrophages from normal donors, the same cells from patients with chronic granulomatous disease (CGD) or normal cells whose oxidative activity had been impaired by catalase pretreatment or glucose deprivation exerted considerably less or no antileishmanial activity during the early (6-24 h) postphagocytic period . By 48 h after infection, however, 1-d CGD monocytes and oxidatively impaired normal cells killed 40 and greater than 80% of LDP, respectively . Although a longer period of lymphokine stimulation was required and the resulting antileishmanial effects were not as rapid as with normal cells, activated CGD monocytes and macrophages also eventually achieved promastigocidal and amastigostatic activity . These results indicate that human mononuclear phagocytes utilize both oxygen-dependent and -independent mechanisms to achieve activity against ingested Leishmania, and also demonstrate (a) the differential susceptibilities of the two forms of L . donovani to intracellular killing, (b) the key role of oxygen intermediates in effective mononuclear phagocyte antimicrobial activity, (c) the capacity of lymphocyte products to enhance oxygen-dependent as well as -independent pathways, and (d) the vulnerability of the monocyte-derived macrophage to Leishmania infection in the absence of lymphokine stimulation. J Dent Res, 1983 Jul, 62(7), 837 - 41 A comparison of antimicrobial activity of four disclosant dyes; Baab DA et al.; Four disclosant dyes were tested for antimicrobial activity against 27 oral reference strains and five non-oral human pathogens . Erythrosine and fluorescein inhibited most gram-positive and gram-negative organisms associated with dental plaque, and were bactericidal to selected strains . Fast green and brilliant blue demonstrated little antimicrobial activity. Vet Q, 1983 Jul, 5(3), 122 - 7 'Pink eye' or 'zere oogjes' or keratoconjunctivitis infectiosa ovis (KIO) . Clinical efficacy of a number of antimicrobial therapies; Konig CD; In a comparative study the clinical efficacy of five different treatments of keratoconjunctivitis infectiosa ovis (KIO) were tested, namely an intramuscular injection of chloramphenicol base (dosage 15 mg/kg), spiramycin base (Suanovil dosages 10 to 25 mg/kg), oxytetracycline (Engemycine Forte, Terramycin LA, dosages respectively 5 and 10 mg/kg), tiamulin (Dynamutulin, dosage 10 mg/kg) and subcutaneous injection of procaine penicillin G, benzathine penicillin G . and dihydrostreptomycin in the lower eyelid . It appeared from these field trials that spiramycin base, oxytetracycline and tiamulin had a clearly positive effect on the clinical course of 'pink eye', although with tiamulin there was only a temporary effect (high percentage of relapses) . In view of the field data the following dosage schemes are, for the time being, advised: spiramycin base (Suanovil), and oxytetracycline (formulation with a good biological availability) both 20 to 30 mg/kg and, if necessary, to be repeated on days 5 and 10 after the first intramuscular injection . The dosage scheme advised for tiamulin is 20-30 mg/kg to be repeated on day 3 and if necessary on days 6 and 9 after the intramuscular injection . In mild cases it is sufficient to rub the eyes with for example oxytetracycline eye-ointment, a few times a day. J Antibiot (Tokyo), 1983 Jun, 36(6), 684 - 7 M-9337, a new antistreptolysin, produced by Streptomyces sp; Miyamura S et al.; A new biologically active substance, M-9337, was obtained from Streptomyces strain M-9337, a soil isolate . The producing organism was subsequently determined to be a new strain and named Streptomyces antihaemolyticus M-9337 . The active substance was prepared as white yellow powder from culture broth by solvent extraction and silica gel thin-layer chromatography . It showed no antimicrobial activity and potent inhibitory activity against streptolysin, a type of hemolysin. Am J Hosp Pharm, 1983 Jun, 40(6), 995 - 7 Therapeutic use of restricted antibacterials in Czechoslovakia; Krcmery V et al.; The therapeutic use of restricted antibacterials in Czechoslovakia was studied . Data from 10 hospitals were collected over one year for approximately 10,000 therapeutic applications of eight restricted antibacterials to 8411 patients . The drugs monitored were oxacillin, kanamycin, gentamicin, carbenicillin, co-trimoxazole, colistin, cephalosporins, and lincomycin/clindamycin . Eighty-nine percent of the patients received the restricted antibacterials for therapeutic (rather than prophylactic) purposes . Approximately 16% of these patients received two or more of the drugs, and many of them received nonrestricted antibacterials concurrently . Patients on pediatric, newborn, and prematurely born wards received 55% of the restricted antimicrobials, where oxacillin and gentamicin were used most frequently . Therapy with these drugs was initiated without regard to bacteriological examination for causal bacteria and susceptibility in 7% of all cases, causal bacteria were not reported in an additional 10%, bacterial susceptibility was not determined in another 29%, therapy was administered in 7% of cases in which the bacteria were known not to be susceptible, and confirming susceptibility results were known in advance of therapy in only 30% of the cases . The restricted antibacterials were overused and were frequently prescribed for patients who may not have needed antibacterial therapy at all. Obstet Gynecol, 1983 Jun, 61(6), 723 - 7 Serum gentamicin levels in patients with post-cesarean endomyometritis; Duff P