Langenbecks Arch Chir, 1981, 353(4), 233 - 40 {Parenteral antibiotic prophylaxis or oral antimicrobial bowel preparation for colorectal surgery (author's transl)}; Aeberhard P et al.; A prospective randomized trial was designed to establish whether parenteral antibiotic prophylaxis was as effective as oral antimicrobial bowel preparation in preventing sepsis after colorectal surgery . Patients scheduled for elective resection of colorectal cancer received metronidazole and kanamycin either orally in the preoperative phase or parenterally as a short-term perioperative prophylaxis . The former regimen resulted in reduction of the microbial concentrations in the bowel contents in the absence of therapeutic serum concentrations at the time of operation, whereas the latter achieved therapeutic intraoperative serum levels without altering the colonic microflora . 72 patients were studied . There was no significant difference in the occurrence of postoperative sepsis between the two groups (a total of 72 patients) . These results differ from those obtained at the Birmingham General Hospital using the same protocol, in which postoperative sepsis was significantly more common in the group of patients having oral bowel preparation . This difference was most probably due to an overgrowth of kanamycin-resistant coliforms during the period of oral antibiotic preparation . The presence of resistant organisms did not, however, result in failure of systemic prophylaxis . The authors conclude that short-term parenteral application is the safer method of antibiotic prophylaxis in colorectal surgery and is to be preferred to oral antimicrobial bowel preparation. Methods Find Exp Clin Pharmacol, 1981 Jan-Feb, 3(1), 29 - 32 Evaluation of cephradine-chemoprophylaxis in Cesarean section; Papaloucas A et al.; The clinical efficacy of the prophylactic use of cephradine was evaluated prospectively in 118 women who underwent cesarean section . The patients of the cephradine group had a significantly lower (p less than 0.01) postoperative morbidity rate (17.79%) as compared with the control group (51.06%) . The mean hospitalization time was also significantly shorter (p less than 0.01) in the cephradine group (7.2 +/- 0.13) than in the control group (10.9 +/- 0.23) . Cephradine was proved to be an effective antimicrobial agent for chemoprophylaxis, due to its wide antimicrobial spectrum, beta-lactamase resistance, low percentage protein binding, large volume of distribution and non metabolic degradation. Appl Environ Microbiol, 1981 Jan, 41(1), 233 - 6 Susceptibility of Legionella pneumophila to three cooling tower microbicides; Grace RD et al.; Investigation of epidemic outbreaks of Legionnaires disease by Center for Disease Control personnel has resulted in the isolation of Legionella pneumophila from water in the air-conditioning cooling towers or evaporative condensers at the site of the outbreak . It is suspected that improperly maintained open, recirculating water systems may play a role in the growth and dissemination of this pathogen . The objective of this study was to determine the antimicrobial activity of three chemically different, commercially available, cooling tower microbicides against L . pneumophila . Using two in vitro test systems, a combination of N-alkyl dimethyl benzyl ammonium chloride and bis (tri-n-butyltin) oxide was found to kill L . pneumophila at a concentration 25 times less than the minimum recommended use concentration, whereas N-alkyl 1,3-propanediamine and methylene bis (thiocyanate) were active at concentrations equal to or greater than the concentrations recommended for use by the manufacturer. Rev Infect Dis, 1981 Jan-Feb, 3(1), 19 - 27 Kinetics of antimicrobial action; Mattie H; To better quantify the relative antibacterial activity of beta-lactam antibiotics in vitro, mathematical descriptions of bacterial growth were developed . Growth curves for the initial 2-to 4-hr period of exposure to antibiotic can be expressed as quadratic functions of time . Moreover, the rate of change of growth (a) shows a linear dependence on the logarithm of the antibiotic concentration . For some drug-organism interactions, the initial growth rate (k0) is also a concentration-dependent variable . This mathematical quantitation of the antibacterial action of a drug in vitro covers a range of concentrations above and below its minimal inhibitory concentration . The slope of the regression line of a on log concentration may vary for different microorganisms and antibiotics . However, several analogues yield parallel concentration-effect slopes, a circumstance allowing for the calculation of potency ratios . Two murine models were used to determine if these in vitro studies could predict activity in vivo . The relative efficacy in vivo also was expressed as a potency ratio, which was measured in terms of the number of bacteria in either homogenized kidney after intravenous challenge or an infected thigh muscle . For drugs with similar pharmacokinetics, the potency in vivo could be predicted from the value in vitro . However, for drugs with concentration curves in serum of different shapes, the potency in vivo varied from the value in vitro . A more prolonged course of drug in serum, which yielded a flatter concentration curve, appeared to be associated with greater activity in vivo. Rev Infect Dis, 1981 Jan-Feb, 3(1), 125 - 31 Pharmacokinetics of ampicillin in serum and in dermal suction blisters after oral administration of bacampicillin; Schreiner A et al.; After oral administration of 0.8 g of bacampicillin, the median concentration of ampicillin in serum peaked at 1-2 hr and reached 8.4 and 12.3 micrograms/ml in two groups of 13 and four healthy volunteers, respectively . In the fluid of dermal blisters produced by suction, the peak values were 2.6 and 2.7 micrograms/ml, respectively . After oral administration of 1.6 g of bacampicillin to four healthy individuals, the median peak concentrations were 15.5 micrograms/ml in serum and 3.8 micrograms/ml in blister fluid . The rate of penetration of ampicillin into the blister fluid was lower than the rate of gastrointestinal absorption of bacampicillin, and the elimination of ampicillin from the blister fluid was slower than from serum; the half-life in blister fluid was approximately twice that in serum . Concentrations of ampicillin in the blister fluid exceeded those in serum at greater than or equal to 3 hr . Concentrations of less than 0.7 micrograms/ml were observed in blister fluid 11 hr after administration of the dose . The bioavailability of ampicillin was relatively greater after a 1.6-g dose of bacampicillin than after a 0.8-g dose . Inflammation in the blister fluid that was induced by endotoxin, which provoked a strong cellular response but cased no increase in the concentration of protein in the fluid, did not significantly influence the pharmacokinetics of ampicillin . The results suggest that the pharmacokinetics of antimicrobial agents in serum and in extravascular foci may be relevant to the setting of breakpoints between sensitivity and resistance of pathogens of antimicrobial agents. Hum Pathol, 1981 Jan, 12(1), 16 - 22 Toxic shock syndrome: clinicopathologic findings in a fatal case; Abdul-Karim FW et al.; A 15 year old girl presented with a painful desquamative rash, fever, and profound hypotension . Despite antimicrobial therapy and intensive supportive measures, she died 80 hours after admission . The premortem skin biopsy and autopsy findings, which included subepidermal edema and blister formation, subacute vasculitis, and striking interstitial edema involving several organs, are consistent with a toxin mediated process . Current knowledge of the pathogenesis of the toxic shock syndrome and its differential diagnosis are discussed in light of the clinicopathologic findings in this case. Arzneimittelforschung, 1981, 31(12), 2123 - 6 New alpha-aryl-beta,N-imidzolylethyl benzyl and naphthylmethyl ethers with antimycotic and antibacterial activity; Nardi D et al.; A new series of alpha-aryl-beta,N-imidazolylethyl benzyl and naphthylmethyl ethers was synthesized and tested for antimycotic and antimicrobial activity . All compounds showed antifungal activity; most of them were also active against gram-positive bacteria, whereas no activity was detected against gram-negative bacteria . Structure-activity relationships are discussed . The alpha-(2,4-dichlorophenyl)-beta,N-imidazolylethyl 4-phenylthiobenzyl ether nitrate (8), which showed good skin tolerability and in vivo antimycotic activity comparable with or better than 1-{2,4-dichloro-beta-(2,4-dichlorobenzyloxy)phenethyl}imidazole (miconazole) and 1-(alpha-(o-chlorophenyl)benzhydryl}imidazole (clotrimazole), was selected for further researches. Arzneimittelforschung, 1981, 31(8A), 1311 - 6 {The chemistry of antimicrobially active 1-hydroxy-2-pyridones (author's transl)}; Lohaus G et al.; The unsaturated delta-keto esters (3) obtained by condensation of acid chlorides with esters of di- or trialkyl-acrylic acids can be cyclized with hydroxylamine to yield 1-hydroxy-2-pyridones (4) . However, in many cases a two-steps synthesis may be of advantage in preparative respect, the ketoesters being cyclized to 2-pyrones (7), which then are reacted with hydroxylamine in the presence of certain bases to give 4 . The hydroxy-pyridones show pronounced antifungal activity in vitro as well as in experimental guinea pig dermatophytosis. Arzneimittelforschung, 1981, 31(5), 828 - 30 Influence of biological fluids on the release of 125I from povidone-iodine; Abdullah ME et al.; A study on the influence of vaginal smear, blood cells and human plasma on the release of 125I from povidone-iodine was conducted . The total amounts of iodine released from povidone-iodine in presence of saliva and vaginal smear are 9.51% and 5.99%, respectively, as compared to 5.9 in normal saline solution . Blood cells and plasma were found to take up 54.2 and 80.1% of iodine released from povidone-iodine . The possible effect of these fluids on the antimicrobial activity of povidone-iodine is discussed. J Int Med Res, 1981, 9(4), 277 - 82 The use of antimicrobials in the mouth; Cannell JS; The use of antimicrobials in the mouth, particularly in the form of antiseptic mouth-washes, is widely practised . The purposes for which such treatment is used are very diverse and reports are widely scattered throughout the literature . It is the purpose of this review to bring together diverse literature references and to present a short but comprehensive survey of the subject. Prog Clin Biol Res, 1981, 54, 209 - 18 Pharmacological control of inflammatory connective tissue diseases; Lorenzen I; The primary cause of the most common inflammatory rheumatic diseases in unknown . Microbial infection combined with an increased susceptibility due to genetically determined alterations in the immune system is probably of importance . Non-specific processes of inflammation and repair are the immediate causes of the clinical symptoms, and anti-inflammatory therapy is at present the corner stone in the control of these diseases . The highest priority in research should be given to drugs, which in controlled clinical trials have demonstrated ability to cause remission of disease activity . Important examples are D-penicillamine, glucocorticoids and the cytostatic drugs . The effects of these drugs on the metabolism of proteoglycans and collagen in granulation tissue and normal connective tissue may explain some of the beneficial effects, but also some of the side effects . Rational pharmacotherapy in the inflammatory rheumatic diseases may be a combination of anti-inflammatory drugs with immunotherapy and possibly antimicrobial therapy. Rev Infect Dis, 1981 Jan-Feb, 3(1), 12 - 8 Current practices in antimicrobial dosing; Neu HC; There has been minimal utilization of pharmacologic principles in the establishment of treatment programs for many infectious diseases . Drugs with markedly different half-lives and peak levels in serum have been prescribed at the same dosage intervals . No attempt has been made to determine if the efficacy of dosing programs in which levels in serum that exceed bactericidal levels are achieved but in which doses are administered infrequently is greater than or equal to that of current programs . Double-blind studies of therapeutic programs in which drugs with different pharmacokinetic properties are compared are the only means of eliminating the current confusion regarding dosing practices. Clin Toxicol, 1981 Jan, 18(1), 41 - 5 Clinical toxicology of clotrimazole when administered vaginally; Wolfson N et al.; Clotrimazole, a tritylimidazole and a new antimicrobial agent, produced itching and irritation of the vulva and vaginal area in less than 1% of the population (N = 131) studied . No abdominal cramps, headache or lightheadedness, nausea, vomiting, and diarrhea were observed when 200 mg of clotrimazole was inserted deep in the vagina for several days. Vet Med Nauki, 1981, 18(4), 85 - 93 {Preclinical studies of Pharmachem's teravit}; Dilov P et al.; Studied was the preparation Teravit Pharmachim in terms of its physical and chemical properties, antimicrobial activity, resorption, retention, and distribution, within the body of chickens and albino rats . It was found that Teravit Pharmachim was strongly sensitive to light, slightly hygroscopic, and relatively heat resistant . It showed good antimicrobial activity with regard to both Gram-positive and Gram-negative organisms . At 60-day feed application to albino rats at the rates of 30 and 300 mg/kg it stimulate the growth of test animals, and at the rate of 1500 mg/kg it delayed their development but did not produce negative effects on the red and white blood