Infect Immun, 1979 Jul, 25(1), 366 - 75 Efficacy of antimicrobial therapy in experimental rat pneumonia: effects of impaired phagocytosis; Bakker-Woudenberg IA et al.; The importance of intact host defense mechanisms for successful antimicrobial therapy was investigated in an animal model . Recovery from lobar pneumococcal pneumonia as a result of penicillin therapy was studied in normal rats and in rats treated with cobra venom factor . This factor was used to selectively suppress the phagocytosis of pneumococci as a result of complement depletion . Although complete recovery from the infection occurred in normal rats after appropriate penicillin therapy, this was not the case in cobra venom factor-treated rats . Within the limitations of this study, evidence is presented for loss of antibiotic activity as a consequence of impaired phagocytosis. J Pharm Sci, 1979 Jul, 68(7), 866 - 71 Synthesis and evaluation of benzylfluorenyl and 1-arylethyl quaternary ammonium salts for antimicrobial and antineoplastic activities; Dimmock JR et al.; A number of substituted benzyldimethyl-9-fluorenylammonium bromides (II) and 9-benzylfluorenyl-9-trimethylammonium bromides (IV) were synthesized and examined for antimicrobial and anticancer activites . Series IV showed greater antimicrobial activity than Series II while some corresponding acyclic fluorene analogs were bereft of antimicrobial activities . Significant antineoplastic activity was not found in Series II and IIV . Representative fluorenes subjected to a preliminary screen for various pharmacological activities revealed marked anti-inflammatory and analgesic properties coupled with some antihistaminic activities . The acyclic quaternary ammonium compounds demonstrated substantial pressor activites. Arch Surg, 1979 Jul, 114(7), 805 - 8 Use of antimicrobials in the management of open fractures; Gustilo RB; The role of antibiotic therapy in open fractures is secondary to adequate debridement, irrigation, and definitive wound care . Experimental and clinical studies indicate that parenteral administration of appropriate antibiotics within three hours after injury helps to prevent wound sepsis . Intial wound cultures of 158 open fracture wounds revealed bacterial growth in 70.3% . Eighty-six were Gram-positive, 57 were Gram-negative, and 32 yielded mixed bacterial growth . Sensitivity studies of these organisms suggest that cephalothin sodium is the most effective antibiotic for prophylaxis . In a prospective study from 1969 to 1975, treatment of 520 patients was as follows: debridement, copious irrigation, and primary closure for types 1 and 2 fractures and secondary closure for type 3 fractures . No primary internal fixation was done except in vascular injuries . Cultures were taken of all wounds and antibiotics were given before surgery and for three days postoperatively . In type 3 open fractures, severe soft tissue injury, and segmental or traumatic amputation, the infection rate was 9%, compared to a 44% infection rate in the retrospective study from 1955 to 1968. Arch Intern Med, 1979 Jul, 139(7), 821 - 2 Candida fungus balls in the common bile duct . Unusual manifestation of disseminated candidiasis; Magnussen CR et al.; Disseminated candidiasis appearing as Candida fungus balls in the common bile duct developed in a patient with acute myelogenous leukemia . The patient had received broad-spectrum antimicrobial therapy for fever of unclear origin and subsequently manifested signs of liver cell dysfunction . A percutaneous transhepatic cholangiogram demonstrated three radiolucent defects in the distal part of the common bile duct, which proved to be fungus balls at operation . The liver was studded with microabscesses that disclosed C albicans on biopsy . The biliary tract fungus balls were removed surgically, and the patient was treated with 2,001 mg of intravenously administered amphotericin B over a 2 1/2-month period . No evidence of Candida infection is evident eight months after completion of therapy. Arq Inst Biol (Sao Paulo), 1979 Jul-Dec, 46(3-4), 87 - 92 {Antimicrobial drugs in poultry nutrition: resistance levels in Escherichia coli}; Lopes CA et al.; In a battery experiment, a hundred of day old broiler chicks (Hubbard) divided into ten groups, were fed for eight weeks with 50, 75 or 100mg/Kg of ration of chloramphenicol and tetraciclyne; 40, 80 or 120mg/ 2 liters of drinking water of nitrofurazone . During three months defecated feces from each bird were sampled and analysed at intervals of 15 days for the isolation of Escherichia coli strains which were submitted to the determination of drug resistance . The results showed that utilization of antimicrobial drugs selected a resistant population of Escherichia coli at 300 microgram/ml of chloramphenicol tetraciclyne and 30 microgram/ml of nitrofurazone, during the dietary period . In addition the characterization of the R factor made by conjugation against apropriated recepient strains, demonstrated it's presence in some of the tested strains has only been noted the mobilization of the tetraciclyne marker. Nord Vet Med, 1979 Jul-Aug, 31(7-8), 309 - 15 The effect of protein-binding on the excretion of three sulphonamide preparations in the milk of dairy cows, examined by chemical and microbiological methods; Soback S et al.; The relationship between the protein-binding of sulphonamides and their excretion in the milk of dairy cows was studied using three preparations commercially available in Finland . After a preparations containing sulfadiazine and sulfadimidine was given intravenously to dairy cows the drugs were excreted into milk to a greater extent than in the case of sulfamethoxypyridazine and especially of sulfaphenazole given similarly . An inverse relationship was found between the degree of protein-binding in the serum and the excretion into milk . The antimicrobially active concentrations of sulphonamides in serum and milk persisted for less than 24 hours when the doses recommended by the manufacturers were used . From a pharmacological point of view the sulfadiazine-sulfadimidine combination seems to be the drug of choice . Although no traces of sulphonamides were detected 48 hours after the dosing, the question of milk residues could not be answered because the minimum detection level of the methods used in the study was approximately 1 microgram/ml . The IDF standard method for the detection of penicillin in milk is not suitable for the detection of sulphonamide residues in milk. Surv Ophthalmol, 1979 Jul-Aug, 24(1), 33 - 8 Resistance to infection of the external eye: the role of tears; Selinger DS et al.; The external eye is continuously exposed to an environment containing potentially pathogenic microorganisms . One of the mechanisms which protects the eye from infection is the tear layer . We review the current knowledge of those antimicrobial substances known to be present in tears and the role they might play in preventing infection . These substances include lysozyme, lactoferrin, beta-lysin, and the antibody-complement system of proteins. J Pharm Sci, 1979 Jul, 68(7), 930 - 1 New compounds: arylsulfonylhydrazones derived from various heterocycles; Juneau R et al.; Ten arylsulfonylhydrazones were prepared from various heterocycles . The antimicrobial activity of these compounds was investigated, as was the cytotoxic activity of one of them. J Dent Res, 1979 Jul, 58(7), 1722 - 32 Antibacterial susceptibility of plaque bacteria; Newman MG et al.; Selected anaerobic, capnophilic and facultative bacteria isolated from patients with various forms of periodontal health and disease were tested for their susceptibility to antibiotics and antimicrobial agents . Specific bactericidal and minimum inhibitory concentrations were compared to disc zone diameters, thereby generating new standards for the potential selection of antimicrobial agents. Infect Immun, 1979 Jul, 25(1), 153 - 6 Effect of estrogens on the myeloperoxidase-mediated antimicrobial system; Klebanoff SJ; Estradiol 17 beta prevented the fall in the microbicidal activity of the myeloperoxidase-H2O2-halide system induced by high H2O2 concentrations . In contrast, when the H2O2 (and halide) concentrations were low the myeloperoxidase-H2O2-halide antimicrobial system was inhibited by estradiol . These properties of estradiol 17 beta were shared by estradiol 17 alpha, estrone, estriol, ethinyl estradiol, and phenol, but not by estradiol-3-benzoate, testosterone, progesterone, hydroxyprogesterone, cortisone, hydrocortisone, or deoxycorticosterone. Quad Sclavo Diagn, 1979 Jun, 15 Suppl 1, 336 - 48 {Mechanisms of action of chemoantibiotics (author's transl)}; Gargani G; An useful drug for infectious diseases should have a selective antimicrobial activity and no action on animal cell . The general target, besides some very restricted process like in M . tuberculosis, are: 1) purine synthesis, 2) DNA replication, 3) protein synthesis, 4) cell-wall synthesis, 5) cytoplasmic membrane . On purine synthesis are active the sulphamidic on DNA replication nalidixic acid on Gram-negative bacteria, and griseophulvin on dermatophites . Many drugs have their target in the sequential stages of protein synthesis, among these the aminoglycosides are mainly bactericidal . The antibiotics which block the building of cell-wall are the best, according the target does not exist in animal cell; among them, penicillins and cephalosporins are bactericidal . On contrary cytoplasmic membrane, which is similar to the animal cell membrane has to be evaluated as a bad target . Polimyxins on bacteria, polyene antibiotics on fungi, have this target and are bactericidal, but their use is restricted for toxicity . Antibiotics must be selected in therapy according to their mechanism of action and to the immunological state of the patient . Some bactericidal antibiotics have to be reserved for immuno suppressed people. Zentralbl Bakteriol {B}, 1979 Jun, 168(5-6), 507 - 16 {About the antimicrobial activity of substituted aromatic aldehydes and alcohols (author's transl)}; Rehn D et al.; In the scope of our research about the antimicrobial activity of serveral chemicals a number of substituted benzaldehydes and benzylalcohols was investigated under standardized conditions following the method of DGHM (German Society of Hygiene and Microbiology) against bacteria, dermatophytes and moulds . The germicidal activity, demonstrated by the suspension test, is generally low except under special conditions (low or high pH-value) . The germistatic activity, demonstrated by the MIC-test, is much higher than the germicidal effect (figs . 