et al.; Serum gentamicin levels were measured by agar diffusion bioassay in 38 patients undergoing treatment with clindamycin-gentamicin for post-cesarean endomyometritis . Patients received intravenous gentamicin in a dose of 1 mg/kg actual body weight every eight hours . All trough levels were less than 1 microgram/ml . The mean 30-minute postinfusion level was 5.78 +/- 2.43 micrograms/ml (mean +/- SD) . The range of postinfusion concentrations was 1 to 12 micrograms/ml . Postinfusion concentrations were less than 5 micrograms/ml in 13 patients, but none of these individuals experienced a clinical failure of antimicrobial therapy . There were no statistically significant differences in mean age, weight, hematocrit, serum creatinine, estimated creatinine clearance, or administered dose in patients with therapeutic gentamicin levels and patients with apparent subtherapeutic levels . The authors conclude that postinfusion gentamicin concentrations fluctuate widely in obstetric patients receiving 1 mg/kg/dose and that apparent subtherapeutic postinfusion levels still may be clinically efficacious, depending upon the antimicrobial susceptibility of the infecting microorganisms. Antimicrob Agents Chemother, 1983 Jun, 23(6), 897 - 901 Comparison of the nephrotoxicity and auditory toxicity of tobramycin and amikacin; Gatell JM et al.; A total of 157 patients were treated with tobramycin or amikacin in a controlled prospective randomized trial . Dosages were adjusted to renal function according to a nomogram . Trough and peak aminoglycoside levels were available at the end of the trial . Of the above total, 113 recipients of nine or more doses of tobramycin or six or more doses of amikacin, without other apparent cause of renal failure, were evaluated for nephrotoxicity . Thirty-six patients were evaluated for auditory toxicity . The patients in groups evaluated for either nephrotoxicity or auditory toxicity were similar with respect to intensity and etiology of bacterial disease, concurrent exposure to other antimicrobial drugs, age and sex distribution, initial serum creatinine level, and total dose and duration of antimicrobial therapy . Nephrotoxicity of similar severity developed in 4 of 59 (6.8%) recipients of tobramycin and in 7 of 54 (13.1%) recipients of amikacin (P greater than 0.05) . Mild auditory toxicity developed in 3 of 19 (15.7%) recipients of tobramycin and in 2 of 17 (11.7%) recipients of amikacin (P greater than 0.05) . When patients with abnormally high mean trough or peak aminoglycoside levels were excluded from comparison, nephrotoxicity was 6.12 and 5.12% (P greater than 0.05) and auditory toxicity was 17.6 and 7.69% (P greater than 0.05) in the groups given tobramycin and amikacin, respectively . We conclude that the nephrotoxicity and auditory toxicity of amikacin and tobramycin are not significantly different and that such toxicities are indeed infrequent events when the dosages of these drugs are adjusted to hold blood levels within the safe boundaries suggested by the studies of others. South Med J, 1983 Jun, 76(6), 800 - 3 Atypical Pneumocystis carinii pneumonia: the potential hazards of empiric treatment; Peters JW et al.; Pneumocystis carinii pneumonia occurred in two patients with unusual clinical findings . In one case, P carinii infection was diagnosed for the first time in a patient with Crohn's disease . Due to the lack of typical features in both cases an empiric trial of antimicrobial therapy could have delayed diagnosis and initiation of specific treatment for P carinii . Contrariwise, without histologic confirmation, specific therapy for P carinii pneumonia might have been mistakenly discontinued in the second patient . Empiric therapy with trimethoprim-sulfamethoxazole may cause rapid disappearance of P carinii cysts from pulmonary tissues and cause subsequent biopsies to be falsely negative in patients who fail to respond to treatment. J Appl Bacteriol, 1983 Jun, 54(3), 417 - 23 The bactericidal, fungicidal and sporicidal properties of hydrogen peroxide and peracetic acid; Baldry MG; The antimicrobial properties of aqueous solutions of peracetic acid and hydrogen peroxide have been compared . Peracetic acid exhibited excellent antimicrobial properties, especially under acidic conditions . Reductions by a factor of 10(6) in the numbers of vegetative bacteria are obtained within 1 min at 25 degrees C using a solution containing 1.3 mmol/l of peracetic acid . Rapid activity against bacterial spores and yeasts also occurs . Hydrogen peroxide is more effective as a sporicide than as a bactericide, with sporicidal action being obtained using a solution containing 0.88 mol/l . Bactericidal action is poor but hydrogen peroxide was bacteriostatic at concentrations above 0.15 mmol/l. Am J Vet Res, 1983 Jun, 44(6), 1154 - 8 In vitro action of combinations of antimicrobial agents and EDTA-tromethamine on Escherichia coli; Wooley RE et al.; Combinations of EDTA-tromethamine and 7 antimicrobial agents {chloramphenicol, nalidixic acid, oxytetracycline, penicillin, polymyxin B, streptomycin, and triple sulfa (sulfamethazine, sulfapyridine, and sulfathiazole}) were tested for synergistic activities against Escherichia coli . Three in vitro tests were used including minimal inhibitory concentrations of the drugs, a 2-dimensional microtiter checkerboard technique, and bacterial inhibition studies . A strong synergistic inhibitory action was observed with combinations of EDTA-tromethamine plus penicillin and EDTA-tromethamine plus oxytetracycline . Combinations of EDTA-tromethamine plus chloramphenicol also had a synergistic action, but to a lesser extent than that with penicillin and oxytetracycline . When streptomycin or nalidixic acid was mixed with EDTA-tromethamine, a slight synergistic action was noticed . There was no synergistic effect recorded with combinations of EDTA-tromethamine and triple sulfa . Combinations of EDTA-tromethamine and polymyxin B had an antagonistic effect. Quad Sclavo Diagn, 1983 Jun, 19(2), 176 - 91 {Comparison of AMS and MS-2 in the identification and antibiotic sensitivity of clinically isolated bacterial strains}; Chiaradia V et al.; 282 clinical bacterial strains have been identified with AMS and MS-2 . Among biochemical tests only lysine, adhonitol , glucose did not show significant differences . The overall correlation has been 86.3% . The results of the susceptibility to antimicrobial agents on 98 bacterial strains revealed an overall agreement of 79.3%, an essential agreement of 91%. Pediatr Ann, 1983 Jun, 12(6), 445 - 9 Management of infections; Whitley RJ et al.; Over the last decade, significant advances have been made in the management of bacterial and viral infections in the immunocompromised host . These advances have been achieved through carefully performed studies, addressing the need for early antimicrobial therapy . The utilization of the empiric antibacterial therapy has prompted a significant decrease in mortality and morbidity from life-threatening bacterial infections in the immunocompromised patients . Similarly, the development of antivirals for therapy of herpes virus infections in man is significantly changing our ability to improve survival in children who suffer from chickenpox and progressive herpes simplex virus infections . The future demands improved anti-bacterial agents as well as methods of prevention of viral infections in the immunosuppressed host . These latter avenues will take the form of live attenuated viral vaccines. Ophthalmic Surg, 1983 Jun, 14(6), 502 - 5 Nocardia asteroides endophthalmitis; Chen CJ; A case of exogenous Nocardia asteroides endophthalmitis with impending corneal perforation was diagnosed by culture and successfully treated with vitrectomy, penetrating keratoplasty, and intraocular, topical, and systemic antimicrobial therapy . The patient regained excellent vision. J Infect Dis, 1983 Jun, 147(6), 1006 - 10 Expression of cell-mediated antimicrobial immunity by mouse trophoblast monolayers; Pavia CS; Monolayers of mouse trophoblast cells were produced after short-term culture (two to four days) of ectoplacental cone cells derived from 7.5-day-old mouse conceptuses and were then tested for phagocytic activity . Following brief intervals of coincubation with the blood stage form of Plasmodium berghei, the parasite that causes rodent malaria, cultured trophoblast cells were found to phagocytose large amounts of parasitic material . In a manner similar to that of peritoneal macrophages, trophoblast cells ingested predominantly hemozoin pigment granules, while internalization of nonparasitized red blood cells occurred infrequently . Trophoblast-mediated phagocytosis was sensitive to the inhibitory effects of cytochalasin B . The expression of this form of immunelike function by midstage trophoblastic elements may play an important role during embryogenesis by protecting the fetoplacental unit from injury by invading microorganisms or by limiting congenitally acquired infections. Antimicrob Agents Chemother, 1983 Jun, 23(6), 870 - 3 Ceftriaxone distribution between maternal blood and fetal blood and tissues at parturition and between blood and milk postpartum; Kafetzis DA et al.; The penetration of ceftriaxone into the fetus at parturition was studied in 17 subjects . Despite its high protein binding, ceftriaxone quickly reached the umbilical cord blood, amniotic fluid, and placenta, achieving substantial concentrations, which then disappeared, with elimination half-lives of approximately 6 h, identical to that of the mother . The elimination half-life of ceftriaxone of 5 to 6 h in these mothers was somewhat shorter than that reported for normal subjects . The concentrations of ceftriaxone achieved in fetal tissues were sufficient for therapeutic effects . The penetration of ceftriaxone into milk was studied 3 days postpartum in 20 other patients . This antimicrobial agent entered breast milk rapidly and disappeared with a half-life of 12 to 17 h . The concentrations achieved were only 3 to 4% of those in maternal serum and were most likely of little clinical relevance. Pathol Biol (Paris), 1983 Jun, 31(6), 501 - 3 {Comparative in vitro effect of 7 quinolones on Ureaplasma urealyticum}; Cantet P et al.; Some new quinolones may be used for the treatment of gonococcal urethritis . U . urealyticum is considered as a potential agent of urethritis . This report describes the in vitro antimicrobial activity of seven quinolones against 45 clinical isolates of U . urealyticum . The MIC's geometric mean is (microgram/ml): rosoxacin (1,74), pefloxacin (4,6), oxolinic acid (9), flumequin (12,12), norfloxacin (15,75), nalidixic acid (27) . Pipemidic acid is constantly inactive (greater than 128 micrograms/ml) . The results of these susceptibility studies provide support for undertaking clinical evaluations of new quinolones against infections with U . urealyticum. J Exp Med, 1983 Jun 1, 157(6), 1780 - 93 Interferonlike factors from antigen- and mitogen-stimulated human leukocytes with antirickettsial and cytolytic