picture . Teravit Pharmachim was shown to bind the proteins of the body liquids and tissues, which depended on the biologic substrate and the antibiotic concentration . At the single oral application (chickens) or the administration with feed in the course of 60 days (albino rats) Teravit Pharmachim was resorbed depending on the dose, was retained in the blood, and was further followed up in the internal organs . It was eliminated from the body for about 3 to 5 days, did not cumulate in the ovarian follicles, and was not excreted with the eggs. G Ital Cardiol, 1981, 11(5), 643 - 9 {Surgical treatment of infectious endocarditis in the active phase . Experience in 40 cases}; Scalia D et al.; Despite recent advances in antimicrobial therapy infective endocarditis (IE) still remains a major surgical problem . All patients undergoing surgical treatment for IE at our Institution since 1970 were reviewed; among these in 40 IE was considered to be active at time of operation . Thirty patients were males and 10 females, ranging in age from 11 to 66 years (average 41); indications for operation were heart failure in 31, mycotic emboli in 5, and sepsis in 4 . Nine were in NYHA functional class 11, 18 in NYHA class III, and 13 in class IV . Aortic valve replacement (AVR) was performed in 24 cases, mitral valve replacement (MVR) in 5 and multiple valve replacement (PVR) in 11 . Overall hospital mortality was 15% (4.2% in the AVR group, 40% in the MVR group, and 27% in the PVR group) . Postoperative follow-up was available in all survivors . Four patients died in the late postoperative period for not infective causes . Almost long-term survivors show, from 7 months to 10 years (average 58 months) postoperatively, a significant improvement . No complications related to the initial infective process were recorded . According to the results of the present study the following conclusions can be drawn: 1) active IE does not represent a contraindication to open heart surgery and prosthetic valve replacement; 2) the surgical results depend not only on the degree of cardiac failure, but mainly on its duration; 3) early surgical intervention affects favourably the prognosis, especially in cases of isolated aortic valve involvement; 4) the surgical management of IE removes the focus of infection. Mikrobiyol Bul, 1981, 15(3-4), 179 - 87 {Formulation studies of the wetting solutions for hard contact lenses . 1 . Microbiological studies}; Unlu N et al.; The purpose of this study was to develop hard contact lens wetting solutions which would contain suitable and sufficient antimicrobial agents for preventing contamination . In the first part of the formulation studies, microbiological methods were employed to determine the adequate antibacterial concentrations of benzalkonium chloride and disodium EDTA. Tokai J Exp Clin Med, 1981 Jan, 6(1), 23 - 33 Influence of medium and diluent pH and diffusion time on antibiotic bioassay; Yamada Y et al.; The effects of pH assay medium and diluents and of diffusion time on antibiotic bioassays were investigated to determine optimal assay conditions . Assays of penicillins, cephalosporins and macrolide derivatives were found to be little affected by the pH of the diluent, whereas the pH of the diluent exerted a noticeable influence on aminoglycoside assays, in which, therefore, it is essential to use a diluent at approximately p H 8.0 . The data obtained have also demonstrated that the assays of penicillins, cephalosporins, macrolide derivatives and aminoglycosides were influenced by the pH of the assay medium . It is important to carry out penicillin or cephalosporin assays on plates of medium adjusted to approximately pH 6.0 and macrolide derived or aminoglycoside assays on a medium which is adjusted to approximately pH 8.0 . The optimal duration of preculturing of assay plates for diffusion at 4 degree C after addition of the sample was determined to be 2 hours for the penicillins and cephalosporins . Diffusion of more than 2 hours was inadequate for assays of these antimicrobial agents . Diffusion times of less than 2 hours . For the macrolide derivatives and aminoglycosides, preculturing of 2 hours for diffusion at 4 degrees C was noted to be optimal, while preculturing for less than 2 hours proved inadequate . Diffusion times exceeding 2 hours had little effect on the assay of these antibiotics. J Clin Microbiol, 1981 Jan, 13(1), 76 - 9 Isolation of mycobacteria from undecontaminated specimens with selective 7H10 medium; Rothlauf MV et al.; Media containing antimicrobial agents have been formulated for use as an adjunct to the standard media in an effort to reduce contamination and improve isolation of mycobacteria from clinical specimens . Selective 7H10 (S7H10) was developed for use in the isolation of mycobacteria from undecontaminated material . During a 33-month period, 10,782 clinical specimens were cultured in parallel on S7H10 without decontamination and on 7H11 after treatment with 2% sodium hydroxide-N-acetyl-L-cysteine . Results of this study show the overall contamination rate to be threefold lower on S7H10 than on 7H11 (304 versus 1,000) . The number of specimens negative on NaOH-treated, 7H11-cultured specimens and contaminated on S7H10 was 282, whereas that negative on S7H10 but contaminated on NaOH-7H11 was 923 . There were 6 positive cultures missed due to contamination on S7H10, compared with 61 on 7H11 . Positive cultures on S7H10 outnumbered those on 7H11 by 106 . This evaluation of S7H10 shows that it can be used with undecontaminated specimens in conjunction with standard methods and media for isolation of mycobacteria from clinical specimens. J Biomed Mater Res, 1981 Jan, 15(1), 9 - 18 Gelatin-based sprayable foam as a skin substitute; Neumann PM et al.; Physical and antimicrobial properties of a newly developed gelatin based spray-on foam bandage for use on skin wounds have been evaluated . The aqueous foam is sprayed from aerosol containers and effectively covers and washes uneven wound surfaces . The foam dries to form an adherent and stable three-dimensional matrix which diminishes evaporative water losses . The foam possesses antimicrobial activity against gram-positive, gram-negative, and fungal contaminants. J Int Med Res, 1981, 9(6), 453 - 8 Comparative merits of two topical corticosteroid antimicrobial drugs; Barba-Rubio J et al.; The anti-inflammatory and antimicrobial activities of two topical creams, one containing halcinonide, neomycin and nystatin (HNN), and the other betamethasone valerate, gentamicin, iodochlorhydroxyquin and tolnaftate (BGI), were compared in a randomized, parallel study of 154 patients (eighty-seven secondarily infected eczematous dermatoses; sixty-seven cutaneous candidiasis) . Repeated clinical assessments showed that the two creams produced equivalent therapeutic responses both in patients with infected eczematous lesions and candidiasis . HNN and BGI creams eradicated the bacterial pathogens isolated prior to treatment in 80% and 76%, respectively, of the patients with eczematous dermatoses . The organism most frequently isolated in these patients was S . aureus . Local irritation prompting discontinuance of therapy occurred in just one patient receiving HNN, and two patients receiving BGI. Arzneimittelforschung, 1981, 31(7), 1157 - 62 {Pharmacokinetic studies on the penetration of azlocillin and mezlocillin into bone and tissue fluid (author's transl)}; Wittmann DH et al.; During and after hip replacement arthroplasty antimicrobial concentrations in serum, bone and tissue-fluid were determined microbiologically using agar diffusion assay technique after 15-min infusion of 5 g 6-{D-2-(2-oxoimidazolidine-1-carboxamido)-2-phenylacetamido} - penicillanic acid (azlocillin) and 5 g 6-{D-2-(3-methylsulfonyl-2-oxoimidazolin-1-ylcarboxamido)-2-phenylacetamido}-penicillanic acid (mezlocillin) and after i.v . bolus injection of 2 g mezlocillin . Serum pharmacokinetic data on the individual patients are computer derived using a modified open two-compartment model . The geometric mean of bone level determinations at defined intervals with deviation factor are presented . These results are related to the organic bone compartment and are expressed in mg/l . From the tissue fluid-concentration curve, peak concentration CP and its time were calculated . The time for which one-fourth of the peak concentration CP 1/4 was maintained in tissue fluid was determined graphically . This concentration is compared with the cumulative minimum inhibitory concentrations of representative bacteria causing bone and joint infections . These results are focused as criteria of valuation of antimicrobial chemotherapy. Adv Exp Med Biol, 1981, 135, 139 - 54 Antimicrobial properties of iron-binding proteins; Bezkorovainy A; The transferrins are iron-binding proteins with molecular weights of around 80,000, which interact with a maximum of two ferric atoms per each protein molecule . The best known transferrins are the serotransferrins from animal sera, lactoferrins from milk, and conalbumin from egg-white . The iron-deficient transferrins will inhibit the growth of certain bacteria and fungi by making iron unavailable for bacterial metabolism . Such activity is abolished if the transferrin is saturated with iron . Many organisms can produce small molecular-weight iron-binding compounds called siderophores that can successfully utilize the iron sequestered by the transferrins . Such organisms are very virulent . Overwhelming evidence is now available to indicate that the transferrins play an important role in mammalian host-defense mechanisms . Thus, iron injections into animals infected with virulent bacteria result in increased death rates, and parenteral iron administration to human infants predisposes them to fatal septicemia . On the other hand, in cases of systemic infection, the organism responds by lowering its total serum iron, so as to make the serotransferrin present less saturated with iron . This phenomenon is called nutritional immunity . The iron apparently moves into the storage tissues from the circulation, and furthermore, it is withheld from circulation by the reticuloendothelial system . Laboratory results in such cases indicate low total serum iron levels and high unsaturated iron-binding activity values, thus increasing the bacteriostatic effects of the serotransferrins . Increased lactoferrin levels are observed in the milks of mastitic cattle. Microbios, 1981, 30(120), 73 - 85 Antimicrobial activity of some alkyl esters of gallic acid (3,4,5,-trihydroxybenzoic acid) against Escherichia coli NCTC 5933 with particular reference to n-propyl gallate; Boyd L et al.; The growth inhibitory and bactericidal activities of eight alkyl esters of gallic acid towards Escherichia coli NCTC 5933 have been determined . A previously suggested role for gallic acid and its esters as shikimate antimetabolites could not be substantiated . No induction of gross changes in cell morphology was observed . Bactericidal activity was accompanied only be very slight leakage of general ionic materials from the bacteria . Propyl gallate did not appear to uncouple oxidative phosphorylation from respiration as indicated by its failure to stimulate proton translocation across the cytoplasmic membrane. Infection, 1981, 9(6), 296 - 9 A comparison of the use of antimicrobials with other common peroral drugs in the pediatric population of Helsinki; Peltola H; 7,068 children treated in 1978 aft the emergency room of the outpatient department at the Aurora City Hospital, Helsinki, took part in a survey to investigate their previous use of medication . On average, each child had received at least 1.5 complete courses of a drug during the preceding 12 months . The use of antimicrobial agents (3,952 complete courses) was alarming . They were prescribed more frequently than antitussives (3,678 courses) or peroral anticoryzeal preparations (2,498 courses) . A marked reduction in the use of antimicrobials, antitussives and peroral antihistamines, but not of antipyretics, was observed in late summer. Int J Fertil, 1981, 26(3), 161 - 9 A review of cervical mucus and sperm interactions in humans; Fordney-Settlage D; Cervical mucus is an aqueous or gel mixture of fluids, ions and compounds, and cells, primarily produced by the endocervical epithelium . The amount secreted varies with menstrual phase and compositions changes under hormonal influence . Sodium shows the greatest concentration change at ovulation but does not change early enough to be of value in natural family planning practice . Dried mucus has a fern appearance due to NaCl crystals at ovulation . Other substances, less clearly related, are too difficult to analyze or in too low concentration . Soluble proteins, amino acids, and simple sugars show wide fluctuation and probably influence sperm penetration and nutrition . One function of mucus is antimicrobial activity of leukocytes, which decreases at midcycle . Another, sperm transport, is a function of estrogen's effect on mucus rather than ovulation . Sperm concentration in the mucus column is maximal from 15 minutes to 2 hours after vaginal deposition . Rapid penetration into cervical mucus favors sperm survival because of its optimal pH . Infertility may be caused by immunoglobulins or spermagglutinins in cervical mucus . To date, no constituent of cervical mucus has been identified which undergoes an easily detectable change 4 days before ovulation . Several potential methods for use in natural family planning are suggested. Eur J Nucl Med, 1981, 6(6), 245 - 8 125I-beta-iodo-D-alanine-synthesis, biodistribution and antimicrobial activity; Shiue CY et al.; Methyl N-carbobenzoxy-beta-iodo-D-alaninate (1) served as an intermediate to synthesize methyl beta-iodo-D-alaninate (2) and beta-iodo-D-alanine (3) . The 125I-labeled compound 1 was synthesized by the melt method and used to synthesize 125I-labeled compounds 2 and 3 . Compound 3 was shown to be substrate for D-amino acid oxidase . It was also shown that compounds 2 and 3 were rapidly eliminated from normal mammalian tissues and that compound 3 inhibited the Escherichia coli growth in a dose-dependent manner at 100-500 microgram/ml while compound 2 showed no effect at 500 microgram/ml level . Therefore, it was suggested that compound 3 may serve as an abscess localizing agent. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 845 - 7 Pelvic inflammatory disease, 1980; St John RK et al.; PIP: The term pelvic inflammatory disease (PID) is used to refer to diseases caused by acute ascending genital tract infection . Over 500 of the world's leading researchers met at the Center for Disease Control, Atlanta, Georgia, in April 1980, to review many facets of PID from their various perspectives . Since PID occurs more frequently among women younger than 25, its economic and social consequences are very serious . The risk of PID increases among women who use IUDs; in some Asian countries illegally induced abortions are among the most common causes of PID: in some African countries PID is associated most frequently with female circumcision . The microbiologic causes of PID are highly controversial . An accurate differential diagnosis of PID is very difficult since the clinical symptoms and signs are highly variable; laparoscopy is essential for accurate diagnosis . Antimicrobial treatment requires an extremely accurate microbiologic diagnosis; there is a great need for careful, therapeutic studies . Prevention of PID is tied to the design and implementation of control policies for sexually transmitted diseases . Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 1048 - 54 Computer-assisted analysis of the therapy of acute salpingitis; Bell TA et al.; Isolation rates of microorganisms recovered by culdocentesis and/or laparoscopy in nine studies of salpingitis were multiplied by the proportions of each species which would be inhibited in vitro at peak and 1/2 peak serum levels of 13 antimicrobial drugs to yield a prediction of efficacy for the drugs . Efficacies of several hundred combinations of two and three of these drugs were estimated also . Some pairs of oral drugs were predicted to be as efficacious as some parenteral regimens of two or three drugs now in use . The predictions with this model parallel the results of some recently reported studies of therapy for salpingitis, and the model may prove to be a useful tool for future trials and therapy. Klin Wochenschr, 1980 Dec 1, 58(23), 1271 - 81 {Oxidative metabolism of phagocytes: physicochemical events and clinical relevance (author's transl)}; Block LH et al.; The microbicidal activity of phagocytes is primarily dependent upon two intracellular processes: degranulation and respiratory burst . The latter one is associated with a partial reduction of molecular oxygen leading to the production of highly reactive oxydizing agents with microbicidal activity . Since an efficiant intracellular antimicrobial function of phagocytes is mainly based on the intracellular process of fusion of lysosomes with the phagocytic vesicles and the production of highly reactive oxygen radicales, disturbances of both these events will cause increased susceptibility against microorganisms and in most of the cases severe infections. J Exp Med, 1980 Dec 1, 152(6), 1610 - 24 Macrophage oxygen-dependent antimicrobial activity . IV . Role of endogenous scavengers of oxygen intermediates; Murray HW et al.; The activities of the endogenous O2- and H2O2 scavenging enzymes, superoxide dismutase (SOD), glutathionine peroxidase (GP), and catalase, were measured in lysates of the intracellular parasite, Toxoplasma gondii, and in various macrophage populations . During 72 h of cultivation in standard medium alone, the catalase activity of in vivo-activated toxoplasma-immune macrophages (IM) and immune-boosted macrophages (IB) progressively increased by eight- to ninefold, and correlated with the previously observed parallel decline in these cells' antitoxoplasma activity and capacity to release H2O2 . SOD and GP activities either remained constant or decreased during this 3-d period . Lymphokine exposure, which preserved the antitoxoplasma activity and oxidative capacity of 48- and 72-h cultures of IB and IM cells, blunted the rise in catalase levels and had no effect on SOD or GP . Inhibition of IB and IM macrophage catalase by aminotriazole maintained toxoplasmastatic activity otherwise lost after 48 h of cultivation . In addition, IB and IM cells from acatalasemic mice contained 20- to 30-fold less catalase, and showed comparatively little decline in either H2O2 release or antitoxoplasma activity during 72 h in culture . In vitro-(lymphokine) activated resident macrophages from normal mice had the highest levels of SOD, GP, and catalase, and these cells failed to kill or inhibit T . gondii despite enhanced extracellular release of O2- and H2O2 . Toxoplasmas were also found to contain all three enzymatic scavengers . Aminotriazole inhibition of lymphokine-activated cells' catalase or of toxoplasma catalase was effective in inducing these macrophages to display antitoxoplasma activity . Moreover, and in contrast to normocatalasemic resident cells, those from acatalesemic mice were readily induced by lymphokine to inhibit the replication of untreated virulent toxoplasmas . These results suggest that endogenous O2- and H2O2 scavenging enzymes, which function within both T . gondii and activated macrophages as host cell antioxidant protective mechanisms, may reduce the effectiveness of phagocyte antimicrobial activity . Thus, the presence of SOD, GP, and especially catalase within both target and effector cell may be important determinants of macrophage oxygen-dependent processes. J Antibiot (Tokyo), 1980 Dec, 33(12), 1443 - 8 Dnacins, new antibiotics . I . Producing organism, fermentation, and antimicrobial activities; Tanida S et al.; Dnacins are new antibiotics produced by an actinomycete, strain No . C-14482 (N-1001) . The characteristic features of the organism are: the formation of coremia on solid media, production of rod-shaped motile spores with peritrichous flagella from mature aerial mycella, fragmentation of the mature organism (at later stage of growth) in liquid media in which some fragmented elements have motility, lysozyme resistance, meso-diaminopimelic acid in the cell wall, and a guanine-cytosine content of 71 +/- 1 mol% . The organism has been designated as Nocardia sp . No . C-14482 (N-1001) . Dnacins show strong activity against various GRam-negative, Gram-positive, and acid-fast bacteria, but slight activity against fungi . The antibiotics hardly affect the growth of Escherichia coli K-12 under anaerobic condition even at concentrations more than five times that of the minimum inhibitory concentrations under aerobic conditions. Pharmazie, 1980 Dec, 35(12), 748 - 51 Dihydroxybenzene derivatives of antimicrobial activity; Badawi A et al.; For possible antimicrobial activity, catechol-3,5-disulphonyl-chloride resercinol-4,5-disulphonylchloride and resorcinol-2,4,6-trisulphonylchloride were condensed with amines, phenols, 8-hydroxyquinolin and hydrazine hydrate. J Bacteriol, 1980 Dec, 144(3), 884 - 90 Overproduction of outer membrane protein suppresses envA-induced hyperpermeability; Grundstrom T et al.; A quantitative study on outer membrane components was performed in a number of envelope mutants of Escherichia coli K-12 exhibition different permeability properties for antimicrobial agents . The envA1 allele causing an increased influx for both hydrophobic and hydrophilic drugs was found to be associated with a deficiency in the amount of lipopolysaccharides . The sefA1 envA1 double mutant was found to have a higher outer membrane buoyant density, apparently due to an increase in protein content . This double mutant was still low in lipopolysaccharide content. J Clin Periodontol, 1980 Dec, 7(6), 463 - 78 Effect of selective antimicrobial therapy on plaque and gingivitis in the dog; Heijl L et al.; The present investigation was performed to assess the effect of selective antibiotic therapy on developing plaque and gingivitis in dogs, which at the start of the study had normal gingiva . Fifteen beagle dogs were used . Throughout the entire observation period the animals were fed a diet which favored plaque accumulation . A baseline examination involved assessments of plaque, gingivitis and gingival exudate . The subgingival bacterial flora was assessed by dark-field microscopy . Subsequently the teeth of the right jaws were allowed to accumulate plaque . A careful tooth-cleaning program was maintained in the left jaws . Plaque and gingivitis assessments were repeated and subgingival plaque sampled in the right jaws after 14 and 28 days . On experimental day 28 the second part of the study was initiated . The dogs were randomly distributed into three groups of five animals each . A new baseline examination was performed in the left jaws, after which all tooth cleanings were terminated . During the subsequent 28 days each group of dogs was treated with one of three antimicrobial compounds (vancomycin, metronidazole or clindamycin) . Examinations were repeated after 14 and 28 days . The results demonstrated that systemic administration of antimicrobial substances can reduce the rate of plaque formation, change the composition of the developing subgingival microbiota and prevent (or retard) the onset of gingivitis . A comparison of the ability of the three compounds to prevent the formation of a "gingivitis-inducing" plaque revealed that metronidazole and clindamycin were markedly more effective than vancomycin . In fact, in dogs receiving metronidazole and clindamycin treatment, the initiation of gingivitis was almost entirely prevented during the 28 days of treatment. Arch Pathol Lab Med, 1980 Dec, 104(12), 617 - 20 Complement-induced vascular leukostasis . Its role in tissue injury; Jacob HS; The plasma complement system evolved as a beneficial antimicrobial mechanism . However, this system can be activated chaotically in such situations as extracorporeal perfusion, trauma, sepsis, or acute pancreatitis . When so activated, the complement component C5a may aggregate granulocytes and cause leukoembolization; it is suggested that such leukoembolization is an important, previously unsuspected mechanism of tissue damage . In addition, toxic oxygen species, such as superoxide, that are produced by granulocytes that have been triggered by C5a can damage the endothelium, an event that may, if it occurs in the lungs, contribute to the development of the adult respiratory distress syndrome (ARDS) . Hence the previously empiric use of high doses of corticosteroids in treating shock states, particularly in cases of the ARDS, may have a physiologic basis since very high concentrations of such drugs have been shown to inhibit both superoxide production and granulocyte aggregation. J Antibiot (Tokyo), 1980 Dec, 33(12), 1425 - 30 C-19393 S2 and H2, new carbapenem antibiotics . II . isolation and structures; Harada S et al.; Two new beta-lactam antibiotics, C-19393 S2 (1) and H2 (2), were isolated from the culture filtrate of Streptomyces griseus subsp . cryophilus nov . subsp . The structures were determined by spectral analysis as shown in Fig . 2 . The antibiotics have broad antimicrobial activity and strongly inhibit beta-lactamases . The minor product (2) is more stable than cephalosporin C in aqueous solution. J Anim Sci, 1980 Dec, 51(6), 1347 - 51 Effects of the dietary inclusion of copper and(or) antibiotics on the performance of weanling pigs; Stahly TS et al.; Five trials involving 518 pigs were conducted to determine the effects of the dietary addition of copper (0 or 250 ppm as copper sulfate) with and without antibiotics (55 ppm chlortetracycline, CTC, or 27.5 ppm virginiamycin VIR) on the rate and efficiency of gain and survival of early-weaned pigs . The experimental animals consisted of all pigs weaned from each of 67 litters at 28 +/- 2 days of age, regardless of weight or condition . In trials 1 through 4, single additions of copper, CTC or VIR to the corn-soybean meal-based diet improved (P less than .05) daily gains by 22, 22 and 17%, respectively, and feed to gain ratios by 5.1, 8.9 and 8.2% compared with those of pigs fed the unsupplemented diet during the 28-day trials . However, only the addition of copper to the diet increased (P less than .05) postweaning pig survival . Dietary inclusion of both copper and an antibiotic (CTC or VIR) further improved daily gains (P less than .05) by 10 to 11% and feed to gain ratios by 2 to 5% compared with the single addition of each antimicrobial agent . In trial 5, 125 ppm of copper were found to optimize daily gain and feed intake, whereas 250 ppm were required to maximize pig survival . These data demonstrate that high levels (125 to 250 ppm) of dietary copper increase the growth rate and reduce the incidence of mortality among weanling pigs . The data also indicate that the growth-promoting effects of copper and CTC, a broad spectrum antibiotic, or VIR, a gram-positive antibiotic, are additive in nature. J Infect Dis, 1980 Dec, 142(6), 825 - 34 Antibodies to mycobacteria in human tuberculosis . I . Development of antibodies before and after antimicrobial therapy; Kaplan MH et al.; Circulating antibodies were detected before treatment in the serum of 18 of 40 patients with newly acquired tuberculosis and of eight of 12 patients with reactivated tuberculosis by microimmunodiffusion tests with unheated mycobacterial