1--4) . The relation structure-germistatic activity is discussed. In Vitro, 1979 Jun, 15(6), 409 - 14 Selection of a chemically defined medium for culturing adult newt forelimb regenerates; Conn ME et al.; Three commercially available tissue-culture media were evaluated for their ability to support continued growth and differentiation of 14-day regenerates of adult newt forelimbs . Serums, embryo extracts, egg ultrafiltrates, and antimicrobial agents were avoided in this analysis . The hormones insulin and L-thyroxine were added to these chemically defined media to enhance continued cellular metabolism and growth . The optimum conditions appeared to be cultivated at 25 degrees C (pH 7.2 to 7.4) in media osmotically adjusted to conditions approximating amphibian blood values (i.e . 225 m0SM for 199, 244 m0SM for CMRL-1066, and 262 m0SM FOR L-15). J Antibiot (Tokyo), 1979 Jun, 32(6), 621 - 5 CI-867, a new broad-spectrum semisynthetic penicillin; Kaltenbronn JS et al.; The synthesis and antimicrobial activity of a new semisynthetic penicillin are described . Both in vitro and in vivo, the compound shows promising antibacterial activity when compared with piperacillin and ticarcillin . High activity is shown against Pseudomonas and other Gram-negative bacteria. JAMA, 1979 Jun 1, 241(22), 2401 - 3 Gentamicin and ticarcillin serum levels; Murillo J et al.; Ticarcillin disodium and gentamicin sulfate serum levels were measured one and five hours after intravenous administration . Patients receiving ticarcillin plus gentamicin had a significantly lower mean gentamicin level one and five hours after antibiotic administration than patients receiving cephalothin sodium plus gentamicin . The serum ticarcillin levels were significantly lower five hours after administration in patients receiving ticarcillin plus gentamicin than in those receiving ticarcillin plus cephalothin . Low antibiotic serum levels in patients with serious infections treated with these antibiotic combinations are of potential clinical significance; therefore, to ensure an optimal antimicrobial therapy, it is advisable to determine the drug serum concentrations (especially aminoglycoside) even in patients with normal renal function when treating with combinations of antimicrobials. Onkologie, 1979 Jun, 2(3), 102 - 7 {Effectiveness of gnotobiotic measures in the treatment of acute leukemia: the results of a prospective randomized clinical study}; Dietrich M et al.; 60 adult patients with acute leukemia (AL) previously untreated or in relapse received induction chemotherapy with different types of supportive care . Group A was decontaminated by nonabsorbable antibiotics in strict reverse isolation, group B was isolated only and group C was treated under routine hospital conditions . There were less infections in group A and B compared with group C . 76% of patients in group A achieved remission, in contrast to 57% in group B and 59% in group C . Late evaluation three years after termination of the study showed that all patients were dead except four patients being in first remission after discontinuation of maintenance treatment . Three patients were treated in group A, one patient in group C . However, the differences of survival and remission rates were not significant . Failure to demonstrate significant advantage of isolation and decontamination in treatment of AL was caused by insufficient suppression of microbes by the applied antimicrobial measures . Thus, it is suggested to investigate better antimicrobial treatment before gnotobiotic care is accepted as routine supportive treatment in AL. Farmaco {Sci}, 1979 Jun, 34(6), 507 - 17 Synthesis and biological activities of some indolo{2,3-c}isoquinoline derivatives; Winters G et al.; Indolo{2,3-c}isoquinoline derivatives have been synthesized and tested for their antimicrobial activities . Some of them display good in vitro activity against fungi and gram-positive bacteria. J Infect Dis, 1979 Jun, 139(6), 698 - 706 Use of antimicrobial drugs in general hospitals . II . Analysis of patterns of use; Shapiro M et al.; The hospital charts were surveyed of 5,288 patients in 20 hospitals that were randomly selected from the 194 general hospitals in Pennsylvania . Antimicrobial drugs were administered to 28% of the patients, with little variation in pattern according to hospital size . Surgical services accounted for 61% of the patients who received antimicrobial drugs, and the proportion of patients receiving such drugs varied from 84% on thoracic and cardiovascular surgical services to 13% on obstetrical services . General medicine accounted for 29% of the patients who received antimicrobial drugs and pediatrics for 9% . Eight percent of the hospital population accounted for 50% of all antimicrobial drugs used . Ampicillin was the most frequently used drug, being given in 22% of all courses, with cephalosporins (18%), benzylpenicillins (14%), and tetracycline (13%) next in order . Approximately 30% of the antimicrobial courses were used for prophylaxis. J Infect Dis, 1979 Jun, 139(6), 688 - 97 Use of antimicrobial drugs in general hospitals . I . Description of population and definition of methods; Townsend TR et al.; The patterns of use of antimicrobial drugs in a random sample of general hosptials in Pennsylvania were studied . The sample was tested for validity, and all deaths and discharges were analyzed for 10 random days drawn across the year spanning July 1973 to June 1974 . Methods were developed for abstracting the hospital records and for determining the reproducibility of the findings of the physician and nonphysician chart reviewers . More than 99% of the requested charts were available . In the 5,288 charts reviewed, most of the required data were readily available . The study population was 84% white and 58% female; most patients were in hospitals that had more than 300 beds and that were located in towns with populations of greater than 10,000 . In 41% of the 2,070 antimicrobial courses administered to almost 30% of the patients, an explicit clinical statement of why the drug was being given could be found in the chart . The information for review was found in clinical charts, but in half of the charts, the information required was not on face sheets and discharge summaries. JAMA, 1979 May 25, 241(21), 2283 - 6 Antibiotic control in a municipal hospital; Recco RA et al.; The choice of an antibiotic for a patient is often a difficult decision . The clinician must contend with a bewildering variety of bacteria and use a number of expensive and toxic antimicrobial agents judiciously . To deal with the problems of excessive and inappropriate use, the medical staff of Coney Island Hospital established compulsory, prospective antibiotic control . Two years after initiation of this program, we analyzed changes in sensitivity patterns of hospital flora, physicians' prescribing habits and antibiotic use . A trend toward increasing resistance on the part of some Gram-negative isolates to certain beta-lactam antibiotics was noted . Antibiotic costs decreased an average of 38%, while prescribing skills improved. J Antibiot (Tokyo), 1979 May, 32(5), 436 - 41 Studies on Actinomycetales producing antibiotics only on agar culture . II . Isolation, structure and biological properties of N-carbamoyl-D-glucosamine (substance SF-1993); Omoto S et al.; N-Carbamoyl-D-glucosamine was isolated from the culture of Streptomyces halstedii SF-1993 . It showed weak antimicrobial activity against some Gram-negative bacteria and some fungi. Clin Chem, 1979 May, 25(5), 659 - 64 Relative stabilities of purified human mitochondrial and cytoplasmic isoenzymes of aspartate aminotransferase in lyophilized materials; Sampson EJ et al.; Eight different pools of purified human mitochondrial and cytoplasmic isoenzymes of aspartate aminotransferase were prepared, to examine the effects of the following matrix variables: the matrix support material (bovine serum albumin and polyvinylpyrrolidone), endogenous pyridoxal concentration, and azide as an antimicrobial preservation . Storage temperatures of 25 and 37 degrees C were used as a rapid and convenient means of accelerating the degradation process . Activity of the enzyme was measured with and without pyridoxal in the reaction solution . We found that the mitochondrial isoenzyme was consistently more labile than the cytoplasmic isoenzyme under identical storage conditions . Both isoenzymes were more stable in matrixes containing bovine serum albumin than in those containing polyvinylpyrrolidone . No apparent difference in the stability of either isoenzyme was observed at matrix pyridoxal concentrations of 15 micromol/L and 150 micromol/L . Only the mitochondrial isoenzyme in matrixes containing bovine serum albumin and 15 micromol of pyridoxal per liter had increased activity (about 9%) when pyridoxal was added to the enzymatic reagent . The amount of activity in reconstituted specimens did not apparently change after 72 h at 4 degrees C. J Pharm Sci, 1979 May, 68(5), 591 - 5 Heterocyclic analogs of amphetamine: Thioureas, dithiocarbamates, and negatively substituted amides; Foye WO et al.; A series of heterocyclic analogs of amphetamine was synthesized . The