actions on Rickettsia prowazekii . Infected human endothelial cells, fibroblasts, and macrophages; Wisseman CL Jr et al.; Unique features of the primary site of rickettsial replication in typhus fevers, i.e., within the endothelial cells of small blood vessels in tissues, suggest that effector mechanisms, other than those dependent on phagocytosis by activated macrophages with enhanced microbicidal properties, most likely are necessary to explain the cell-mediated immune control of intracellular rickettsial replication in these sites . Theoretically, such mechanisms might involve contact between infected endothelial cells and activated T lymphocyte subpopulations or macrophages or immunologically induced soluble factors or lymphokines . Support for the existence of at least one of these alternative effector mechanisms is presented here for Rickettsia prowazekii . Cultures of human blood leukocytes, upon immunologically specific stimulation with R . prowazekii antigen or nonspecific stimulation with the mitogen phytohemagglutinin, produce soluble factor(s) in the supernatant fluid which, in culture, have (a) an intracellular antirickettsial action on R . prowazekii-infected human endothelial cells, fibroblasts, and macrophages, and (b) a specific cytolytic action on R . prowazekii-infected, but not uninfected bystander, human fibroblasts . Neither action is demonstrable in R . prowazekii-infected chicken embryo fibroblasts . The factor(s) has no direct antimicrobial action on extracellular rickettsiae and is inactivated by heating at 56 degree C for 1 h or by acid treatment at pH 2 . Expression of the antirickettsial action requires new host cell messenger transcription and protein synthesis, whereas the cytolytic action does not . The circumstances of production and action and the properties of the factor(s) responsible for the intracellular antirickettsial, and perhaps also the cytolytic action are consistent with those of immune interferon (IFN-gamma). Hosp Formul, 1983 Jun, 18(6), 625 - 8, 631-5, 638 Drug usage in newborn intensive care units; Russell WL et al.; A national survey of neonatal intensive care units (NICUs) was undertaken to obtain information concerning drug usage, dosages, methods of administration, incidence of drug-induced phlebitis, and drug reference sources . Antimicrobial agents are the most frequently used drugs in NICUs . Dosages reported by NICUs generally agreed with dosage recommendations by the manufacturer and literature citations . A 10% estimate of phlebitis was the consensus report by NICUs . Calcium gluconate was implicated most often as causing phlebitis, and most NICUs reported that drugs are not mixed with hyperalimentation solutions . The Pharmacy and Therapeutic Committee should review drug dosages in neonates and establish policies for intravenous drug administration methods and rates to ensure uniform initial doses and to provide a consensus among clinicians using these medications. Acta Chir Belg, 1983 May-Jun, 82(3), 222 - 6 {Appendicitis in children}; Hoekman P et al.; In 218 children of less than 16 years old appendectomy was performed . Presence of appendicitis was confirmed histologically in 199 cases . The ratio boys to girls was two to one . In one third the appendix had perforated . Administration of a combined Ampicillin-Metronidazole antimicrobial therapy, started during surgery, proved to be very efficacious in avoiding infectious complications . In this group the complication rate remained below 3%. J Antimicrob Chemother, 1983 May, 11(5), 413 - 8 Susceptibility of Chlamydia psittaci (ovis) to antimicrobial agents; Johnson FW et al.; Minimum inhibitory (MIC) and minimal lethal (MLC) concentrations of 30 antimicrobial agents were determined for field strains and for the A22 EAE vaccine strain of Chlamydia psittaci (ovis) . No differences in susceptibility could be detected between strains . The antimicrobials could be divided into four groups . Group A had no effect on growth and development, Group B were bacteriostatic at concentrations in excess of 100 mg/l, Group C were bacteriostatic at concentrations of 10 mg/l or less but were bactericidal at concentrations above 10 mg/l and Group D were bactericidal at concentrations above 0.5 mg/l . The value of antimicrobials in aiding diagnosis and in the therapy of chlamydial abortion of ewes is discussed. Contact Dermatitis, 1983 May, 9(3), 186 - 9 Is Cytox 3522 (10% methylene-bis-thiocyanate) a human skin sensitizer? Andersen KE, Hamann K. Methylene-bis-thiocyanate is an antimicrobial agent in Cytox 3522 (American Cyanamid Corporation) and Nalco 206 (Nalco Chemical Company) . Both are wide-spectrum industrial biocides . Cytox 3522 showed a strong sensitization potential in guineau pigs using the Guinea Pig Maximization Test and the Open Epicutaneous Test procedures . In spite of this, human sensitization has not been reported . This may be explained by several factors such as limited exposure, low-use concentration and a lack of diagnostic patch tests in selected patients. Am J Pathol, 1983 May, 111(2), 224 - 33 Clinical and pathologic features of cyclic hematopoiesis in grey collie dogs; DiGiacomo RF et al.; Clinical and pathologic features of cyclic hematopoiesis in 18 grey collie dogs, aged 10 to 113 weeks, were reviewed . The dogs were grouped according to weeks of age: 10-16 (I), 17-21 (II), 30-35 (III), and less than 52 (IV) . Clinical illness occurring during each hematopoietic cycle was classified as none, mild, moderate, or severe, based on the neutrophil