culture filtrate, arabinogalactan, arabinomannan, and a specific culture filtrate fraction . Some patients responded to a single antigen, while others responded to two and at times four or more . Some of these antibodies reacted with polysaccharides, but many reacted with protein . Antibiotic treatment increased the percentage of responders from 46% to 60% in new cases and from 66% to 75% in relapse cases and increased the concentration of antibodies . In evaluation of serologic tests in tuberculosis, the effect of prior chemotherapy must be weighed . These microimmunodiffusion tests appear to be specific for Mycobacterium tuberculosis. Surg Gynecol Obstet, 1980 Dec, 151(6), 747 - 52 Topical antimicrobial cream sensitivity testing; Rodeheaver GT et al.; These gratifying results have made topical antimicrobial sensitivity testing an integral part of bacteriologic monitoring of the burn wound . Presently, we use the needle extrusion test routinely on all burn patients at our center . Its selection over the other antimicrobial tests is based on technical considerations . The needle extrusion test can be completed by an experienced technician within five minutes, but the disk diffusion test and agar-well diffusion test take two and five times longer, respectively . This time saving is an important consideration when the microflora of ten or more burn patient at our center are being monitored by this test every other day . This test system may prove useful for the topical antibiotic selection for the treatment of other wounds beside the burn wound . Its potential value in these other conditions must await the results of carefully controlled clinical studies. J Antibiot (Tokyo), 1980 Dec, 33(12), 1545 - 50 Urea treatment and pronase digestion of antitumor protein antibiotics, auromomycin and neocarzinostatin; Suzuki H et al.; Low molecular weight substances were separated from antitumor protein antibiotics, auromomycin and neocarzinostatin, by Sephadex G50 column chromatography, after denaturation with 8 M urea . The low molecular weight fraction of auromomycin, but not the protein fraction, showed antimicrobial and DNA-cleaving activities . More than 90% of the auromomycin and neocarzinostatin proteins were digested with a high concentration of pronase E . The digested samples of both antibiotics exhibited the same degree of activities as the original drugs in the inhibition of growth and DNA synthesis of mouse lymphoblastoma L5178Y cells and in causing strand scission of isolated PM2 phage DNA . The low molecular weight chromophores were recovered on Sephadex G50 column from the pronase-digested antibiotics . The results suggest that the in vitro biological activity of auromomycin and neocarzinostatin are principally attributed to the non-protein compounds of low molecular weight. MMW Munch Med Wochenschr, 1980 Nov 7, 122(45), 1591 - 4 {Urethro-adnexitis}; Hofstetter A; Urethroadnexitis in the male is one of the most frequent diseases with which the urologist has to deal and, because of the complex anatomical and physiological connections as well as the polymicrobial genesis, to which he must devote particular care in diagnosis in order to be able to carry out rational treatment . To avoid unnecessary antimicrobial therapy, congestive states and psychovegetative complaints must be differentiated . The pathophysiology, diagnosis and therapy of the acute and chronic forms are discussed. Am Rev Respir Dis, 1980 Nov, 122(5 Pt 2), 79 - 87 Clinical indications for and effects of bland, mucolytic, and antimicrobial aerosols; Wanner A et al.; The clinical usefulness of bland, mucolytic, and antimicrobial aerosols in the management of obstructive airway disease or bronchopulmonary infections was critically reviewed at th last Conference on th Scientific Basis of Respiratory Therapy in 1974 . From the information available at that time, it was cocluded that there was little scientific basis for these therapeutic modalities . It was also suggested that the value of aerosol therapy should be evaluated by objective tests . The relatively few studies reported during the last 5 years have not generated new data in support of such aerosol therapy . Three criteria have been used to assess the efficacy of bland and mucolytic aerosols: respiratory function, mucociliary function, and subjective symptoms . Although respiratory and mucociliary function have generally been found to remain unaltered or to deteriorate after administration of bland or mucolytic aerosols, some investigators have observed facilitated expectoration or improved cough efficiency . The effectiveness of antimicrobial aerosols is more difficult to evaluate, and their value in patients with bacterial or fungal pulmonary infections remains to be demonstrated . Considering the cost and potential hazards of aerosol therapy, its use should be restricted to forms of aerosols whos clinical value has been objectively demonstrated; a reassessment of the literature suggests that bland and currently used mucolytic and antimicrobial aerosols do not meet this requirement. J Chir (Paris), 1980 Nov, 117(11), 643 - 6 {Comparative study of the in vitro- and vivo- antimicrobial activity of seven antiseptic solutions for use on surgeon's hands (author's transl)}; Bernard J et al.; The antibacterial activity of 7 antiseptic solutions has been studied both "in vitro en in vivo" . The results obtained in both case were necessary and complementary since some products (e . g . Solubacter) show an irregular activity either "in vitro or in vivo" but show specific actions which can explain those result . Others (e . g . Betadine scrub), very active in vitro react slowly in vivo . The 3 solutions that have been shown to be the most antibacterial in both cases are 90 degrees alcohol . Remanol and Hibiscrub . Their efficacy has been shown to be fast, regular and relatively long lasting. South Med J, 1980 Nov, 73(11), 1527 - 9 Rocky Mountain spotted fever: diagnostic dilemma of the atypical presentation; Tenenbaum MJ et al.; Two patients with Rocky Mountain spotted fever presented with atypical manifestations which led to a delay in diagnosis and treatment . Such clinical manifestations occurring in endemic areas during warm months should not eliminate consideration of the proper diagnosis . If RMSF cannot be ruled out, therapeutic regimens should include appropriate antimicrobial coverage. Obstet Gynecol, 1980 Nov, 56(5), 629 - 34 Cefoxitin for prophylaxis in premenopausal women undergoing vaginal hysterectomy; Hemsell DL et al.; To determine the unbiased incidence and types of postoperative infection and their alteration(s) by antimicrobial prophylaxis, a prospective double-blind study was performed using perioperative intramuscular cefoxitin or placebo given to premenopausal women undergoing vaginal hysterectomy at Parkland Memorial Hospital . The clinical and surgical profiles of the 2 groups of women were similar, but there were marked differences in their postoperative clinical courses . Only 8% of the 50 women given cefoxitin had major postoperative infection, compared to 57% of the 49 women given placebo (P < .001); this was associated with a 2.8-day reduction in the hospital stay for those given cefoxitin (P < .001) . No clinically significant side effects were observed. J Antibiot (Tokyo), 1980 Nov, 33(11), 1289 - 99 Chemical modification of fortimicin A; Suami T et al.; Chlorination of antibiotic fortimicin A with triphenylphosphine and carbon tetrachloride has been attempted, and 2-chloro-, 2,5-dichloro-, and 2-chloro-4-ene derivatives have been obtained . Successive dehalogenation of the chlorinated fortimicins A with tributylstannane gave the corresponding deoxyfortimicins A . Among five deoxyfortimicins A, 2-deoxyfortimicin A exhibits improved antimicrobial activity, compared to the parent fortimicin A. J Antibiot (Tokyo), 1980 Nov, 33(11), 1281 - 8 Synthesis of demethyl derivatives of istamycin A; Ikeda D et al.; 4-N,6'-N,3-O-Tridemethylistamycin A0 (9) and 6'N,3-O-didemethylistamycin A0 (15) were synthesized from 3,2',6'-tri-N-benzyloxycarbonyl-3',4'-dideoxyneamine 1,6-carbamate (1) through an aziridine derivative 6 by an analogous procedure employed in the total synthesis of istamycin A0 (19) . Acylation of 15 with glycine at the 4-methylamino group gave 6'-N,3-O-didemethylistamycin A (18) having interesting activities especially against pseudomonas, but 4-N,6'-N,3-O-tridemethylistamycin A (12) derived from 9 showed only weak activity . Therefore, the 4-N-methyl group of istamycin A (20) is essential for the antimicrobial activity. Jpn J Antibiot, 1980 Nov, 33(11), 1163 - 5 Phlebitis associated with the intravenous use of cephapirin and cephalothin in the combination therapy of antibiotics; Meguro S et al.; Phlebitis related to antibiotic infusion is one of the most frequent causes of morbidity in the debilitated patients with severe infection . There are a number of causes of infusion-induced phlebitis such as pH of intravenous fluid, needle used, and contamination of venipuncture site . Vein used to play an important role, particularly in patients with granulocytopenia receiving intravenous infusion . Cephalothin is an effective antibiotic in the treatment of granulocytopenic infection and is widely used currently . When cephalothin was introduced commercially, the frequency of phlebitis was as high as 50% . The main reason was thought to be acidity of the antibiotic solution . The cephalothin solution used currently is neutral in pH, but prevention of phlebitis is still not perfect . In contrast, cephapirin recently developed cephalosporin antibiotic, which resembles cephalothin in the antimicrobial activity and pharmacological properties caused less phlebitis than cephalothin in initial clinical studies . The patients receiving chemotherapy for malignant diseases frequently die of infections . A cephalosporin antibiotic is administered intravenously for a prolonged time in the presence of thrombocytopenia, and under such circumstances, other antibiotics such as carbenicillin (CBPC) and aminoglycoside are usually used in combination . The influence of these antibiotics injected through the same vein must be considered, but the possibility of phlebitis due to CBPC and aminoglycoside is negligible . In the present clinical study, 24 granulocytopenic patients were treated with the combination of antibiotics, cephapirin-carbenicillin-amikacin and cephalothin-carbenicillin-amikacin . Besides the clinical effect of the antibiotics, the incidence and severity of phlebitis were studied. Am J Vet Res, 1980 Nov, 41(11), 1905 - 11 Host metabolic alterations during inflammatory stress as related to nutritional status; Powanda MC; Malnutrition predisposes to infection, whereas infection can exacerbate malnutrition, resulting in hindered growth and development . This interplay between infection and nutrition suggests that host metabolism has a role in host defense during infection . Infection occasions profound alterations in host trace metal, nitrogen, and hormone metabolism and redistribution as a result of factors {leukocyte endogenous mediator (endogenous pyrogen)} released from stimulated phagocytes . Many of these alterations occur even in malnourished, protein-restricted, and zinc-deficient animals and persons, bespeaking the essential nature of these changes . Although these metabolic sequelae of infection appear to be of value to the host during acute illness, a metabolic deficit is often incurred which may persist long after resolution of clinical illness . Understanding host-parasite sequences will allow formulation of an integrated approach to the care of infected patients, combining the appropriate elements of nutrition with the best features of antimicrobial therapy. Am J Vet Res, 1980 Nov, 41(11), 1882 - 3 Sensitivities of Escherichia coli isolated from bovine and porcine enteric infections to antimicrobial antibiotics; Coates SR et al.; The antibiotic sensitivities of Escherichia coli isolated from 91 diarrheal pigs and 98 diarrheal calves were determined to 19 different microbials by the Kirby-Bauer method . Virtually all E coli isolated from pigs and calves were sensitive to amikacin, colistin, gentamicin, and polymyxin B . In vitro minimum inhibitory concentrations for these 4 antibiotics were determined for isolates from both pigs and calves. J Pharm Sci, 1980 Nov, 69(11), 1292 - 5 Antimicrobial activity of N-chloramine compounds; Kohl HH et al.; Cellular mechanisms of action of two representative N-chloramines were studied . Both compounds, 3-chloro-4,4-dimethyl-2-oxazolidinone (I) and N-chlorosuccinimide (III), inhibited bacterial growth and exerted profound inhibition of bacterial DNA, RNA, and protein synthesis at a concentration of 10(-5) M . Enzymes containing sulfhydryl groups generally were significantly inhibited by these chloramines at 10(-4) M . Dihydrofolate reductase, which contains no sulfhydryl groups, also was inhibited but at much higher chloramine concentrations (10(-2) M); ribonuclease, which also contains no sulfhydryl groups, was unaffected . All of these inhibitory effects of the chloramines could be prevented if sulfhydryl-containing reagents (mercaptoethanol or dithiothreitol) were added before or together with the chloramine . Once inhibition was produced by the chloramine, it was not reversible by later addition of the sulfhydryl reagents . These results suggest that these chloramines act at sulfhydryl sites as well as at other sites in both cells and purified enzymes. J Antibiot (Tokyo), 1980 Nov, 33(11), 1341 - 7 Biosynthesis of anthracycline antibiotics by Streptomyces galilaeus . II . Structure of new anthracycline antibiotics obtained by microbial glycosidation and biological activity; Matsuzawa Y et al.; New anthracycline antibiotics derived from epsilon-, gamma- and beta-rhodomycinones and epsilon-isorhodomycinone by the microbial glycosidation using an aclacinomycin-negative mutant, the strain KE303, of Streptomyces galilaeus MA144-M1 were studied to elucidate their structures and biological activities . These antibiotics were the products in which the anthracyclinones added as precursors were linked at C-7 or C-10 position with the same trisaccharide moiety (cinerulosyl-2-deoxyfucosyl-rhodosaminyl group) as in the parental antibiotic aclacinomycin A . In addition to antimicrobial activity, they exhibited the growth inhibition of cultured L1210 leukemia cells and the marked inhibition against DNA and RNA synthesis. J Antibiot (Tokyo), 1980 Nov, 33(11), 1224 - 30 Lonomycins B and C, two new components of polyether antibiotics . Fermentation, isolation and characterization; Mizutani T et al.; Lonomycin B (II), C44H75O14Na, m.p . 