heterocycles employed included the 2-furyl, 2-thienyl, 3-methyl-2-thienyl, 3-pyridyl, and 6-methyl-2-pyridyl rings . The aliphatic amine group was converted to the N-methylthiourea, dithiocarbamate, methanesulfonyl, trifluoromethanesulfonyl, and trifluoracetyl functions since similar conversions of the beta-phenethylamine structure had shown blood pressure-lowering effects and some loss of behavioral effects . p-Chlorophenyl and 1-naphthyl analogs were also converted to these derivatives . Behavioral and other biological effects, including antiarthritic, passive cutaneous anaphylactic, and antimicrobial, were observed . The 3-methyl-2-thienyl analog of amphetamine significantly increased papillary muscle contractile force without producing arhythmias. J Antibiot (Tokyo), 1979 May, 32(5), 511 - 7 Inhibition of the respiratory-linked membrane potential in E . coli membrane vesicles by octapeptin; Swanson PE et al.; Octapeptin is a peptide antibiotic which affects bacterial membrane structure and selective membrane permeability for protons and potassium . The influence of octapeptin on the formation of a membrane potential generated across bacterial vesicles was monitored using the Rb+-valinomycin transport system . Octapeptin inhibited the respiratory-linked generation of membrane potentials formed in the presence of succinate or Asc/PMS . In addition, the antibiotic inhibited {3H}-leucine transport driven either by succinate or Asc/PMS . These studies support the proposal that the antimicrobial activity of octapeptin is due to inhibition of the formation of a membrane potential generated in the presence of appropriate respiratory substrates. Pediatr Clin North Am, 1979 May, 26(2), 261 - 8 Antibiotic-associated pseudomembranous colitis in children; Prince AS et al.; Antibiotic-associated colitis is a rare complication of antimicrobial therapy in children . Ampicillin, penicillin, and clindamycin are the drugs most frequently reported to cause pseudomembranous colitis in pediatric patients . This diagnosis should be suspected in any child with significant diarrhea during or after a course of antimicrobial therapy, especially if the diarrhea persists after the drug has been discontinued . The diagnosis is established by proctoscopic findings of typical plaques of pseudomembranes . Most cases resolve promptly when the implicated antibiotic is stopped; however, the disease can be fulminant, progressing to toxic megacolon, peritonitis, and shock . Therapy of patients who have persistent diarrhea after the offending antibiotic has been discontinued should include oral vancomycin . Close fluid management is crucial for survival. Jpn J Antibiot, 1979 May, 32(5), 627 - 30 {Two-dimensional diffusion method for determining antimicrobial agents (author's transl)}; Takimoto M et al.; Intending to improve the accuracy of determination of antibiotics, a two-dimensional diffusion method using large agar plate was introduced . Three antimicrobial agents, ampicillin, PC-904, and tobramycin, were used . Inhibition zones of B . subtilis on the agar plate were measured which were formed as a result of diffusion of these agents . The relationship between the concentration of antimicrobials and the size of inhibition zones was studied . Plotting the data-points on the graph, it was predicted that there might be a relationship of quadratic equation between the diameter of inhibition zone and the logarithm of concentration of the agents . On the other hand, mathematical considerations were taken to find out a physical principle or an equation which governs the diffusion of antibiotics in the agar . Assuming that antibiotics spreads in the agar after the principle of simple diffusion, an equation was lead which shows how the antibiotics distributes in the agar in relation to time . The equation was written as, (formula: see text) where, S is amount of antibiotics, D diffusion constant, r distance from the center of diffusion, t period during which the diffusion proceeds . As a result of the mathematical calculations mentioned, it was confirmed that the relation between the size of zones and the logarithm of concentration of antibiotics is described by a quadratic equation as predicted on the basis of experimental data. Arch Ophthalmol, 1979 May, 97(5), 875 - 7 Limulus lysate assay for early detection of certain Gram-negative corneal infections; Wolters RW et al.; The limulus endotoxin assay has been previously demonstrated to be the most sensitive method available for detection of bacterial endotoxin . A commercially available form of limulus amoebocyte lysate was used in this study for detection of Gram-negative corneal infections in both experimental animals and in a group of nine patients . The limulus assay enabled rapid detection of Gram-negative infections in both the experimentally induced ulcers in rabbits and in the patients studied . False-positive reactions did not occur in corneal infections due to either Gram-positive bacteria, fungi, or herpes simplex keratitis . The limulus test proved to be more sensitive than examination of Gram-stained smears of corneal scrapings and became positive earlier than bacterial cultures . The limulus test was helpful in the diagnosis of partially antibiotic-treated corneal infections but could not be used to assess the response to antimicrobial therapy, since endotoxin persisted in the corneal scrapings for some time after initiation of therapy. Vet Clin North Am Small Anim Pract, 1979 May, 9(2), 357 - 62 Management of pyothorax; Holmberg DL; Pyothorax is a serious disease process which requires both medical and surgical intervention . Late recognition, management problems, and likely recurrence make successful treatment difficult and often frustrating . Aims of therapy should be to avoid undue stress to the patient, to relieve respiratory distress by thoracocentesis, to eliminate infectious agents with antimicrobials, to remove pleural exudate, and to provide supportive care . Close monitoring of the patient is necessary to prevent iatrogenic complications such as pneumothorax, hemothorax, hypothermia, or hypoproteinemia . Exploratory thoracotomy for removal of granulomatous material and fibroelastic pleural "peels" is occasionally necessary to resolve compressive cardiopulmonary lesions. Am Fam Physician, 1979 May, 19(5), 91 - 8 New concepts in otitis media; Schwartz RH; Pneumatic otoscopy increases the physician's diagnostic acumen . Movement of the tympanic membrane is observed and measured more precisely by tympanometry and acoustic impedance . Ampicillin-resistant strains of Hemophilus influenzae are appearing . It is possible to detect these with deep nasopharyngeal cultures . New reports show the value of antimicrobial prophylaxis in recurrent otitis media . High-risk populations that deserve special attention are children with cleft palate and Down's syndrome. Oral Surg Oral Med Oral Pathol, 1979 May, 47(5), 475 - 8 Antimicrobial effectiveness in endodontic therapy using formocresol and two new alcoformol agents . Mechanical preparation during the first visit; Simon M et al.; Antimicrobial effectiveness of two alcoformol agents (AF 8.75 and AF 3.5) was studied in a clinical trial by means of bacteriologic examination of the root canals . After the initial culture was taken, the root canal was reamed and a second culture was taken . One of the disinfectants was sealed in the pulp chamber for one week . At the second visit, a third culture was taken . No statistically significant differences were found between the effectiveness of the disinfectants; the cumulative effect of mechanical preparation and disinfection was such that initially positive teeth did not differ significantly from initially negative teeth when treated by this procedure. Oral Surg Oral Med Oral Pathol, 1979 May, 47(5), 471 - 4 Antimicrobial effectiveness in endodontic therapy using formocresol and two new alcoformal agents . Mechanical preparation during the second visit; Simon M et al.; Antimicrobial effectiveness of alcoformol two agents (AF 8.85 and AF 3.5) was studied in a clinical trial by means of bacteriologic examination of the root canals . After the initial culture was taken, one of the disinfectants was sealed in the pulp chamber for one week . At the second visit, the root canal was reamed and a second culture was taken . It was found that AF containing 3.5 percent formaldehyde is a satisfactory disinfectant for root canals of vital teeth . A concentration of 8.75 percent was needed for disinfection of teeth with necrotic pulps. Z Naturforsch {C}, 1979 May-Jun, 34C(5-6), 485 - 6 Antimicrobial activity of quaternary ammonium salts of some saturated heterocycloalkyl amines {1}; Lacko I et al.; Antimicrobial activity of N-alkyl-N-dodecylpiperidinium bromides and N-ethyl-N-dodecylheterocycloalkyl ammonium bromides (pyrrolidine, morpholine, perhydroazepine) determined on grampositive and gramnegative bacteria, yeasts and moulds, presented as minimum inhibition concentration (MIC) . Comparison of the effect of change of structure: lengthening of alkyl chain, change of heterocyclic ring . Change in the length of alkyl chain markedly affects the antimicrobial activity, change of heterocyclic ring has no substantial effect . The most active compounds were N-heptyl-and N-hexyl-N-dodecylpiperidinium bromides. Rev Infect Dis, 1979 May-Jun, 1(3), 434 - 67 From penicillin-binding proteins to the lysis and death of bacteria: a 1979 view; Tomasz A; The mechanism by which interference with the biosynthesis of bacterial cell wall causes death and lysis of bacteria appears more complex than originally thought . In an earlier model of the mode of action of beta-lactams, it was assumed that, in the presence of the antibiotics, bacteria synthesize a mechanically weak (poorly cross-linked) cell wall that ruptured under the osmotic-mechanical pressure of the normally growing cytoplasmic mass . However, recent findings suggest a much more complex picture . Lysis and, in at least some bacteria, loss of viability as well, seem to be catalyzed by autolytic enzymes (murein hydrolases), the destructive activity of which is triggered in the beta-lactam-treated bacterium via a poorly understood mechanism . Furthermore, different species of bacteria respond quite differently to treatment with the same beta-lactam: some bacteria are both killed and lysed, others only lose viability, whereas still other species respond mainly by a reversible inhibition of growth (beta-lactam-tolerant bacteria) . In addition, structurally different beta-lactams may cause quite different biochemical, morphological, and antibacterial effects, even within the same bacterial species . It is conceivable, therefore, that there is more than one mechanism for loss of viability and/or lysis . Most of the bacteria examined so far contain a number (four to eight) of different penicillin-binding proteins . Genetic and physiological evidence obtained in E . coli indicate that these proteins play essential roles in a variety of physiological functions, such as maintenance of structural integrity, shape, and cell division . Pneumococci with a suppressed autolytic system are resistant to he lytic (and, partially at least, to the bactericidal) effect of beta-lactams . Interference with cell wall synthesis seems to trigger autolysin activity by upsetting the cellular control of autolytic enzyme . It is suggested that the irreversible antimicrobial effect of beta-lactams may have an indirect mechanism in other bacteria as well. Ann Acad Med Singapore, 1979 Apr, 8(2), 141 - 3 Adverse drug reaction reporting in the Singapore General Hospital; Tan SF et al.; Adverse Drug Reaction reporting was made mandatory in the Singapore General Hospital in January 1978 . Reports on a total of 59 patients were received on 34 drugs ranging from antibiotics to Chinese medicine . Antimicrobial drugs topped the list of adverse reactions . The most frequently reported drugs in decreasing order of reports were ampicillin, allopurinol, aspirin compound preparations, cloxacillin, digoxin, streptomycin, penicillins and insulins . Allergies were the most common reactions seen. Jpn J Antibiot, 1979 Apr, 32(4), 555 - 61 {Therapeutic effect of midecamycin on Mycoplasma pneumoniae pneumonia in adults (author's transl)}; Kikuchi N et al.; The clinical efficacy of a macrolide antibiotic, midecamycin, was studied in 12 adult cases with Mycoplasma pneumoniae pneumonia . The therapeutic effects were excellent or good in 9 cases and fair in 2 cases . On defervescence and disappearance of shadows on chest X-ray the therapeutic effect was satisfactory, but on disappearance of cough therapeutic effect was not clear in some cases . Taking into consideration the antimicrobial activity of midecamycin against Mycoplasma pneumoniae, serum concentration and side effects of midecamycin, this antibiotic is expected to be effective in the treatment of Mycoplasma pneumoniae pneumonia. Br J Surg, 1979 Apr, 66(4), 275 - 7 Loop colostomy closure; Henry MM et al.; The records of 74 patients who had loop colostomies closed at Addenbrooke's Hospital between 1970 and 1975 were studied retrospectively . One death from a pulmonary embolus occurred and the incidence of fistula from the site of closure was found to be 5.4 per cent . A number of differing factors were assessed . Closure 6 weeks after the colostomy's formation and preoperative antibiotic (antimicrobial) bowel preparation appeared to be factors associated with a favourable outcome . On the other hand, an initial operation for carcinoma and closure less than 6 weeks after the colostomy's formation were factors related to a less favourable outcome. Antibiotiki, 1979 Apr, 24(4), 270 - 3 {Antimicrobial action spectrum of triterpene and steroid glycosides}; Shcheglov VV et al.; Antimicrobial activity of 9 triterpene glycosides of the plant and animal origin was studied . It was found that saponins inhibited the fungal growth to different extents and had no activity against grampositive and gramnegative bacteria . Triterpene glycosides of the animal origin, i.e . holoturins A and B, stichoposids A and C had the most pronounced antifungal activity as compared to the saponins isolated from plants . Changes in the length of the carbon chain from 2 to 6 monosugars had no significant effect on the activity of the triterpeneglycosides studied. J Pharm Sci, 1979 Apr, 68(4), 459 - 62 Antibacterial and antifungal activities of isatin N-Mannich bases; Kupinic M et al.; The antimicrobial and antifungal activities of 29 congeneric isatin N-Mannich bases were investigated by testing against standard test microorganisms and 21 pathogenic Gram-negative microorganisms . Considerable growth inhibition of Gram-negative bacteria and yeasts and slight inhibition of Gram-positive bacteria resulted when they were treated with the various N-Mannich bases of isatin and 5-nitroisatin, respectively. J Pharm Sci, 1979 Apr, 68(4), 407 - 11 Synthesis and antimicrobial evaluation of quaternary salts of 4-phenyl-1,2,3,6-tetrahydropyridine and 3,6-dimethyl-6-phenyl-tetrahydro-2H-1,3-oxazine; Grier N; Fifteen predominantly alkyl bromide quaternary salts of 1-substituted 4-phenyl-1,2,3,6-tetrahydropyridine and 10 from 3,6-dimethyl-l-phenyltetrahydro-2H-1,3-oxazine were synthesized . None was effective against the parasitic protozoan Eimeria tenella and the helminth trichostrongyle nematode . Nearly all inhibited Gram-positive and Gram-negative bacteria; maximum efficiency was obtained with nonyl through dodecyl bromide salt derivatives . Antifungal effectiveness paralleled these results . The oxazinium salt analogs were inhibitory in an in vitro peridontal microorganism screen . The decyl bromide derivative at 0.05% in drinking water prevented dental plaque and reduced calculus deposition in rats but not in hamsters fed cariogenic diets . A 0.01% concentration of the tetrahydropyridinium analog caused increased plaque in rats compared to nonmedicated control animals. J Invest Dermatol, 1979 Apr, 72(4), 165 - 70 Updated in vivo methods for evaluating topical antimicrobial agents on human skin; Leyden JJ et al.; Updated and expanded in vivo quantitative testing procedures to determine the efficacy of topical antimicrobial agents are presented . The occlusion test measures the ability of an agent to prevent the expansion of the resident microflora which occurs when an impermeable dressing is applied to the forearm . Measurements are made at 24 and 48 hr . The expanded flora test measures the ability of an agent to suppress a dense population of micro-organisms produced by expansion of the resident flora of the forearm by prior application of an impermeable occlusive dressing . Measurements are made at 6, 24 and 48 hr or after 10 min in the case for agents designed for immediate degerming . The persistence test measures the ability of an agent to establish a reservoir in skin and exert an antimicrobial effect up to 3 days after the last application of the test material . The ecological shift test determines any major alteration in cutaneous microbial ecology following several applications of the material under occlusive dressings . The serum inactivation test determines whether the presence of serum proteins interferes with antimicrobial activity. J Antibiot (Tokyo), 1979 Apr, 32(4), 361 - 7 Antibiotic X-5108 . IX . Chemical conversion of mocimycin to aurodox and derivatives of aurodox, goldinamine and mocimycin; Maehr H et al.; Mocimycin was converted to the acylesters by selective acylation of the hydroxyl group of the 4-hydroxy-1-methyl-2(1H)pyridinone moiety . Subsequent N-methylation at the nuclear nitrogen and removal of the protective group from the resulting reaction products afforded aurodox . Mono-O-acetylmocimycin and several analogous aurodox esters thus prepared possess antibacterial activity in vitro and growth-promotion properties in poultry . Esters of aurodox involving the hydroxyl group of the 4-hydroxy-1-methyl-2(1H)pyridinone moiety are activated . Accordingly, acetic acid treatment of the aurodox esters generates O-acylgoldinamines which undergo transacylation furnishing N-acylgoldinamines . Alternatively, N-acylgoldinamines can be prepared by selective mono--o-arylsulfonylation of aurodox, liberating o-arylsulfonylgoldinamine by treatment with acetic acid followed by N-acylation and removal of the protective arylsulfonyl group . A third approach to N-acylgoldinamines consists in direct N-acylation of goldinamine itself which is prepared by acetic acid treatment of aurodox . None of these derivatives prepared, however, exhibited significant antimicrobial or growth-promoting properties, suggesting that goldinonic acid moiety, or a closely related derivative thereof, is required for biological activity. Dtsch Zahnarztl Z, 1979 Apr, 34(4), 362 - 4 {Intensive drug therapy of the marginal periodontium}; Overdiek HF et al.; Two composite pastes composed of iodoformglycerin-tween 80 and tribromphenol-bismuth-glycerin were examined using the results of microbiologic studies . Because of their broad antimicrobial spectrum and their easy application, both pastes are suitable for primary control of bacteria in periodontal pockets, particularly when the complete picture of an inflammation is present . The application period for the therapeutic use of corticosteroids should be limited . In addition to freedom from pain, initially slight tissue damage may worsen considerably with prolonged use of these pastes. Semin Nucl Med, 1979 Apr, 9(2), 108 - 13 Intracavitary uses of colloids; Croll MN et al.; Pleural and peritoneal effusion secondary to primary malignancy is a significant problem in the management of the cancer patient . Respiratory embarrassment and discomfort associated with the formation and collection of fluid in the chest and abdomen are