count, rectal temperature, clinical signs, and use of antimicrobial therapy . The dogs in Groups I, III, and IV had severe infections episodes during one-fourth of all hematopoietic cycles; whereas the dogs in Group II had severe infections during two-thirds of cycles . However, during the cycle prior to death, all groups were similar, each having two-thirds of clinical syndromes classified as severe and one-third as mild . More dogs died during the neutropenic phase of the hematopoietic cycle than during the nonneutropenic phase . Pathologic findings showed distinct patterns in relation to age . Younger dogs showed evidence of acute infectious processes, especially in the lungs, gastrointestinal tract, and kidneys; whereas older dogs had chronic inflammatory changes in those organs . Amyloidosis was a prominent finding in dogs over 30 weeks of age . These findings indicate that predictable age-related changes in tissues of grey collie dogs impair various organ systems and thereby contribute to morbidity and mortality in older dogs . consequently, future clinical and pathologic studies of grey collies should take into consideration the age of the dogs under study. J Med Microbiol, 1983 May, 16(2), 175 - 82 Characteristics of motile curved rods in vaginal secretions; Sprott MS et al.; Motile curved rods seen in vaginal secretions have been isolated on Columbia agar supplemented with 5% human blood and vitamin K . Growth occurred anaerobically and in 5% oxygen but not in more aerobic conditions . There were two distinct groups of these organisms, distinguishable by morphology, biochemical activity and susceptibility to metronidazole . All isolates were sensitive to a wide range of antimicrobial agents, with the exception of nalidixic acid and polymyxin, but one group was resistant to metronidazole . There was little difference between the results of tests of susceptibility to aminoglycosides or to metronidazole performed in anaerobic and microaerophilic conditions . Motile curved rods were isolated from 18 of 80 patients with a clinical diagnosis of non-specific vaginitis, but from only two of 39 without the disease. Pathol Biol (Paris), 1983 May, 31(5), 370 - 4 {Focus and value of the assay of 5 beta-lactams using high-performance liquid chromatography}; Jehl F et al.; Severe infectious diseases treatment often needs a frequent antimicrobial agent blood levels control . These controls are still performed by microbiological assay procedure . High performance liquid chromatography (HPLC) is now allowing a new kind of assay procedure and improves on speed, specificity and sensitivity . We developed a procedure allowing us to monitor every day by routine, five beta-lactam antibiotics with only one analytical column: benzylpenicillin, ampicillin, cloxacillin, mezlocillin and cefotaxime . A single extraction procedure suitable to the five beta-lactam antibiotics and to various body fluids and the use of three mobile phases, permit us to give a quick answer to the clinicians and thus to consider a rapid adaptation of the doses being administered . In consideration of the specificity, it is possible to control blood levels of each beta-lactam antibiotic even by associated antimicrobial treatment, what is sometimes impossible using the microbiological assay procedure . Cefotaxime is well separated from its active metabolite desacetyl-cefotaxime . The disparity of the levels obtained, for the same posology, essentially by prematures and new-borns, but also in case of massive infusions for endocarditis justify the use of a rapid and specific procedure like high performance liquid chromatography (HPLC). Experientia, 1983 Apr 15, 39(4), 386 - 7 Peroxidase activity and thiocyanate accumulation in salivary glands; Bratt P et al.; Salivary glands with high, low, or no peroxidase activity do not differ in {S14CN-} after the i.v . injection of KS14CN, nor do the glands differ from blood and muscle in {S14CN-} . The content of SCN- in a salivary gland does not mirror the gland's participation in the peroxidase-mediated antimicrobial mechanism. Clin Obstet Gynaecol, 1983 Apr, 10(1), 93 - 103 Pathophysiology of abscess formation; Bieluch VM et al.; Clinical and experimental data provide evidence for interactions between aerobic and anaerobic organisms in abscess formation . The organisms present represent a subset of those normally found at nearby mucosal surfaces . Certain organisms, most notably B . fragilis, emerge from the normal flora as important in abscess formation . Suspected virulence factors for B . fragilis include oxygen tolerance, capsular polysaccharide and the other enzymes produced by this organism . Other factors, as yet incompletely understood, probably play a role . In addition, the large number of organisms present in an abscess, the presence of antibiotic inactivating enzymes, the hostility of the anaerobic environment to antimicrobial activity and host defences, as well as the fibrous capsule surrounding an abscess, contribute to the persistence of infection despite antibiotic therapy and the need for drainage . The contribution of both aerobic and anaerobic organisms in the formation of abscesses must be remembered when one chooses antibiotic therapy for such infections. Antimicrob Agents Chemother, 1983 Apr, 23(4), 531 - 5 Relationship between structure and antiplaque and antimicrobial activities for a series of bispyridines; Slee AM et al.; A series of bispyridines were examined for their bactericidal activities against in vitro, preformed, pure-culture