181-182 degrees C, and lonomycin C (III), C43H73O14Na, m.p 186-187 degrees C, were isolated as their sodium salts from the fermentation broth of Streptomyces ribosidificus TM-481 . Their physicochemical properties demonstrated that II and III are closely related congeners of lonomycin A (I) . The identical mass spectra of methyl esters of I and II indicated that II is a stereoisomer of I . On the other hand, the mass spectrum of a methyl ester of III showed a peak at m/e 810 due to M+-H2O which is smaller by 14 mass units than the maximum peak at m/e 824 due to M+-H2O of the methyl esters of I and II . This result together with the elemental analysis strongly suggested that III is a demethyl derivative of I or II . II and III are slightly less active than I in their antimicrobial activities. J Antibiot (Tokyo), 1980 Oct, 33(10), 1087 - 97 BBM-928, a new antitumor antibiotic complex . I . Production, isolation, characterization and antitumor activity; Ohkuma H et al.; A complex of the antitumor antibiotic BBM-928 was produced by an actinomycete strain No . G455-101 . Four components, BBM-928 A, B, C and D, were isolated in crystalline form and characterized . They were shown to be cyclic depsipeptide antibiotics containing a quinoline nucleus as the chromophore . BBM-928 A is a monoacetyl derivative of BBM-928 B and a diacetyl derivative of BBM-928 C . BBM-928 components exhibit antimicrobial activity against Gram-positive and acid-fast bacteria . BBM-928 A is highly active in mice against various experimental tumors including leukemia P388, leukemia L1210, melanoma B16, LEWIS lung carcinoma and sarcoma 180 . BBM-928 B is less active than BBM-928 A, and BBM-928 C has no antitumor activity. Antimicrob Agents Chemother, 1980 Oct, 18(4), 529 - 31 In vitro susceptibility of Mycobacterium marinum to eight antimicrobial agents; Sanders WJ et al.; The in vitro susceptibilities of 16 Mycobacterium marinum strains to eight antimicrobial agents were determined by the agar dilution technique . The most active drugs were amikacin and kanamycin . Tetracycline, doxycycline, and minocycline were inhibitory, predominantly at concentrations slightly below the expected blood and tissue levels . Trimethoprim-sulfamethoxazole and erythromycin demonstrated activity only at concentrations greater than those usually attained in serum and tissues . Gentamicin was relatively inactive. Br J Vener Dis, 1980 Oct, 56(5), 332 - 6 Tetracycline in nongonococcal urethritis . Comparison of 2 g and 1 g daily for seven days; Bowie WR et al.; In a previous study treatment with minocycline 100 mg orally every day for seven days was as effective for nongonococcal urethritis (NGU) as 200 mg for seven days or 100 or 200 mg for 21 days . In this prospective, randomised study men with NGU received tetracycline either 500 mg or 250 mg four times daily for seven days . of 200 men initially enrolled, Chlamydia trachomatis was isolated from 40% and Ureaplasma urealyticum from 48% . Eight of 10 homosexual men compared with 39 (21%) of 190 bisexual or heterosexual men had negative culture results for both C trachomatis and U urealyticum (x2 = 15.5, P < 0.0005) . U urealyticum was isolated more frequently from chlamydia-negative men and from men with 10 or fewer sex partners during their lifetime . Both regimens were equally effective in their in-vivo activity against C trachomatis and U urealyticum . Failure rates were similar with the two regimens . More obvious failure with purulent or profuse mucoid discharge and pyuria occurred more frequently with the 250-mg regimen (20% of 76 men on the 250-mg regimen compared with 7% of 67 men on the 500-mg regimen; x2 = 4.45, P < 0.05) . Failure occurred more frequently in men who were initially chlamydia-negative and in men in whom U urealyticum persisted after medication . Thus, the 250-mg regimen appeared to be as effective as the 500-mg regimen in the initial treatment of NGU . However, one-third of men had persistent or recurrent urethritis with these regimens, and there is a need for antimicrobial agents with greater in-vivo activity, especially against chlamydia-negative NGU. Dent Clin North Am, 1980 Oct, 24(4), 813 - 26 Chemotherapeutics in periodontics; Ciancio SG; In this article emphasis has been placed on the major chemotherapeutic aspects of periodontal therapy in the 1970s . During this decade investigations of chlorhexidine stimulated many studies relevant to the role of topical antimicrobial agents to prevent or treat gingivitis . Major attention focused on the effect of these agents on supragingival plaque . In the 1980s attention will be focused on the effect of antimicrobial agents on subgingival plaque and gingivitis . Already, innovative methods of delivering medications into the gingival crevice are being evaluated . The use of antibiotics systemically to treat periodontal disease will reach its peak in the next decade . It is most likely that antibiotics that concentrate in gingival crevicular fluid and have minimal side effects will become useful adjuncts in periodontal therapy. Br J Exp Pathol, 1980 Oct, 61(5), 465 - 70 Antibiotic cross-resistance patterns of ambodryl and promazine resistant mutants; Ray S et al.; The antihistaminic drug ambodryl (Am) and the tranquillizer promazine (Pr), which had previously shown significant antimicrobial activities, were used to select bacterial mutants representing different levels of resistance to their action . These Am and Pr mutants were found to have simultaneously developed cross-resistance to penicillin (Pe), streptomycin (Sm), chloramphenicol (Cm), tetracycline (Tc) and kanamycin (Km) . Certain first-step Am mutants of sensitive wild-type bacteria which were also sensitive to these antibiotics developed resistance to Pe and Sm as well as to Pr and the antihistamine benadryl (Bn) . The next-step mutant of Am resistance not only doubled its resistance to these antibiotics and chemotherapeutics, but broadened its resistance-spectrum to cover Tc and Cm . These observations on cross-resistances seem to be best explained on the basis of a reduction in cell-membrane permeability acting in a nonspecific manner . The role of such cross-resistance in accounting for an overall increase in the minimum inhibitory concentrations (MIC) of many drugs against several groups of bacteria is evaluated. Br Med J, 1980 Sep 20, 281(6243), 765 - 9 Collecting and banking human milk: to heat or not to heat? Bjorksten B, Burman LG, De Chateau P, Fredrikzon B, Gothefors L, Hernell O. Data on human breast milk and its handling when fed to babies who cannot be breast-fed were reviewed to determine whether the method of processing and storage affected the properties of the milk . Breast milk is normally contaminated by potential pathogens, which seem to produce no ill effects, but it also contains antimicrobial properties which protect against infection . The evidence suggests that pasteurisation not only eliminates pathogenic bacteria but also damages bacteriostatic mechanisms, so making the milk more susceptible to later contamination . Pasteurisation also affects the nutritional properties of milk . Freezing has little effect on milk proteins, while a study on the effect of refrigeration showed that there was little bacterial growth at temperatures below 8 degrees C . Several years' experience of feeding donated raw milk to newborn infants has confirmed that it produces no ill effects . These findings suggest that pasteurisation of donated breastmilk is unnecessary, and it is not recommended, while the decision whether or not to freeze the milk may be made on practical grounds . Raw breast milk can be safely stored at 4-6 degrees C for 72 hours. Farmakol Toksikol, 1980 Sep-Oct, 43(5), 628 - 31 {Relationship between cationic structure and the biological activity of cationic surface-active substances}; Pis'ko GT et al.; The paper concerns the toxicity and antimicrobial activity of the derivatives of ethylene-, hexamethylenediamine, piperidine and guanidine containing an alkyl group with 10-12 carbon atoms adjacent to nitrogen ones . Alkyl derivatives of hexamethylenediamine and guanidine exhibit less toxicity compared to those of piperidine and ethylenediamine . Antimicrobial activity of the compounds is cation is cation structure-dependent and is most pronounced in guanidine and piperidine derivatives having a wide spectrum of antimicrobial action . A series of polymethylene derivatives showed decreased antibacterial activity and emergence of an antifungal effect with increase in the number of methylene groups between nitrogen atoms. Am J Med Sci, 1980 Sep-Oct, 280(2), 73 - 80 Polymicrobial sepsis: an analysis of 184 cases using log linear models; Mackowiak PA et al.; Polymicrobial sepsis is a common and frequently fatal clinical condition that has received relatively little attention in published reports . Retrospectively, we reviewed the case records of 184 patients with polymicrobial sepsis seen at three Dallas hospitals between 1972 and 1977 . Analysis of clinical data using log linear models enabled us to identify significant positive correlations (p < 0.05) between mortality resulting from polymicrobial sepsis and underlying disease category, failure to manifest fever, a pulmonary portal of entry, hypotension, and hospital-associated sepsis . No significant correlation with outcome could be demonstrated for age, hospital service, species of infecting microorganisms, number of microorganisms isolated from blood, WBC count, or antimicrobial therapy . In spite of indirect evidence for synergistic relationships between microorganisms responsible for polymicrobial sepsis in man, we could not resolve whether antimicrobial regimens that are effective against all of the microorganisms participating in polymicrobial infections are required to insure a favorable outcome. Antimicrob Agents Chemother, 1980 Sep, 18(3), 403 - 8 Susceptibility of Legionella pneumophila to twenty antimicrobial agents; Edelstein PH et al.; Thirty-three isolates of Legionella pneumophila, all except one of which were clinical isolates, were tested against 20 antimicrobial agents by using an agar dilution technique . Erythromycin, rifamp}in, and rosaramycin were the most active agents tested . Aminoglycosides, chloramphenicol, and cefoxitin also inhibited the organisms at low concentrations . Other agents, including moxalactam, cefoperazone, and cephalosporins, exhibited moderate to little activity . Tetracycline, doxycycline and minocyeline were apparently inactivated by charcoal-yeast extract medium . There was slight inoculum dependence noted with most of the antimicrobials tested, particularly the beta-lactam agents . There was no consistent difference in susceptibility between Center for Disease Control-supplied stock strains and recent clinical isolates, but there were marked differences with some agents . Susceptibility testing needs to be standardized in view of the influence of inoculum size, strain variation, and the medium used. Surg Gynecol Obstet, 1980 Sep, 151(3), 349 - 52 Short term chemotherapeutic prophylaxis in gastrointestinal operations; Giercksky KE et al.; In a prospective, randomized study on surgical prophylaxis in elective gastrointestinal operations, 145 adults were allocated to either one of three groups . Those in group 1 received one single preoperative dose of 200 milligrams of doxycycline and 2 grams of tinidazole . Those in group 2 were given three doses of 80 milligrams of gentamicin and 600 milligrams of clindamycin with eight hour intervals, beginning one hour preoperatively . Group 3 patients served as controls and obtained no antimicrobial agent . The prophylactic regimens significantly reduced the infectious complications, as evidenced by fewer infections, less total antibiotic dosage and shorter hospitalization . In the prophylactically treated groups, anaerobic infections were less frequent than in those in the control group. Z Hautkr, 1980 Sep 1, 55(17), 1162 - 71 {Interactions between amphotericin B and hydroxytetracycline}; Raab W et al.; By means of the Warburg assay (manometric technique), investigations were performed to elucidate interactions between amphotericin B, a polyene antifungal antibiotic, and hydroxytetracycline . Those two compounds were combined in clinical therapy . On resting yeasts and bacteria, interactions could be ruled out . On the contrary, on both types of microbes a significant increase in antimicrobial actions could be seen in the presence of the second substance . The antimycetic activity of amphotericin B was significantly increased in the presence of hydroxytetracycline (in five-fold concentrations) . The antibacterial activity of hydroxytetracycline was significantly higher in the presence of amphotericin B (same concentrations) . The clinical implication of these results is briefly discussed. Oral