among the most distressing symptoms encountered as a result of malignant disease . The guidelines for treatment should be based on respiratory symptoms, and with the understanding that the procedure is palliative . Both surgical and medical forms of treatment have been used . These include thoracostomy-tube drainage alone or with the instillation of antimicrobial agents . Pleurectomy is effective but should be reserved for situations in which conservative approaches have failed . Antitumor agents, such as nitrogen mustard, are effective but toxic . The mode of action of antineoplastic agents is related to their ability to cause pleural sclerosis and obliterate the pleural space . Systemic chemotherapy and external beam radiation are rarely effective . The intracavitary application of radioactive colloids has been used since 1945 . Colloidal radioactive gold Au 198 has been replaced by the pure beta emitter, colloidal chromic phosphate P 32 . Instillation of a colloidal suspension of radioactive phosphorus represents a significant and effective palliative therapeutic modality for malignant effusion. Eur J Clin Pharmacol, 1979 Mar 26, 15(2), 127 - 32 Image of systemic antimicrobial agents as perceived by physicians in a 900 bed hospital; Gomez J et al.; A survey among hospital staff physicians was conducted in order to evaluate their attitudes towards systemic antimicrobial agents . Direct questions about the value of different agents and choice within pairs of antimicrobial drugs, stating the reasons for the preference, were included in the questionnaire used . Gentamicin, penicillin G and ampicillin were the most popular antibiotics among respondents . On the other hand, ampicillin, penicillin G, sulfonamides, tetracycline and aminoglycosides were the agents perceived as most often associated with side-effects . Low toxicity, bactericidal effect, diffusion in the body and familiarity with the drug were acknowledged as the most important attributes in choice of a systemic antimicrobial agent, but a broad spectrum of antibacterial activity appeared as a major determinant in the choice of these drugs when physicians were asked to select one substance from members of several pairs listed . The results suggest that certain important misconceptions may have played a substantial role in the prescribing habits of the physicians surveyed. JAMA, 1979 Mar 23, 241(12), 1254 - 6 Antimicrobial vs placebo prophylaxis in noncardiac thoracic surgery; Truesdale R et al.; A prospective, double-blind evaluation of the efficacy and safety of prophylactic cephalosporins was done in 57 patients undergoing noncardiac thoracic surgery . Twenty-eight received cephalosporin therapy, and 29 received placebo . Overall, the incidence of postoperative infections was the same; infections developed in five (17.8%) of the 28 patients in the cephalosporin group and in five (17.2%) of the 29 patients in the placebo group . Of the five deaths attributable to infection, three occurred in patients receiving placebo and two in patients receiving cephalosporin therapy . No differences were noted in WBC counts, fever, duration of hospitalization, hypersensitivity reactions, or abnormal liver functions . However, drug fever, phlebitis, and abnormal renal function occurred more often in the patients receiving cephalosporin therapy. Br Med J, 1979 Mar 10, 1(6164), 663 - 6 Drug-induced peripheral neuropathies; Argov Z et al.; Review of the various drugs in current clinical use showed that over 50 of them may cause a purely sensory or mixed sensorimotor neuropathy . These include antimicrobials, such as isoniazid, ethambutol, ethionamide, nitrofurantoin, and metronidazole; antineoplastic agents, particularly vinca alkaloids; cardiovascular drugs, such as perhexiline and hydrallazine; hypnotics and psychotropics, notable methaqualone; antirheumatics, such as gold, indomethacin, and chloroquine; anticonvulsants, particularly phenytoin; and other drugs, including disulfiram, calcium carbimide, and dapsone . Patients receiving drug treatment who complain of paraesthesie, pain, muscle cramps, or other abnormal sensations and those without symptoms who are receiving drugs that are known or suspected to be neurotoxic should undergo neurological examination and studies of motor and sensory nerve conduction . This will allow the incidence of drug-induced peripheral neuropathy to be determined more precisely. Med Lett Drugs Ther, 1979 Mar 9, 21(5), 21 - 4 Update: drugs in breast milk. {Mechanism of antimicrobial active components (author's transl)} Zahner H. The extreme chemical heterogeneity of antimicrobial inhibitors may be compared with the large heterogeneity of the sites of attack . From the host of questions regarding the mechanism of action three problems are selected at random for discussion: 1 . Penetration or transport of inhibitors into the cell . At least some of the inhibitors must penetrate into the cell and find their way to very specific points of action; and it does not go without saying that the antibiotics reach their targets without previously reacting with other cell components or without being "trapped" by the cytoplasmic membrane . In some instances an active transport, i.e . a "misuse" by antibiotics of a transport system for a substrate can be demonstrated . 2 . Distribution of the targets in the cell . Distribution of the inhibitors over the possible targets is not uniform . The question why this is so remains unanswered . 3 . The membrane as the point of attack for inhibitors . The probability that an inhibitor has a bactericidal effect also on resting cells is greatest with substances that act on the membrane . The question as to the function of the antibiotics for the active cell arises and the "defence function" of the antibiotics is called in question. Appl Environ Microbiol, 1979 Mar, 37(3), 610 - 3 Comparative study on the antimicrobial effect of 0.5% chlorhexidine gluconate and 70% isopropyl alcohol on the normal flora of hands; Aly R et al.; A gloved-hand wash method was used to compare the antimicrobial effect of chlorhexidine gluconate alcohol emollient hand wash (HIBISTAT) with that of 70% isopropyl alcohol on the normal flora of the hands (81 subjects) under conditions designed to mimic use by surgeons . Results of the immediate postwash effects on the bacterial counts for all 3 tests days showed that chlorhexidine significantly reduced the normal flora of the hands . When compared with the base line bacterial counts, there was 85, 96, and 98% reduction with chlorhexidine treatment and 84, 93, and 90% reduction with alcohol treatment on days 1,2, and 5, respectively . The difference between chlorhexidine and alcohol treatments was not statistically significant on days 1 and 2, but was significant on day 5 (P less than 0.01) . For delayed postwash bacterial counts (for persistent antimicrobial effects), the overall log means were 4.9943 and 5.4684 for chlorhexidine and alcohol treatments, respectively . The difference between the two treatments was significant (P less than 0.01) . After the chlorhexidien treatment, there was no significant growth of bacteria over a period of 6 h when compared with the base line bacterial counts. Appl Environ Microbiol, 1979 Mar, 37(3), 505 - 10 Fourteen-year survival of Pseudomonas cepacia in a salts solution preserved with benzalkonium chloride; Geftic SG et al.; A strain of Pseudomonas cepacia that survived for 14 years (1963 to 1977) as a contaminant in an inorganic salt solution which contained commercial 0.05% benzalkonium chloride (CBC) as an antimicrobial preservative, was compared to a recent clinical isolate of P . cepacia . Ammonium acetate was present in the concentrated stock CBC solution, and served as a carbon and nitrogen source for growth when carried over into the salts solution with the CBC . The isolate's resistance to pure benzalkonium chloride was increased step-wise to a concentration of 16% . Plate counts showed 4 x 10(3) colony-forming units per ml in the salts solution . Comparison of growth rates, mouse virulence, antibiotics resistance spectra, and substrate requirements disclosed no differences between the contaminant and a recently isolated clinical strain of P . cepacia . The results indicate that it is critical that pharmaceutical solutions containing benzalkonium chloride as an antimicrobial preservative be formulated without extraneous carbon and nitrogen sources or be preserved with additional antimicrobial agents. Growth, 1979 Mar, 43(1), 19 - 35 Practical application of generic growth theory and the significance of the growth curve parameters; Pruitt KM et al.; The generic growth curve is developed by plausibility arguments based on simple growth models . Parameters of the generic curve include the maximum size, maximum specific growth rate, and a dimensionless velocity constant which can be related to metabolic efficiency in the case of nutrient-limited growth . Parameter estimates are obtained from estimates of the size and time at the point of inflection, the size and time at any other arbitrarily selected point, and the maximum size . Parameter estimates thus obtained and used as initial estimates in nonlinear least squares analysis often give rapid convergence to a minimum error mean square . {For the growth of Escherichia coli K-12 in liquid medium, the generic curve could be simplified to a form containing only three parameters: the maximum specific growth rate, the maximum size, and the time required to reach maximum size . When the bacteria were inhibited by the addition of increasing amounts of the lactoperoxidase antimicrobial factor, there was no significant change in viable counts or maximum specific growth rate, but the time required to reach maximum growth increased linearly with increasing amounts of added antimicrobial factor.