plaques of selected oral plaque-forming bacteria . The antimicrobial activities of these agents were examined in relation to their molecular configurations . These studies demonstrated that the length of the interpyridine polymethylene group bridge and the length of the alkyl side chain were important determinants of antiplaque and antimicrobial efficacy . The most potent compounds of the bispyridine series were studied to determine the minimal conditions (concentration, duration, and frequency) of treatment required for likely clinical efficacy. J Infect Dis, 1983 Apr, 147(4), 615 - 23 Selective antimicrobial modulation of the intestinal flora of patients with acute nonlymphocytic leukemia: a double-blind, placebo-controlled study; Guiot HF et al.; Thirty-three patients with acute nonlymphocytic leukemia were studied during remission-induction treatment in a double-blind, placebo-controlled, randomized study to ascertain the effect on the incidence of infection of an oral regimen of selective antimicrobial modulation (SAM) . A decrease in the number of major acquired infections was observed: three infections occurred in 16 patients receiving the SAM regimen compared with eight infections in 17 patients given the placebo . The reduction of infection was correlated with a reduction of fever, with a reduction of the frequency of administration of antimicrobial agents for the treatment of infection, and with the selective elimination of aerobic and facultative anaerobic gram-negative rods from the digestive tract . Substantial unfavorable side effects were not observed. Mayo Clin Proc, 1983 Apr, 58(4), 246 - 8 Antimicrobial agents in patients with renal insufficiency; Van Scoy RE et al.; The dosage or the time interval of administration (or both) of many antimicrobial agents must be adjusted in anephric patients or those with compromised renal function . Antimicrobial agents that must be adjusted include most but not all of the penicillins, the cephalosporins, the aminoglycosides, vancomycin, and trimethoprim-sulfamethoxazole . The maximal doses of these agents should be decreased in proportion to the reduction of renal function . The dosage of chloramphenicol, clindamycin, rifampin, oxacillin, and nafcillin probably need not be adjusted if hepatic function is essentially normal . The suggested doses are relatively crude guidelines to initial antimicrobial therapy . Administration of the initial dose should be followed by serum antimicrobial assays for accurate adjustment of the dosage . The efficacy of therapy and the possible occurrence of toxicity should be carefully monitored in all patients but particularly in those with renal insufficiency. Mayo Clin Proc, 1983 Apr, 58(4), 241 - 5 Prophylactic use of antimicrobial agents; Van Scoy RE et al.; A major shortcoming in many studies of prophylactic antimicrobial agents has been lack of adequate evaluation of potential advantages and disadvantages in prospective double-blind investigations . Recent data demonstrated that certain bowel preparations given orally and antimicrobial agents applied topically or given parenterally prevent postoperative infections . Several studies have shown that if topically and parenterally administered antimicrobial agents are used, they should be given only during the surgical procedure . Antimicrobial therapy initiated after an operation is generally not indicated for prophylaxis and, in fact, increases the potential disadvantages of prophylaxis . There is no evidence that combinations of orally, topically, and parenterally administered antimicrobial agents reduce infection rates below those achieved by the use of any one route of prophylactic antimicrobial administration. J Infect Dis, 1983 Apr, 147(4), 758 - 64 Spectrophotometric assessment of dose-response curves for single antimicrobial agents and antimicrobial combinations; King TC et al.; The activity of single antimicrobial agents and antimicrobial combinations was examined by measuring their effects on the growth rate constant of a test strain of Escherichia coli . This spectrophotometric method provides a kinetic view of antimicrobial action and is sufficiently precise to define dose-response curves, in contrast to standard methods such as broth or agar dilution testing, which are static and measure only all-or-none responses . The results demonstrate that dose-response curves for single antimicrobial agents are logarithmic (rather than linear) and that the effects of antimicrobial combinations may be exquisitely concentration dependent . Although the results for some antimicrobial combinations were similar with the spectrophotometric and checkerboard methods, other combinations produced different results in the two systems . Additional studies will be necessary to determine whether one or the other of these methods more accurately predicts clinical outcome. J Hyg (Lond), 1983 Apr, 90(2), 195 - 8 Drug resistance among Escherichia coli strains isolated from cerebrospinal fluid; Gross RJ et al.; One hundred and thirty-one strains of Escherichia coli isolated from the cerebrospinal fluid of patients in the United Kingdom were tested for resistance to 13 antimicrobial drugs . Sixty-four strains (49%) were resistant to one or more drugs and 44 (34%) were resistant to three or more drugs . Resistance to ampicillin, sulphonamides, streptomycin and tetracycline occurred most frequently. Can J Comp Med, 1983 Apr, 47(2), 101 - 7 A mail survey of factors associated with morbidity and mortality in feedlot calves in southwestern