Surg Oral Med Oral Pathol, 1980 Sep, 50(3), 273 - 6 9-Aminoacridine--its present status and current recommendations for use as a surgical and endodontic irrigant in dentistry; Schmitz JP; Evidence is presented to support the use of 9-aminoacridine as a safe and effective surgical irrigant in dentistry . The available literature confirms that 9-aminoacridine is a potent antimicrobial agent, effective against a wide range of microorganisms commonly found in septic wounds and causing minimal tissue irritation . The use of 9-aminoacridine for routine root canal irrigation and as an antiseptic in the management of maxillofacial abscesses is recommended. J Dent Res, 1980 Sep, 59(9), 1466 - 72 Hypothiocyanite ion: detection of the antimicrobial agent in human saliva; Thomas EL et al.; The median concentration of hypothiocyanite (OSCN-) in freshly collected whole saliva was 10 microM . The OSCN- concentration increased to a median value of 36 microM during incubation for one h at 37 degrees in vitro . This increase was partially inhibited by adding certain sugars (especially sucrose) . The results suggest that OSCN- is a naturally occurring component of human saliva . Also, dietary carbohydrate may inhibit OSCN- accumulation and antimicrobial action in saliva. Ann Intern Med, 1980 Sep, 93(3), 480 - 9 Oxygen metabolism and the toxic properties of phagocytes; Klebanoff SJ; The products of oxygen reduction (superoxide anion, hydrogen peroxide, hydroxyl radicals) and excitation (singlet oxygen) have been implicated in the toxic properties of phagocytes (neutrophils, eosinophils, and mononuclear phagocytes) . Enzymes that potentiate (such as peroxidase) or limit (such as catalase, superoxide dismutase) the toxicity of these agents contribute to the complexity of the oxygen-dependent antimicrobial systems of phagocytes . These toxic systems are dormant when the phagocyte is at rest but are activated when the need arises and directed to the destruction of invading microorganisms and other foreign cells . Occasionally, the toxic systems are directed against normal host cells and in this way contribute to the pathogenesis of disease. Antimicrob Agents Chemother, 1980 Sep, 18(3), 437 - 42 Carbenicillin plus cefazolin with or without mecillinam as an early treatment of bacteremia caused by gram-negative organisms: randomized double-blind study; Klastersky J et al.; Mecillinam or a placebo was added to a combination of cefazolin and carbenicillin as an early therapy of septicemia caused by gram-negative organisms in patients with serious underlying diseases, none of whom was neutropenic, however . Patients in whom infection was caused by pathogens against which mecillinam and cefazolin or mecillinam and carbenicillin were synergistic might have responded more often than patients treated with nonsynergistic combinations . However, overall results did not show any benefit from combining mecillinam with cefazolin and carbenicillin . This study suggests that in nonneutropenic patients with septicemia caused by gram-negative organisms, there is no need to intensify antimicrobial therapy beyond a certain point of efficacy . The measurement of the bactericidal activity in the serum of treated patients might serve as guide for adequate therapy. Pharmazie, 1980 Aug, 35(8), 466 - 8 Synthesis and antimicrobial activity of some anthranilic acid derivatives; Kar A et al.; The synthesis of eight derivatives of anthranilic acid is described . Investigation of their antimicrobial activity showed that four of the compounds, viz; anthranilohydrazide, 3,4-dihydro-4-oxo-1,2,3-benzotriazine, triazine-beta-naphthol adduct and N-phenyl anthranilic acid showed significant antibacterial activity . None of the compounds showed any noticeable antifungal effect. Pharmazie, 1980 Aug, 35(8), 458 - 60 Biologically active Mannich bases derived from nitroxoline; Movrin M et al.; A series of compounds with various basic side chains were derived from 5-nitro-8-hydroxyquinoline (nitroxoline) . Aminomethylation of nitroxoline led exclusively to the formation of o-substituted phenolic Mannich bases . Depending on the kind of the primary or secondary amine participating in the Mannich reaction differently substituted compounds were prepared in order to study the influence of the basic side chain on their biological activity . The compound with N-bis(2-hydroxyethyl)amino group exhibited the highest mitodepressant activity determined in a phyto test on Lepidium sativum L . Preliminary test for antibacterial and antifungal activities using standard test microorganisms indicate rather strong antimicrobial properties of several synthesized compounds. Am J Dis Child, 1980 Aug, 134(8), 744 - 6 Infectious mononucleosis complicated by severe Mycoplasma pneumoniae infection; Dearth JC et al.; A 14-year-old girl with infectious mononucleosis and secondary immunosuppression had severe dyspnea and cough, spiking fever, rales, and diffuse bilateral pulmonary infiltrates . The pulmonary disease progressed rapidly, necessitating empiric trials of antimicrobial agents . Mycoplasma pneumoniae was isolated from a lung biopsy specimen, transtracheal aspirate, and expectorated sputum, but the relatively long period required to isolate the organism delayed the microbiologic diagnosis . Serologic study of acute and convalescent serum samples confirmed the M pneumoniae infection . Clinical improvement was gradual, and the immunosuppression was transient . The patient's illness appeared to represent microbial synergism, with severe M pneumoniae infection complicating transient immunosuppression induced by infectious mononucleosis. Antimicrob Agents Chemother, 1980 Aug, 18(2), 353 - 4 Effect of clavulanic acid on minimal inhibitory concentrations of 16 antimicrobial agents tested against Legionella pneumophila; Pohlod DJ et al.; A total of 15 Legionella pneumophilia isolated were tested against 16 antimicrobial agents used singly and in combination with clavulanic acid . When combined with clavulanic acid, 4 of the 16 antimicrobial agents produced no enhanced effect . However, the minimal inhibitory concentrations of 12 of the antimicrobial agents were reduced by one-half to one-third when in combination with clavulanic acid . These reductions reflected only a one-dilution decrease, however, in the original minimal inhibitory concentrations . Thus, clavulanic acid combinations appear to be only nominally effective beta-lactamase inhibitors against L . pneumophilia. Ann Surg, 1980 Aug, 192(2), 237 - 43 Impending aortoenteric hemorrhage: the effect of early recognition on improved outcome; Perdue GD Jr et al.; Aortoenteric hemorrhage is the result of enteric erosion and necrosis of aortic wall or anastomotic site . Mechanical or bacteriologic causes may occur singly or in combination . The temporal sequence is such that warning symptoms, often including back pain, fever, hemotochezia, and anemia, are present long before exsanguinating hemorrhage occurs . Vigorous diagnostic efforts, including gallium-67 citrate nuclear scan and computerized axial tomography, lead to a correct diagnosis . This allows planned semielective corrective operation before severe hemorrhage begins . The ideal operation consists of extra-anatomic revascularization, excision of the infected prosthesis, bowel repair with decompression, and sump drainage . Appropriate antimicrobial therapy should be continued until healing is complete . With aggressive diagnostic and therapeutic intervention according to this plan, marked improvement in survival and limb preservation can be anticipated in patients having this complication of aortic surgery . In this series, 15 of 18 patiets having operation recovered, though delayed limb loss occurred in two. Lancet, 1980 Jul 26, 2(8187), 192 - 5 High prevalence of penicillin-insensitive pneumococci in Port Moresby, Papua New Guinea; Gratten M et al.; One-third of 57 strains of pneumococci isolated from patients with severe pneumococcal infections in Port Moresby, Papua New Guinea, in 1978 were penicillin-insensitive (PR) . The infections were community-acquired and comprised cases of bacteraemia, bacteraemic pneumonia, and meningitis . The prevalence of invasive PR strains in children was significantly greater than in adults . Twenty-one serotypes were identified, of which ten types (6, 9, 10, 12-14, 18, 19, 23, 24) showed diminished sensitivity to penicillin; with types 12 and 18 penicillin-insensitivity has not been met with previously in Papua New Guinea and only rarely elsewhere; seven of the 19 PR strains belonged to type 6 . Amongst insensitive strains, minimum inhibitory concentrations of penicillin G ranged from 0.1 to 1.0 microgram/ml (resistance ratios 5 to 50) . Resistance to chloramphenicol and other antimicrobial drugs was not encountered. Med Clin (Barc), 1980 Jul 15, 75(3), 126 - 8 {Chronic ulcerative colitis and autoimmune hemolytic anemia (author's transl)}; Vilaseca J et al.; A 27-year-old male developed an autoimmune hemolytic anemia during the initial episode of chronic ulcerative colitis . Laboratory studies revealed a positive direct Coomb's test (IgG + C), and the presence of specific anti-Hr antibody . Salicylazosulfapyridine was tested by means of immunohematologic techniques, but results discarded this drug as the responsible agent for autoimmune hemolytic anemia . Association of ulcerative colitis and autoimmune hemolytic anemia is an uncommon finding; around 36 cases have been published in the literature . Hemolytic anemia may develop as a consequence of treatment with salicylazosulfapyridine, the antimicrobial of choice in the management of inflammatory diseases of the bowel. Biochemistry, 1980 Jul 8, 19(14), 3307 - 14 Characterization of octapeptin-membrane interactions using spin-labeled octapeptin; Swanson PE et al.; Octapeptin is a membrane-active peptide antibiotic that contains a C10 fatty acid covalently attached to the peptide through an amide bond . Interactions of octapeptin with bacterial membranes and phospholipids were characterized by using spin-labeling techniques and octapeptin derivatives containing fatty acids of varying chain length . Acyl modification of octapeptin demonstrated that the fatty acid of the antibiotic contributed to the antimicrobial activity of octapeptin and its affinity for membranes . The influence of octapeptin and C2 acyloctapeptin on the rates of ascorbate reduction of several membrane-bound doxyl stearates was also examined . These studies demonstrated that octapeptin increaed the rate of diffusion of ascorbate into the lipid bilayer and suggested that the acyl chain contributed to this activity . In addition, an acyl spin-labeled analogue of octapeptin was prepared and shown to retain biological activity . Spectral analysis showed that octapeptin does not aggregate in solution over a wide concentration range . However, the isotropic splitting constant indicated that the acyl chain of octapeptin is not completely exposed to water . It is proposed that the acyl chain of octapeptin in solution interacts with hydrophobic amino acids in the peptide, which partially shields the acyl chain from water . Spectral features of the spin-labeled antibiotic bound to phospholipid dispersions were consistent with directional binding of octapeptin to lipid bilayers with insertion of the fatty acid into the hydrocarbon domain. Arch Dis Child, 1980 Jul, 55(7), 568 - 9 Varicella arthritis in a child; Shuper A et al.; A 2 1/2-year-old girl developed arthritis in a metatarsophalangeal joint concomitantly with varicella . As she recovered within 2 days without antimicrobial treatment, it was considered that the arthritis was directly due to the viral infection . The importance of differentiating viral arthritis from septic arthritis, a well-known complication of varicella, is stressed. Arch Microbiol, 1980 Jul, 126(3), 223 - 30 Metabolic products of microorganisms . 