} Analysis of growth in terms of the generic growth curve can be a powerful technique for finding relationships which may not be apparent from qualitative consideration of the data. J Clin Microbiol, 1979 Mar, 9(3), 418 - 24 Characterization and identification of 95 diphtheroid (group JK) cultures isolated from clinical specimens; Riley PS et al.; Ninety-five cultures of group JK bacteria isolated from clinical specimens were characterized morphologically and biochemically . The microorganisms were isolated primarily from blood cultures . The bacterial cultures produced positive reactions when tested for catalase, Tween hydrolysis, and carbohydrate fermentation . Glucose and galactose were fermented by more than 90% of the organisms . Gas-liquid chromatography of trimethylsilyl derivatives of whole-cell hydrolysates of some of the group JK cultures yielded nearly identical elution profiles . The group JK microorganisms were susceptible to vancomycin but were resistant to most of the other 17 antimicrobial agents tested . A method is presented for differentiating the group JK microorganisms from other similar bacteria encountered in clinical specimens . Although these bacteria rarely occur in clinical specimens, they are capable of producing fatal infections (endocarditis and sepsis) in humans. Compr Ther, 1979 Mar, 5(3), 26 - 32 Therapy for septic shock; Miller HA et al.; PIP: Each year between 71,000 and 142,000 cases of septic shock are estimated to occur . Shock is a derangement in the homeostatic mechanisms of the body secondary to decreased tissue perfusion . The proper treatment of septic shock is based on complete understanding of the altered physiologic events, and, consequently, adequate therapy for shock should be approached from the standpoint of applied physiology in the clinical setting . Currently, sepsis is seen in the patients suffering multiple trauma or burns, undergoing immunosuppressive therapy for cancer or connective tissue disease, or who have undergone organ transplants . The initial therapy needs to consider carefully whether subtle clinical parameters are consistent with sepsis . Time and effort should be given to the prevention of septic shock . Good drainage procedures, proper nutritional therapy, and hydration needs to be maintained at all times . An early aggressive approach with regard to diagnosis can beneficially influence the outcome of infection by reducing the duration and complexity of therapy . Focus is on bacteriology and antimicrobial therapy, hemodynamic and fluid therapy, metabolic and nutritional aspects, complications, and steroids . 4 major complications of sepsis are abnormalities in the clotting pathway and changes in the renal, pulmonary, and cardiovascular systems . Steroids have been recommended for septic shock, for they are stabilizing to the lysosomal membranes in the splanchnic circulation . Experimentally, this has led to a decreased production of myocardial depressant factor . To use steroids properly large doses should be administered early in the shock state . JAMA, 1979 Feb 16, 241(7), 717 - 8 Prophylactic antibiotics in surgery . Practices within surgical services of the Veterans Administration; Munster AM et al.; A survey of prophylactic antibiotic-prescribing habits among chiefs of surgical services of the Veterans Administration yielded a 99% response . These responses have been compared with guidelines set by an expert committee on antimicrobial use for the VA central office . Assuming that 100% concordance with the standards of the committee is a desired state, the average hospital is approximately one third away from this goal (average score, 62.4%) . The majority of errors were those of overuse rather than underuse . The size of the service and the existence of a university affiliation had no influence on the results . Feedback to the chiefs of service regarding the use of antibiotics was informal and tended to be carried out on rounds rather than as a result of formal audits . Most senior surgeons indicated that they would be willing to be influenced by audit guidelines. Antibiotiki, 1979 Feb, 24(2), 92 - 6 {Synthesis and properties of the 14-amino derivatives of daunorubicin and carminomycin}; Povarov LS et al.; Interaction of 14-bromine derivatives of daunorubicin and carminomycin, as well as their aglycones with secondary amines, such as piperidine, N-methylpiperazine and morpholine was studied with a purpose of preparing new potentially antitumor antibiotics . It was found that reaction in acetone or dioxan at a temperature of 50--60 degrees C resulted in formation of 14-amino derivatives of the respective bromides . 14-Piperidinyl- and 14-(N-methylpiperazinyl)-daunorubicin, 14-piperidinyl-daunorubicinon and 14-piperidinyl-carminomycinon were prepared . The structure of the new substances was confirmed by the IR, UV and NMR spectra . The antimicrobial activity of 14-amino derivatives amounted to 10--35 per cent of the activity of the initial antibiotics, i.e . daunorubicin and carminomycin. J Lab Clin Med, 1979 Feb, 93(2), 295 - 300 Abnormal neutrophil chemotaxis and random migration induced by aminoglycoside antibiotics; Khan AJ et al.; Gentamicin and amikacin, administered in therapeutic doses to normal healthy adults, caused a transient decrease in chemotactic migration of their PMNs . In contrast, RM of leukocytes obtained from these individuals was increased significantly . The magnitude of these changes did not correlate with the serum antibiotic concentrations . Separate in vitro experiments with gentamicin, however, revealed an inverse dose-response relationship with chemotactic suppression . The mechanism(s) involved in modifications of these leukocyte functions is not well understood . These findings may be of clinical significance in patients, especially those with altered host defense mechanisms, who require therapy with these aminoglycoside antimicrobial agents. Br J Obstet Gynaecol, 1979 Feb, 86(2), 81 - 6 Activity and characterization of a low molecular fraction present in human amniotic fluid with broad spectrum antibacterial activity; Sachs BP et al.; The isolation of a low molecular weight fraction from amniotic fluid with broad spectrum antimicrobial activity is reported . This fraction consists of a family of peptides whose bactericidal activity is zinc dependent and can be inhibited by phosphate . Peptides are present in early gestation in low concentration increasing in amount from about 28 weeks gestation when antimicrobial activity becomes detectable in whole amniotic fluid . A simple bacteriological assay for this material is described . Its relation to the occurrence of perinatal infection is discussed. J Pharm Sci, 1979 Feb, 68(2), 256 - 7 Antimicrobial activity of chlormerodrin; Pandey VN et al.; A radiochemical study for antimicrobial activity of chlormerodrin was performed using some commonly occurring nonpathogenic and pathogenic microorganisms . Chlormerodrin concentrations of 15-35 and 20-45 microgram/ml of the culture medium were microbiostatic and microbicidal, respectively . The microbiostatic effect was reversible in the presence of cysteine, an amino acid containing a sulfhydryl group. J Pharm Sci, 1979 Feb, 68(2), 182 - 5 Synthesis and antimicrobial activity of 3H-1,2,4-thiadiazolo fused heterocycles; Gardner JO et al.; Various fused 3H-1,2,4-thiadiazoles were prepared . Significant in vitro Gram-positive antibacterial and antifungal activities were observed fro certain members of the series. Drugs, 1979 Feb, 17(2), 111 - 23 Drug prescribing in renal failure; Bennett WM; Drug prescribing for patients with renal failure should incorporate adjustment of dosage regimens in order to avoid accumulation and thus adverse effects . Drugs usually eliminated by the kidneys require the most modification . Since immediate therapeutic efficacy is of importance, the initial or loading dose is essentially unaltered for patients with renal dysfunction . Maintenance doses can be adjusted by either lengthening the interval between doses of by reducing the size of individual doses . In clinical practice, a combination of both methods is used . Serum levels should be used as guides whenever possible . In interpreting these levels, recognition of decreased plasma protein binding and prolonged elimination half-lives in renal failure is imperative . In patients requiring dialysis, consideration must be given to adjustments for drug removal by the artificial membrane . Small molecules unbound to proteins are most easily removed . Specific guidelines for therapy with common drugs prescribed for patients with renal failure are given . These include: (1) narcotics and analgesics; (2) psychotherapeutic drugs; (3) cardiovascular drugs; and (4) antimicrobial agents. Lab Anim Sci, 1979 Feb, 29(1), 35 - 9 The effects of selected antimicrobials on glucose transport in the rat intestine; Hankinson GJ et al.; To determine whether oxytetracycline hydrochloride and the sodium salt of ampicillin have any adverse effects on the rat intestine, enteric enzyme levels and glucose transport rates were measured in vitro in rats . The intestinal transport of glucose did not differ significantly between control animals and those pretreated with ampicillin . For animals pretreated with oxytetracycline, the transport rates were significantly lower than those for the control group . The difference between the ampicillin and oxytetracycline groups, however, was not statistically significant . No significant differences in enteric levels of sucrase and maltase activity were found between any of the groups . The possibility that some antimicrobial agents may interfere with the absorption of nutrients suggested the need for caution in using these drugs in experimental animals. J Urol, 1979 Feb, 121(2), 232 - 5 Gallium-67 scanning and conservative treatment in acute inflammatory lesions of the renal cortex; Brugh R 3rd et al.; Three cases of suspected acute suppurative lesions of the renal cortex treated