Ontario; Hutchings DL et al.; The design and results of a mail survey of a simple random sample of southwestern Ontario feedlot owners are presented . The survey provided general data about management of feedlot calves and the association between a number of factors and disease and/or death rates . The number of calves purchased was related positively, in a linear manner, to mortality and morbidity rates . Increased levels of morbidity and mortality were noted when the ration was changed to corn silage from dry-hay within the first month after arrival . However, it was not clear whether the ration changes preceded or followed increased rates of morbidity and mortality . Prophylactic levels of antimicrobials in the water supply were associated with increased death losses . Shipping cattle by truck, rather than train, was associated with decreased rates of disease . Processing factors, including using vaccines against respiratory disease, were not associated significantly with mortality or morbidity . It was concluded that reducing the number of calves, to approximately 100 per group, not changing the ration to silage within the first month and not using antibiotics in the water supply on arrival could significantly reduce disease and death losses. Pharmazie, 1983 Mar, 38(3), 172 - 3 Syntheses of some 4,4'-biphenylenedihydrazone-3-(3-methyl)-2-pyrazolin-4,5-dione derivatives and their antimicrobial potentialities; Metwally MA et al.; A new series of bispyrazolones were obtained upon treating the bishydrazone derivative 1 with dimethylsulphate, acetic anhydride, benzenesulphonyl chloride, piperidine, morpholine, N-methylaniline and formaldehyde respectively . A Mannich base was prepared from the interaction of 4-phenylhydrazone-3-methyl-2-pyrazolin-5-one and n-butylamine . The condensation of an N-hydroxy methyl derivative with ethyl acetoacetate and diethyl malonate led to the formation of the corresponding N-methyl derivatives . Some of the new bispyrazolones were screened to test their antimicrobial potentialities against Fusarium oxysporum fsp . hycopersici. Farmaco {Sci}, 1983 Mar, 28(3), 167 - 72 {Hydrazines containing 1H-indene units}; Ferranti A et al.; Some derivatives of N'-(5-nitro-2-furoyl)-N2-(3-chloro-1H-indenyl-2-methylene)hydrazine (I) were synthesized and screened for in vitro antimicrobial activity . None was more active than the parent compound and the greater hydrophilic character was associated with loss of inhibitory activity against gram-negative bacteria. Antimicrob Agents Chemother, 1983 Mar, 23(3), 440 - 9 Inhibition of lysosomal phospholipases by aminoglycoside antibiotics: in vitro comparative studies; Carlier MB et al.; Aminoglycoside antibiotics induce an early and characteristic lysosomal phospholipidosis in cultured fibroblasts and in kidney tubular cells . We have recently demonstrated an inhibition of lysosomal phospholipases A1 and A2 by gentamicin and amikacin in vitro . In vivo, gentamicin decreases the activity of phospholipase A1 (Laurent et al., Biochem . Pharmacol . 31:3861-3870, 1982) . In the present study, we examined 14 aminoglycosides for in vitro inhibition of phospholipases . To mimic the situation prevailing in lysosomes, the enzymatic activities were assayed with phospholipid vesicles (liposomes) with a composition similar to that of lysosomal phospholipids (phosphatidylcholine, sphingomyelin, phosphatidylinositol, cholesterol; 4:4:3:5.5, molar ratio) . We measured the hydrolysis of 1-palmitoyl-2-{1-14C}oleoyl phosphatidylcholine contained in the liposomes by a soluble fraction of highly purified lysosomes isolated from rat liver . Similar IC50S (concentrations causing 50% inhibition of enzymatic activity) were observed for dibekacin, gentamicin (with no major difference between C1, C1a, or C2), netilmicin, tobramycin, and kanamycin B . Sisomicin was slightly more inhibitory . Kanamycin A, N1-(L-4-amino-2-hydroxy-1-oxobutyl)dibekacin, and amikacin showed increasing IC50S . Streptomycin caused the least inhibition . Octa- and tetramethylkanamycin A are much less inhibitory than the parent drug . These results point to the number, the nature, and the respective positions of the cationic groups as essential determinants in causing inhibition of phospholipid breakdown . The binding of three aminoglycosides (gentamicin, amikacin, streptomycin) to the liposomes at pH 5.4 was also measured by gel permeation and was found to be related to the respective inhibitory potency of each drug . Insofar as lysosomal phospholipidosis is an early sign of intoxication by aminoglycosides, these results may serve as a basis for the development or screening of less toxic compounds in this class of antimicrobial agents. Rev Infect Dis, 1983 Mar-Apr, 5 Suppl 1, S98 - 104 Selection of antimicrobial agents for treatment of infections of the female genital tract; Ledger WJ; Evaluation of the treatment of 501 patients with pelvic infections and a review of the literature indicate that prospects for clinical cure without surgical intervention are markedly better in women seen early in the course of infection than in those with well-established infections . Among hospitalized patients with early infections, treatment regimens of less than 10 days duration were successful . Traditional therapies (initial treatment with ampicillin, a first-generation cephalosporin, or a combination of penicillin and aminoglycoside, penicillin and tetracycline, or a cephalosporin and an aminoglycoside, followed by clindamycin or chloramphenicol if the patient