185 . The anthraquinones of the Aspergillus glaucus group . I . Occurrence, isolation, identification and antimicrobial activity; Anke H et al.; The occurrence of emodin, erythroglaucin, physcion, physcion-9-anthrone, questin, catenarin, and catenarin-8-methyl ether in different species of the Aspergillus glaucus group (genus Eurotium) was investigated . So far catenarin-8-methyl ether (1, 4, 6-trihydroxy-8-methoxy-3-methylanthraquinone) has not been described as a natural product; it was therefore given the name rubrocristin . The chemical and physical properties of rubrocristin are reported . In addition a new violet pigment (C16H12O5) was isolated and characterized by its MS-, IR- and UV-spectra . The antimicrobial properties of all substances were examined in the agar diffusion assay . Gram-positive bacteria were the most sensitive organisms and catenarin was the most active naturally occurring substance . Synthetically obtained 1, 4, 6, 8-tetrahydroxyanthraquinone was slightly more active than catenarin, whereas rubrocristin showed no antibacterial activity. J Infect Dis, 1980 Jul, 142(1), 77 - 82 The influence of protein binding upon tissue fluid levels of six beta-lactam antibiotics; Wise R et al.; The effect of protein binding upon the penetration of six-beta-lactam (three penicillins and three cephalosporins) antibiotics into tissue fluid was studied in humans . A cantharides blister technique was used . It was found that there was a linear relationship between the percentage of protein binding and the penetration into the blister fluid of the antibiotic as measured by the area under the curve of the protein-free fraction . This finding is further evidence that protein binding may have important influence upon the likely efficacy of an antimicrobial agent. J Bone Joint Surg Am, 1980 Jul, 62(5), 826 - 8 The antimicrobial effectiveness of operative-site preparative agents: a microbiological and clinical study; Ritter MA et al.; Eight wound preparative agents (one triclosan compound, one hexachlorophene compound, and six iodophors) were evaluated under actual operating-room conditions for efficacy in de-germing the operative site prior to the performance of 310 total hip arthroplasties . All of the preparations tested achieved a significant reduction (p less than or equal to 0.001) of indigenous skin microflora compared with the pre-scrub level in both the post-scrub and the postoperative cultures . Two iodophors, when applied as sprays, demonstrated excellent bactericidal action, were less time-consuming and easier to use than the compounds that were applied as scrubs, and did not alter the low (0.42 per cent) infection rate that we have recorded over a period of four years. Surg Gynecol Obstet, 1980 Jul, 151(1), 89 - 92 Prospective evaluation of combinations of antimicrobial agents for endometritis after cesarean section; Sen P et al.; Two hundred and thirty-six women were studied for the development of endometritis following cesarean section . Cultures were taken of the amniotic fluid and endocervix through the internal os during the operative procedure . Of the 236 patients, clinical evidence of endometritis developed in 105 . Positive cultures of the amniotic fluid or the endocervix, or both, were not helpful in predicting significant clinical infection . The patients with endometritis were treated with a combination of either clindamycin and gentamicin or cefazolin and gentamicin . All of the 54 patients, receiving clindamycin and gentamicin improved, but eight of the 51 patients in the cefazolin group failed to respond but, subsequently, improved after the administration of clindamycin . No serious toxicity was observed in either group. Am Rev Respir Dis, 1980 Jul, 122(1), 101 - 5 Isolation of Legionella pneumophila from clinical specimens: salutary effects of lung tissue dilution; Lattimer GL et al.; Diagnosis of legionnaires' disease is seldom confirmed by isolation of Legionella pneumophila . In 2 cases, isolates were obtained using inoculums of diluted lung tissue suspension, even though no growth ocurred when undiluted suspensions were used . It is speculated that tissue dilution decreases the concentration of antimicrobial agents and antibacterial properties associated with lung host defense mechanisms, which allows improved recovery rates . This technique is recommended when attempting isolation of L . pneumophila from clinical specimens. Ann Intern Med, 1980 Jul, 93(1), 62 - 89 Drug therapy in renal failure: dosing guidelines for adults . Part I: Antimicrobial agents, analgesics; Bennett WM et al.; Data are presented in tabular form that provide guidelines for drug use in adult patients with renal insufficiency . The data are derived from the current medical literature . If specific information about a drug is unavailable or conflicting, emphasis is given to normal pharmacokinetic variables in arriving at recommendations for therapy . Nephrotoxicity or adverse effects in patients with renal disease are noted and adjustments for dialysis suggested. Am Rev Respir Dis, 1980 Jul, 122(1), 61 - 4 Antimicrobial drug susceptibility of respiratory isolates of Hemophilus influenzae from adults; Saginur R et al.; Hemophilus influenzae isolates from sputum of 111 patients with chronic bronchitis were tested for susceptibility to 8 antimicrobial drugs . A new beta-lactam, LY-127935, was the most active agent tested . Ampicillin, cefamandole, tetracycline, and cefuroxime showed good activity against most isolates . Two strains, both nontypable, were resistant to ampicillin and produced beta-lactamase . Cefaclor was somewhat less effective, although most strains were susceptible . Erythromycin and cephalexin were of limited utility. Antimicrob Agents Chemother, 1980 Jul, 18(1), 9 - 12 In vitro antimicrobial susceptibility of Actinobacillus actinomycetemcomitans; Slots J et al.; The agar dilution technique was used for determination of the antibiotic susceptibilities of 57 oral isolates and 2 nonoral isolates of Actinobacillus actinomycetemcomitans . Tetracycline, minocycline, and chloramphenicol inhibited more than 96% of the strains tested at a concentration of less than or equal to 2 micrograms/ml; 89% of the strains were inhibited by 2 micrograms of carbenicillin per ml . The other antimicrobial agents tested were less active . Approximately 10% of the A . actinomycetemcomitans strains were resistant to ampicillin, erythromycin, and penicillin G at concentrations of 32 to 64 micrograms/ml . These data suggest that tetracycline and minocycline may be valuable drugs in the treatment of A . actinomycetemcomitans infections. J Urol, 1980 Jul, 124(1), 60 - 1 The clinical use of epididymal aspiration cultures in the management of selected patients with acute epididymitis; Berger RE et al.; Culture and sensitivity testing of specimens obtained by percutaneous and intraoperative needle aspiration of the epididymis have been of clinical importance in choosing proper antimicrobial therapy in selected patients with acute non-venereal epididymitis . We have found aspiration cultures to be valuable in patients 1) with indwelling urethral catheters, 2) who fail to respond to initial antimicrobial therapy, 3) who have epididymitis found on surgical exploration for torsion of the teticle and 4) with recurrent epididymitis in whom the etiologic agent is uncertain. J Infect Dis, 1980 Jul, 142(1), 83 - 6 An in vitro model for investigation of chemotherapeutic agents in leishmaniasis; Berman JD et al.; Clinically achievable concentrations of the three major antileishmanial drugs in use--pentavalent antimony, pentamidine, and amphotericin B--eliminated 90%--100% of the mammalian forms (amastigotes) of Leishmania tropica and Leishmania donovani from in vitro infected human monocyte-derived macrophages . This is apparently the first report of in vitro susceptibility of Leishmania to pentavalent antimony or to pentamidine . The insensitivity of insect forms (promastigotes) multiplying in cell-free media to thee drugs suggests that amastigotes are more sensitive than promastigotes to these antileishmanial agents . Alternatively, macrophages may concentrate or metabolize the drugs to increase their toxicity . In contrast, amphotericin B was toxic to both amastigotes and promastigotes . The sensitivities of Leishmania within human monocyte-derived macrophages in vitro to clinically achievable concentration of antileishmanial agents suggests that this model may be useful for investigation of mechanisms of sensitivity and resistance of antimicrobial agents against Leishmania. Antimicrob Agents Chemother, 1980 Jun, 17(6), 943 - 6 Susceptibility of Bacterium actinomycetem comitans to 45 antibiotics; Hoffler U et al.; The minimal inhibitory concentrations of 45 antimicrobial agents were determined for 14 strains of Bacterium actinomycetem comitans (Actinobacillus actinomycetem-comitans) . All the strains showed good susceptibility to tetracyclines and chloramphenicol, but not to lincomycins . Some strains were clearly resistant to penicillins, cephalosporins, and nitroimidazoles . The lowest minimum inhibitory concentrations were observed with tetracycline, rolitetracycline, methacycline, minocycline, chloramphenicol, and cotrimoxazole. Am J Hosp Pharm, 1980 Jun, 37(6), 829 - 32 Effect of pharmacist consultation on rational antimicrobial therapy; Witte KW et al.; The incidence of rational decisions concerning antimicorbial therapy before and after the establishment of clinical pharmaceutical services in a hospital was compared . A protocol was designed to determine the rationality of physician orders for antimicrobial therapy . This ptocol was used to analyze retrospectively the medical records for patients admitted to a 30-bed surgical unit and a 30-bed medical unit during two months before and after clinical pharmaceutical services were initiated . The results showed that exposure to routine clinical pharmaceutical services appeared to improve prescribing rationality only of drugs used to treat infectious conditions . Since the study design had no control group, the causal effect of clinical pharmaceutical services on the rationality of antimicrobial therapy could not be determined; however, the use of an organized protocol in monitoring antimicrobial therapy allowed an assessment of the use and misuse of antimicrobials in hospitals. Arch Dis Child, 1980 Jun, 55(6), 458 - 60 Antimicrobial activity of colostrum after administering killed Escherichia coli O111 vaccine orally to expectant mothers; Dluholucky S et al.; An attempt was made to see if it was possible to produce antimicrobial activity in colostrum after killed Escherichia coli O111 vaccine had been given orally to expectant mothers . The colostral samples were used in vitro for the inhibition test immediately after the start of lactation . The colostrum from 7 of the 47 vaccine-treated mothers inhibited the growth of E . coli O111 compared with only one colostrum from 101 controls . No complication has occurred either in the vaccine-treated mothers or their suckling babies . The association between the presence of antimicrobial activity in the colostrum and the time of vaccine application was insignificant. J Antibiot (Tokyo), 1980 Jun, 33(6), 604 - 13 Effect of sodium chloride on gentamicin accumulation by Escherichia coli: correlation with bacterial growth and viability; Heller AH et al.; The kinetics of gentamicin accumulation by a sensitive strain of Escherichia coli were investigated at gentamicin concentrations from 0.02 to 200 microgram/ml . Accumulation with time shows two energy-dependent phases and is saturable . Sodium chloride delays the onset of the second more rapid energy-dependent phase and decreases the magnitude of gentamicin accumulation for incubations up to 60 minutes at all gentamicin concentrations tested . Simultaneous determinations of accumulation, cell viability, and growth inhibition indicate that antimicrobial activity is correlated with the magnitude of gentamicin accumulation . These observations suggest that altered bacterial accumulation of gentamicin explains the effect of sodium chloride on the antimicrobial activity of gentamicin. Antibiotiki, 1980 Jun, 25(6), 429 - 32 {Spread and transfer of plasmid resistance in Escherichia coli}; Rudneva SN et al.; Drug resistance of 186 E . coli strains isolated in 1977-1978 from patients and carriers, as well as from the environment was studied with respect to 8 widely used antimicrobial drugs, i.e . tetracycline, streptomycin, chloramphenicol, ampicillin, neomycin, kanamycin, nalidixic acid and sulfanilamides . All of the strains were resistant to sulfanilamides, 39% of the strains were resistant to at least one antibiotic and 5.2% of the strains were resistant to nalidixic acid . Multiple resistance was observed in 60% of the isolates . II variants of various combinations of r-determinants were found . Strains resistant to 2 or 3 antibiotics and combinations of tetracycline + streptomycin and tetracycline + kanamycin + neomycin were most frequent . The number of the antibiotic resistant strains isolated from the humans and environment was 40.5 and 36.8% respectively . The multiple resistance spectra of the strains isolated from the humans were more variable . No transmissive r-determinants were found in the strains resistant to one antibiotic . However 85% of polyresistant E . coli carried conjugative R plasmids . Transmission of the determinants of resistance to ampicillin (90%), streptomycin (80%), chloramphenicol (71.4%), neomycin and kanamycin (55.5%) was most frequent, while the determinants of resistance to tetracycline (37%) were least frequent . The frequency of transmissive R plasmids in the strains isolated from the humans was higher than that in the strains isolated from the environment . It was shown that most of the conjugative plasmids were of fi- character. Arch Intern Med, 1980 Jun, 140(6), 818 - 26 Human nocardiosis . A clinical review with selected case reports; Curry WA; Nocardiosis is an illness caused by several species of the genus Nocardia . Although it is seen in immunocompromised hosts, infection frequently occurs in persons with no recognized predisposition . Infection may be localized to the skin, or it may involve the lungs, disseminating to virtually any organ . Pathogenesis is only beginning to be understood, but, at least in laboratory animals, there seems to be a host-parasite relationship that depends on inadequate clearing of the organism by processes of cell-mediated immunity . Clinical manifestation varies widely according to the sites involved . Diagnosis is principally by culture and may require an aggressive approach . Although sulfonamides remain the mainstay of therapy, preliminary data for other antimicrobial agents are promising. J Allergy Clin Immunol, 1980 Jun, 65(6), 454 - 64 Nonantibiotic effects of macrolide antibiotics of the oleandomycin-erythromycin group with special reference to their "steroid-sparing" effects; Selenke WM et al.; Certain macrolide antibiotics, such as troleandomycin (TAO), oleandomycin, and erythromycin estolate (Ilosone), can lower the maintenance dose of glucocorticoids required by severely asthmatic patients . These effects were postulated to be caused by an as yet undefined steroid-sparing effect . In this study, TAO in combination with methylprednisolone, when compared with methylprednisolone alone, was demonstrated to significantly increase liver glycogen deposition in adrenalectomized mice, intact mice, and adrenalectomized rats; protect histamine-sensitized mice following beta adrenergic blockade or adrenalectomy; further decrease the steroid-lowered