successfully with antimicrobial agents are presented . In support of other reports it appears that selected cases, particularly when diagnosed early, may be managed conservatively without surgical drainage . In those cases of severe sepsis, large intrarenal or perinephric abscesses, resistant organisms or those that are refractory to treatment, surgical intervention may be unavoidable . Gallium-67 nuclear scanning is a safe, non-invasive method of locating rapidly these areas of inflammation and has proved to be a useful tool in earlier diagnosis. Infect Immun, 1979 Feb, 23(2), 522 - 31 Myeloperoxidase, hydrogen peroxide, chloride antimicrobial system: nitrogen-chlorine derivatives of bacterial components in bactericidal action against Escherichia coli; Thomas EL; In the presence of Escherichia coli, myeloperoxidase-catalyzed oxidation of chloride ion resulted in formation of long-lived chloramine and/or chloramide derivatives of bacterial components . The same amount of these nitrogen-chlorine (N-Cl) derivatives was obtained with either hypochlorous acid (HOCl) or the myeloperoxidase system, indicating that myeloperoxidase catalyzed the oxidation of chloride to HOCl . Identical killing was obtained with HOCl or the myeloperoxidase system . About 30 to 50% of the oxidizing equivalents of HOCl were detected as N-Cl derivatives of peptides or peptide fragments that were released from the bacteria . The apparent molecular weight distribution of the peptides decreased with increasing amounts of HOCl, suggesting that peptides were fragmented by oxidative cleavage of chloramide derivatives of peptide bonds . The remaining 50 to 70% of the oxidizing equivalents of HOCl were rapidly consumed in peptide bond cleavage or the oxidation of other bacterial components . There was a close correspondence between the oxidation of bacterial sulfhydryls and bactericidal action . The N-Cl derivatives were lost and the oxidation of bacterial sulfhydryls increased over a period of several h at 37 degrees C . These changes were accompanied by increased killing . The increase in sulfhydryl oxidation and killing could be prevented by washing the bacteria to remove the N-Cl derivatives . Therefore, the N-Cl derivatives could oxidize bacterial components long after the myeloperoxidase-catalyzed oxidation of chloride was complete. Postgrad Med, 1979 Feb, 65(2), 131 - 6, 139-40 Drug-induced pulmonary disease; Filipek WJ; Pulmonary disorders appearing as manifestations of adverse reactions to medications administered orally or parenterally are reviewed . The mechanisms involve toxicity, idiosyncrasy, allergy, or a combination . The drugs and medications include commonly used antimicrobial, antineoplastic, analgesic, vasoactive, neuroactive, and endocrine agents . For most reactions, the mechanisms are unidentified. MMW Munch Med Wochenschr, 1979 Jan 26, 121(4), 141 - 4 {Advances in topical therapy of skin diseases (author's transl)}; Happle R; The anti-inflammatory effect of the new topical corticosteroid fluocortin butyl ester is approximately equal to that of hydrocortisone acetate but it has the advantage that systemic side-effects are lacking . Vitamin A acid and benzoyl peroxide have brought significant advances in the topical treatment of acne . For the treatment of chloasma and other hyperpigmentations the combination of vitamin A acid and hydroquinone with a corticoid is considerably more effective than any of the single components alone . Povidone-iodine with its extraordinarily low sensitization rate has proved useful for external antimicrobial treatment . Extensive or multiple precancerous lesions are effectively treated with 5-fluorouracil . New hair growth can be induced in alopecia areata by the local application of DNCB. J Trauma, 1979 Jan, 19(1), 49 - 51 The role of NADH-NADPH oxidase activity in the leukocyte function of burned patients; Heck EL et al.; Irreversible sepsis, in spite of advancements in topical therapy and antimicrobial agents, remains the leading cause of death in major thermal injury . A defect in intracellular bactericidal capacity in leukocytes from severely burned patients appears to correspond with increases in bacterial wound colonization and ultimate sepsis . This leukocyte defect has been demonstrated by abnormally low nitroblue tetrazolium reduction (NBT) and oxygen consumption of white cells in patients with major thermal injury . The subcellular mechanisms responsible for decreased bactericidal capacity were therefore investigated . Nicotinamide-adenine dinucleotide (NADH) and nicotinamide-adenine phosphodinucleotide (NADPH) oxidase activity was measured in patients with major burns, controls (normals), and in patients with nonburn stress or infection . NADH and NADPH oxidase levels in leukocytes from burn patients were not significantly different from those of normal nonchallenged controls but were significantly lower than the leukocyte values found in the patients with nonburn infections or stress . This NADH and NADPH defect in the subcellular leukocyte fraction suggests that it may be a significant factor in the reduced bactericidal function of the intact leukocyte in thermally injured patients. Arch Otolaryngol, 1979 Jan, 105(1), 39 - 44 Meningitis and hearing loss in children; Keane WM et al.; The hospital records for 100 cases of meningitis in which acute audiometric data has been obtained were reviewed . The incidence of sensorineural hearing loss was found to be 6% . The severity of hearing impairment varied from mild to profound and was frequently bilateral and irreversible . Two-cases showed asymmetrical involvement, and in one case, there was subsequent improvement in threshold sensitivity . Factors that influenced the incidence of neurologic sequela included severity of the initial disease process, age of the patient, and duration of symptoms before diagnosis and treatment . We discuss the pathophysiologic mechanisms that may account for such hearing loss, and we emphasize the importance of early diagnosis and intensive antimicrobial therapy . Careful neurologic evaluation is required after recovery and must include periodic sequential audiometric testing. Bol Med Hosp Infant Mex, 1979 Jan-Feb, 36(1), 23 - 43 {The potentially infected newborn infant}; Sandoval Moron OJ et al.; In order to establish relationship between premature rupture of membranes (RPM) and neonatal infection, together with the importance of other factors during this process, 50 newborns with history of RPM were studied . In a control group and in groups of newborns with less than and more than 24 hours of plain RPM, related to clinically healthy and vigorous infants, no case of infection was found . On the other hand, 30% and 60% respectively of infections were found in groups less than and more than 24 hours of RPM, but with the presence of other contaminating factors that impair immunological response of the newborn, such as: acute maternal infection, prolonged delivery, unexpected birth, pediatric reanimation procedures, organic immaturity, fetal suffering, immediatie neonatal depression and intercurrent pathology . There were two deaths: a case with RPM of 5 hours and another one with 38 hours, but both with high rating due to the presence and intensity of "aggravating factors" mentioned having internal action mechanism that apparently of restrains to the perpetuation of the hypoxia-acidosis cycle . A provisional sheet is presented to evaluate such "aggravating factors" considering that an RPM associated to them represents a high risk of neonatal infection . In cases of clinically healthy newborns with plain RPM, we advice only to watch over them for 3--5 day, but no antimicrobial treatment at all. Arzneimittelforschung, 1979, 29(5), 846 - 8 {Antimicrobial activity of the broad spectrum antimycotic isoconazole nitrate in humans (author's transl)}; Wendt H et al.; A comparative study (occlusion test according to Marples and Kligman) was conducted in 100 test subjects with several formulations of isoconazole nitrate . The following results were obtained: 1 . There are no differences in efficacy between the free base, isoconazole, and the nitrate . 2 . Increasing the active substance concentration of isoconazole nitrate above 1% produced a noticeable increase in its effect so that 2% and 4% preparations are appropriate for particular uses . 3 . 1% isoconazole nitrate (Travogen cream, Gyno-Travogen cream) is more effective than a commercial cream containing 1% clotrimazole . 