remained febrile) were compared with new antibiotic regimens (initial treatment with second- or third-generation cephalosporins) . Among patients with an infected abortion, the results of treatment with traditional regimens were excellent . In patients with salpingo-oophoritis, the immediate cure rates with second- and third-generation cephalosporins were better than those with traditional regimens, but the long-term impact of these drugs on fallopian tube patency is not known . In women with postpartum endomyometritis following cesarean section, double-drug therapy with clindamycin and either gentamicin or ampicillin and single-drug therapy with a second- and third-generation cephalosporin were more effective than traditional therapy. J Pharm Sci, 1983 Mar, 72(3), 221 - 4 Determination of antimicrobial preservatives in pharmaceutical formulations using reverse-phase liquid chromatography; Radus TP et al.; A specific stability-indicating reverse-phase high-performance liquid chromatographic analytical method has been developed to quantitate the antimicrobial preservatives methylparaben, propylparaben, butylparaben, sorbic acid, and benzoic acid in a series of typical pharmaceutical formulations . The mobile phase of this system is a water-acetonitrile mixture, modified by various acids and buffers . The proportions of water and acetonitrile as well as the type and amounts of modifiers are varied in order to achieve optimum chromatography . This method has been used successfully to quantitate preservatives in solutions, suspensions, creams, lotions, and ointments, and can be readily adapted to routine automated assays, either for routine product evaluation or stability programs. Surg Gynecol Obstet, 1983 Mar, 156(3), 351 - 4 Intravenous prophylactic antimicrobial drugs in elective colorectal operations; Bell GA et al.; In a prospective, randomized, double blind study of 123 patients undergoing elective colorectal surgery, 61 received intravenously erythromycin gluceptate, and 62 received intravenously metronidazole perioperatively together with tobramycin . Three dosages of each drug were given . Eight patients in each treatment group had wound infections . Of these, only three in each treatment group were severe enough to require antibiotic therapy and to cause prolongation of hospitalization . Antibiotic levels in the serums of patients, in skin samples and in intestinal walls showed that metronidazole was most frequently detected at satisfactory concentrations in serum and that skin and the intestinal wall did not contain any detectable antibiotic. J Bacteriol, 1983 Mar, 153(3), 1294 - 300 Mycobacteriocins produced by rapidly growing mycobacteria are Tween-hydrolyzing esterases; Saito H et al.; Smegmatocin, a protein produced by Mycobacterium smegmatis ATCC 14468, was found to have an esterase activity, hydrolyzing Tween 80, polyoxyethylene sorbitan monooleate, added to the assay medium for various "bacteriocins" from mycobacteria . Because M . diernhoferi ATCC 19340 (indicator strain for smegmatocin) is highly susceptible to oleic acid and smegmatocin requires Tween 80 for manifestation of its anti-M . diernhoferi activity, it is likely that smegmatocin-mediated antimicrobial action is caused by oleic acid generated by hydrolysis of Tween 80 by the inherent esterase action of smegmatocin . Other mycobacteriocins from rapidly growing mycobacteria also have inherent esterase activity against Tween 80 and require Tween 80 for expression of antimycobacterial action . Smegmatocin was found to hydrolyze various polyoxyethylene (sorbitan) fatty acyl esters but not sorbitan monooleate and glyceryl esters. Diagn Microbiol Infect Dis, 1983 Mar, 1(1), 41 - 7 Considerations about the relationship of inhibitory concentrations and the pharmacologic and toxic properties of antimicrobial agents; Neu HC; Too little attention has been given to the correlation of antimicrobial susceptibility tests and the pharmacokinetics of antimicrobial agents . Ability to perform and provide reproducible, rapid, minimal inhibitory concentration data, combined with the knowledge of serum levels, can be used to yield inhibitory quotients which will improve the chemotherapy of serious infections . Antimicrobial susceptibilities have to be provided rapidly for the life-threatening infections that occur in certain clinical settings . Antimicrobial susceptibilities also must be provided in a manner that demonstrates that one may not be able to achieve therapeutic concentrations with certain drugs . We have reached an era in which knowledge of an organism being susceptible or resistant is no longer adequate. Antimicrob Agents Chemother, 1983 Mar, 23(3), 500 - 2 Scarring as a factor affecting the eradication of microorganisms from the kidney in pyelonephritis; Miller T; The inability of antimicrobial agents to penetrate scarred renal tissue may explain some therapeutic failures . We examined the effect of scarring on antimicrobial therapy by using a unique animal model in which both kidneys were infected to the same degree but only one kidney was scarred . Scar formation could not explain the failure of ampicillin or nitrofurantoin to eradicate renal infection, but co-trimoxazole was less effective in the presence of tissue damage and scar formation than in their absence. Diagn Microbiol Infect Dis, 1983 Mar, 1(1), 25 - 31 Discrepancies between in vitro activity of and in vivo response to antimicrobial agents; Washington JA 2nd; The correlation between in vitro antimicrobial activity and t