glucose tolerance of mice and significantly increase the plasma corticosteroid levels in rats . TAO alone did not have these effects . TAO plus betamethasone, and erythromycin estolate plus methylprednisolone also increased liver glycogen deposition . However, TAO did not appear to potentiate the effects of hydrocortisone . Erythromycin stearate and to a lesser degree erythromycin ethylsuccinate when combined with methylprednisolone also decreased histamine lethality in mice . Leucomycin and tetracycline did not enhance the effects of methylprednisolone . TAO, alone or with methylprednisolone, did not alter serum glutamic oxaloacetic transaminase (SGOT) levels in rats . Thus, TAO and some other macrolides did not exert their effects on corticosteroids as antimicrobial agents, adrenocorticotropic hormone (ACTH)--like compounds, or quasisteroids, but as steroid-sparing agents by some undefined mechanism. Neurosurgery, 1980 Jun, 6(6), 691 - 714 Antimicrobial agents and the central nervous system; Everett ED et al.; There is an ever-expanding number of antimicrobial agents available for the clinician to use to combat infections . We review the majority of such agents that are currently available relative to their theoretical or proven efficacy in the treatment of CNS infections . Due to the unique ability of the CNS to exclude many agents delivered via the blood stream, easily administered and efficacious therapy remains a problem . Based on the pharmacokinetics of anti-infective drugs and their antimicrobial spectrum, at present a penicillin derivative or chloramphenicol should be used whenever possible because parenteral therapy will usually achieve the desired results . In many neurosurgery-associated infections, intrathecal or intraventricular antibiotics may be required to supplement parenteral treatment and/or surgical intervention . Some of the more promising agents (such as rifampin, trimethoprim-sulfamethoxazole, and metronidazole) await further clinical trials to establish their place in the therapeutic armamentarium . Careful, randomized, prospective studies of prophylactic antibiotics must be performed in the neurosurgical setting . A group of tables are included that summarize the expected spinal fluid levels, the sensitivities of organisms commonly causing neurosurgical infections, doses of drugs given intrathecally or intraventricularly, and recommended regimens for certain infections. J Am Vet Med Assoc, 1980 May 15, 176(10 Spec No), 1061 - 8 Pharmacotherapeutics of the newer tetracyclines; Aronson AL; The newer tetracyclines are defined as those tetracyclines available in the United States but not approved for veterinary use . These include demeclocycline, methacycline, doxycycline, and minocycline . Of these, doxycycline and minocycline appear to offer advantages that would render them useful in certain situations in veterinary medicine . Their major advantage lies in their greater lipid solubility relative to other tetracyclines . This characteristic probably accounts for their enhanced antimicrobial effectiveness for some organisms, more efficient absorption after oral administration, and enhanced distribution in the body . The principal excretory organ for doxycycline is the intestine, where the drug diffuses through the intestinal mucosa into the intestinal tract . This unique characteristic makes this drug useful in cases of preexisting renal dysfunction and may render this drug superior to other tetracyclines in the treatment of intestinal infections . Doxycycline is used in other countries for respiratory tract and intestinal tract diseases of poultry . The usefulness of doxycycline and minocycline in food-producing animals may be limited because of persistent drug residues . Minocycline has, in large doses, been used with streptomycin in the elimination of the carrier state of canine brucellosis . The superiority of doxycycline and minocycline, relative to other tetracyclines, in their distribution to areas of he body such as the eye, brain, cerebrospinal fluid, and prostate gland suggests that trials of their efficacy in tetracycline-sensitive infections of these areas are indicated . Pharmacokinetic studies designed to determine optimal dosage schedules have not been made for domestic animals . These determinations are necessary to evaluate most effectively the usefulness of the newer tetracyclines in veterinary medicine. Can J Microbiol, 1980 May, 26(5), 583 - 7 A streptomycete antagonist to Phellinus weirii, Fomes annosus, and Phytophthora cinnamomi; Rose SL et al.; An actinomycete isolated from the rhizoplane of nitrogen-fixing nodules of Ceanothus velutinus was identified as a variety of Streptomyces griseoloalbus . Streptomyces griseoloalbus is a strong antagonist to three destructive root pathogens, Phellinus weirii, Fomes annosus, and Phytophthora cinnamomi, inhibiting all three on several culture media and preventing establishment of F . annosus on hemlock wood disks . The stability and longevity of the antimicrobial substance produced by it, its consistent effect on the pathogens on all substrates, its ability to colonize wood, and its ability to grow at 10 degrees C suggest biological control possibilities for this organism in the Pacific Northwest. Antibiotiki, 1980 May, 25(5), 333 - 8 {Synthesis and properties of the N-acyl derivatives of carminomycin and rubomycin}; Olsuf'eva EN et al.; Synthesis of N-acetylcarminomycin (III) is performed for the first time and the method of selective aminoacylation of 3'-NH2 group of carminomycin (I) and rubomycin (II) is elaborated . The method is based on interaction of N alpha-protected amino acid activated with respect to the carboxyl group with one of the antibiotics followed by removal of the protective group under mild conditions . O-Nitrophenylsulphenyl group (NPS) is used as the protective agent . In case of rubomycin (II), N alpha-NPS-amino acid is attached with the carbodiimide method . In case of carminomycin (I) the similar reaction proceeds inconsistently and carminomycin is acylated with the method of activated ethers and the use of N-hydroxysuccinimide ether of N alpha-NPS-protected amino acid . The following substances were prepared: N-(N alpha-NPS-D-phenylalanyl)-carminomycin (IVa), n-(n alpha-NPIa) and N-(N alpha-NPS-L-alanyl)-rubomycin (VIIa) . Removal of NPS-group is performed under mild conditions (2 equiv . HCl in acetone, 20 degrees C, 2 min) without significant destruction of the antibiotic glucoside bond and results in formation of respective water-soluble hydrochlorides of N-aminoacyl derivatives of carminomycin and rubomycin (IV-VII) . Teh structures of the new compounds are confirmed by the analytical and spectral data (Rf, {alpha} D, IR-, UV- and VO-, PMR-spectra, elementary analysis) and their chemical transformations . Antimicrobial activity of N-acetylcarminomycin (III) and water-soluble hydrochlorides of carminomycin and rubomycin derivatives (IV-VII) against Bas . mycoides is 5-10% of that of the respective initial antibiotics (I) and (II). J Med Chem, 1980 May, 23(5), 469 - 74 Soft drugs . 1 . Labile quaternary ammonium salts as soft antimicrobials; Bodor N et al.; Strategies for the design of safer drugs are discussed . The various classes of "soft drugs" are designed to avoid undesired metabolic disposition (primarily various oxidative routes, occurring via possible toxic intermediates) and to be metabolized by a predictable manner with controlled rates . As a first example for the "soft analogue" type drugs, a new class of antimicrobial, surface-active quaternary salts of the type RCOOCHR1--N+ comes from X- was developed . These "soft" quaternary salts are isosteric analogues of known "hard" quaternary surfactants and are characterized by predictable and controllable cleavage (metabolism) to nontoxic components, while showing good activity against a wide range of bacteria . Due to their soft nature (low toxicity), the new antimicrobials are much safer than the conventional, hard analogues. Am J Med, 1980 May, 68(5), 643 - 8 Improved prognosis for granulocytopenic patients with gram-negative bacteremia; Love LJ et al.; The grave prognosis associated with gram-negative bacteremia occurring in granulocytopenic patients with cancer suggests that granulocyte transfusions are frequently indicated . We have evaluated 67 episodes of gram-negative bacteremia, studied in four consecutive antibiotic trials, in order to correlate prognostic determinants of recovery . These patients had a median absolute granulocyte count of 100/microliter at the time of bacteremia . Empiric antibiotic regimens were begun at the first evidence of suspected infection . Granulocyte transfusions were employed only as clinically indicated by inadequate patient response to antibiotic therapy . Among the 29 patients who had an increase in their granulocyte count of greater than or equal to 100/microliter over the subsequent 14 days, 27 (93 per cent) recovered whereas among 38 patients who had no appreciable increase in their granulocyte count, 21 (55 per cent) improved (p = 0.006) . In this latter group of patients with no granulocyte recovery, the susceptibility of the pathogen(s) to the initial empiric antibiotic regimen was of major importance . None of four patients responded when the pathogen was resistant to both antibiotics initially utilized, six of 14 (44 per cent) patients responded when there was susceptibility to one antibiotic, and 15 of 20 (75 per cent) patients responded when there was susceptibility to both antibiotics (p less than 0.025) . We conclude that patients with gram-negative bacteremia and persistent granulocytopenia will often respond to antimicrobial therapy alone provided the initial choice of empiric antibiotics is appropriate and that their use is instituted promptly . Granulocyte transfusions need not be added unless clinical evaluation indicates inadequate response. South Med J, 1980 May, 73(5), 627 - 30 Approach to the management of fever and granulocytopenia; Delgado DG et al.; In recent years, advances in chemotherapy for malignant disease have resulted in a greater population of patients with granulocytopenia whose course in often complicated by fever . We reviewed the current medical literature in an attempt to identify the most appropriate management of this special patient population . Our findings suggest that patients with fever and granulocytopenia and without a diagnosis of infectious disease who improve on empiric antimicrobial therapy should continue to receive empiric therapy until their granulocytes recover . Patients in this same category who remain febrile probably do not have an infectious cause of their fever, and discontinuation of empiric antibiotics should be considered if they appear clinically stable . A guideline to the management of these patients is presented. Neurosurgery, 1980 May, 6(5), 529 - 39 Ethylene oxide sterilization of bone, dura mater, and fascia lata for human transplantation; Prolo DJ et al.; The use of allogeneic human bone, dura, and fascia has achieved an enduring and accelerating role in the augmentation of spinal fusions and the repair of skeletal and dural defects . Primary sterilization of these nonviable cadaveric tissues magnifies the potential sources and ensures the microbiological sterility of the implant . Subsequent lyophilization facilitates preservation and distribution and reduces the immunogenicity of the graft . The evaluation of gaseous ethylene oxide (EO) as a sterilant was suggested by the delerious effects of alternative methods . Through a series of experiments, the following properties of EO sterilization were studied: (a) surface and interstitial sterilization; (b) the diffusion of EO into tissue, the formation of the reaction products ethylene chlorohydrin (EC) and ethylene glycol (EG), and the desorption of all three from tissues; (c) lyophilization and aeration in the removal of residues; and (d) minimization of residues through pretreatment . Gaseous EO is a very effective surface sterilant of wet bone, dura, and fascia and does not grossly alter these tissues . Its partial penetration through compact bone renders it less reliable for an interstitial antimicrobial effect, unless access to the interior is provided by serial openings . The toxicity of EO, EC, and EG mandates the desorption through lyophilization of these compounds (EC and EG are formed during sterilization with EO) . Before sterilization, bone must be rid of marrow by vigorous irrigation with deionized water . The resultant reduction of the number of cells and of the available chloride decreases antigenicity and the formation of EC . Freeze-drying for more than 72 hours, in some cases augmented by prolonged aeration at room temperature, reduces EO, EC, and EG to acceptable levels . The accurate assay of residues in tissue requires acetone extraction for gas chromatography on rehydrated tissues because extraction of dry tissues gives falsely low results . Rigorous adherence to a protocol incorporating these findings justifies the acceptance of gaseous EO as a safe, relatively rapid, and inexpensive sterilant of bone and soft tissues. Medicine (Baltimore), 1980 May, 59(3), 188 - 205 Legionnaires' disease: report of sixty-five nosocomially acquired cases of review of the literature; Kirby BD et al.; Sixty-five cases of nosocomially acquired Legionnaires' disease are reported and the world literature is reviewed . The etiologic agent, Legionnella pneumophila, has been isolated from several environmental sources at outbreak sites . Legionnaires' disease appears to be acquired by inhalation and is primarily manifested by severe, potentially fatal, pneumonia . Characteristic clinical disease consists of high fever with relative bradycardia, dry cough