4 . The addition of a corticosteroid (diflucortolone-21-valerate 0.1%, Travocort cream) does not influence the action of isoconazole nitrate. Arzneimittelforschung, 1979, 29(6), 932 - 4 Antimicrobial agents in rats . I . Serum levels of parenteral cephalosporins; Marre R et al.; Eleven cephalosporins were tested for their pharmacokinetic properties in rats in order to obtain a basis for experimental evaluation of their in vivo activity . The compounds were administered to female Wistar rats in i.m . doses of 150 or 50 mg/kg . The cephalosporin concentrations in rat serum were determined by the agar-well-diffusion method . Essential differences concerning the serum levels, half-life and the area under the curve could be ascertained . Low serum levels and short half-life could be reported for cephapirin, cephalotin, and cephradin, whereas cefazolin, cefazedone, and cefuroxime produced high and longer lasting serum levels . All cephalosporins were quickly absorbed, most of them were beneath the minimum detectable concentration after 6 h . It is concluded that pharmacokinetic data should be taken into consideration in conjunction with experimental chemotherapy. J Urol, 1979 Jan, 121(1), 45 - 6 The treatment of urethral stricture disease by internal urethrotomy: a clinical review; Kinder PW et al.; The results of internal urethrotomy with 6 weeks of postoperative catheter drainage and antimicrobial therapy in the treatment of urethral strictures in 28 patients are presented . Satisfactory results were obtained in 68 per cent of the patients . Because of the simplicity of this technique and the good results obtained we believe that internal urethrotomy often is the best initial approach to strictures that become difficult to manage by periodic dilation. Nouv Rev Fr Hematol, 1979, Suppl, XIX - XXI {Antimicrobial therapy in granulopenic patients with malignant hematologic diseases (author's transl)}; Klastersky J; Rational antimicrobial therapy in neutropenic patients includes early empiric therapy with combinations of antibiotics active in vitro against the causal pathogen . The duration of therapy is to be adapted to the clinical response . In patients who do not respond to antimicrobial therapy, transfusion of granulocytes and empiric use of antifungal drugs should be considered. Pharmazie, 1979, 34(9), 537 - 8 Potential fungicidal and bactericidal agents . Synthesis of certain 4-(2-amino-1,3,4-thiadiazol-5-yl)quinolines; El-Dine SA et al.; The synthesis of some new 4-{2-alkyl (aryl or aralkyl) amino-1,3,4-thiadiazol-5-yl}-2-substituted quinolines is described . IR, UV, NMR and MS data of representative examples are discussed . Most of the compounds prepared showed a reasonable antifungal and antimicrobial activity. Prog Clin Biol Res, 1979, 35, 9 - 15 Trends in the research on antimicrobial agents; Sensi P; The pharmacotherapy of microbial diseases has achieved brilliant success in the last 40 years, but it still deserves a great research interest . In fact, microbial infections remain the major cause of morbidity, with a definite incidence in mortality . Several dozen antimicrobial agents have been introduced in the therapy of infectious diseases . An active area of research concerns deepening knowledge of chemotherapeutic activity in various pathological conditions, mechanism of action, development of resistance, kinetics, and untoward effects of the available drugs in order to achieve the best utilization . Many researches are also directed at identifying the proper use of combinations of antimicrobials to define synergistic effect or inhibition of resistant strain selection . Finally there are continuous research efforts toward the development of new agents to overcome the drawbacks of the available ones . This problem is approached mainly in two ways, either by modification of the present antimicrobial drugs or by search for completely new entities through various screening sophistications . Examples of studies and results in the mentioned fields are reviewed. Prog Clin Biol Res, 1979, 35, 59 - 61 Enquiry on the antibiotic usage at Ancona Regional Hospital; Dini M et al.; A survey of the use of antimicrobial agents in the Regional Hospital of Ancona was carried by the Infectious Disease Department in collaboration with the Hygiene Institute, Ancona, in all patients admitted in the hospital in a 15-day period, March 1--15, 1978 . This study has shown an overuse of antibiotics in this series of patients . Despite the limitations of the survey it can be a useful aid to know the situation of antibiotic therapy in this Italian hospital. Int J Obes, 1979, 3(2), 119 - 22 Granulocyte functions during treatment of obesity; Palmblad J et al.; Food deprivation is known to suppress antimicrobial defence under certain conditions . This potentially negative consequence of weight reduction treatment for obesity was studied in 11 obese patients who were treated with a mixed, balanced 600 kcal(2.5MJ)/day diet for 4 weeks . The mean body weight fell from 103 +/- 5 to 95 +/- 6 kg . The antimicrobial defence was studied before and during the diet period by analyses of polymorphonuclear granulocyte bactericidal capacity and adherence . No signs of impaired granulocyte function were found . The possibility remains that during prolonged treatment by semistarvation host defence may be impaired, especially in grossly obese patients whose antimicrobial defence may be already impaired before treatment. Acta Biol Med Ger, 1979, 38(4), 539 - 44 {Chemical and biological properties of a fluorescence derivative of gentamycin}; Kusnir J et al.; By reaction with 4-phenylspiro{furan-2(3H),1'-phthalan}-3,3'-dione a fluorescing gentamycin derivative was produced which is characterized by the following properties: High fluorescence intensity in UV light, which enables simple and sensitive determination up to 10(-9) M . In this way it is possible to determine the localization of this substance in tissues, cells and body fluids . When favorably stored, the derivative is chemically stable . At pH 8 and storage at +5 degrees C in the dark for 27 days the substance loses only 5% of its original fluorescence . In comparison with the nonsubstituted gentamyzin the derivative has a twofold higher binding capacity to serum albumin . The antimicrobial properties are retained; the range of antimicrobial effects is similar to that of gentamycin. Prog Pediatr Surg, 1979, 13, 39 - 50 The immunological state of the neonate following surgery--consequences for immunotherapy of neonatal septicaemia; Belohradsky BH et al.; In addition to an innate functional dysmaturity of the neonate's immune system, operation, anaesthesia, and intensive care measures can significantly worsen this physiological immune deficiency . Given the fact that antimicrobial therapy as well as progress in intensive care of infected operated neonates and prematures did not significantly decrease the high mortality rate in this patient age group we began performing fresh-blood exchange transfusions as supportive immunotherapy in the treatment of neonatal septicaemia . Since indication for exchange transfusion has been adopted as early as septicaemia was suspected only 46% of the operated neonates (13 out of 28) died of their infection, compared to 82% of the patients (23 out of 28) who did not undergo exchange transfusion. Infection, 1979, 7 Suppl 4, S349 - 53 Renal lymph and interstitial fluid concentration of co-trimazine: an experimental study in dogs; Maigaard S et al.; Renal clearance and renal hilar lymph and interstitial fluid concentrations of co-trimazine were investigated in dogs during constant intravenous infusion . The lymph was obtained by direct cannulation of the lymphatics, and the interstitial fluid from small plastic tissue chambers, implanted 4--6 weeks before the experiments . The clearance values for trimethoprim and sulphadiazine, compared to the glomerular filtration rate, as measured by 125I-iothalamate clearance, showed a net tubular secretion of trimethoprim and tubular re-absorption of sulphadiazine . Renal lymph and interstitial fluid concentrations were found to be lower than the plasma concentrations, corresponding well with earlier findings for several other antimicrobial agents . We found a statistically significant difference between lymph/plasma and interstitial fluid/plasma ratios, indicating different composition and origin of lymph and interstitial fluid. Scand J Infect Dis, 1979, 11(2), 147 - 9 Clindamycin excretion in the pancreatic fluid of dogs; Rubinstein E et al.; Clindamycin phosphate in dosage of 15 mg/kg was administered intravenously to dogs . Serum and pancreatic juice clindamycin concentrations were assayed . Pancreatic juice clindamycin concentrations varied between 1.32--5.5 micrograms/ml . Clindamycin was still detectable in the pancreatic juice 4 1/2 h after its administration . Clindamycin, in combination with other antimicrobials, may be potentially effective in the prophylaxis and therapy of some of the infectious complications associated with pancreatitis. Pharmazie, 1979, 34(2), 103 - 6 {Identification of an antimicrobially active constituent isolated from propolis (author's transl)}; Schneidewind EM et al.; On isolating and identifying antimicrobially active propolis constituents, the authors detected a substance that must be regarded as a mixture of caffeic acid esters . The caffeic acid moiety was unequivocally identified by various chemical and spectroscopic methods . The results obtained from the gas chromatographic study of the alcohol fraction after hydrolysis of the isolated compound identify benzyl alcohol, phenyl ethyl alcohol and cinnamic alcohol as ester components . Furthermore, the mass spectroscopic findings are indicative of the presence of a caffeic acid pentenyl ester in the mixture . Attempts to separate this ester mixture by recrystallization and thin-layer chromatography failed. J Clin Pathol, 1979 Jan, 32(1), 66 - 72 Distribution in clinical material and identification of Pseudomonas maltophilia; Holmes B et al.; During the 10-year period ending March 1976, 128 (8.5%) of 1506 strains of Gram-negative non-fermentative bacteria submitted to the National Collection of Type Cultures for computer-assisted identification have been strains of Pseudomonas maltophilia . These figures suggest that Ps . maltophilia is both a relatively common species in clinical material in the United Kingdom and also that many laboratories experience difficulty in identifying this species . We report the sources from which our strains were isolated and also characteristics of the species by which it may be recognised . The clinical significance of Ps maltophilia is discussed and also the susceptibility of this species to certain antimicrobial agents. Am Rev Respir Dis, 1979 Jan, 119(1), 19 - 23 Anaerobic bacterial pneumonitis; Bartlett JG; Clinical features of 46 patients with anaerobic bacterial pneumonitis were compared with those of patients with pneumococcal pneumonia . The presenting features in these 2 groups were comparable in terms of fever, leukocyte count, and radiographic abnormalities . In only 2 patients with anaerobic bacterial pneumonitis was putrid sputum noted on initial evaluation . None of the patients with anaerobic bacterial pneumonitis had shaking chills, although this was reported by nearly one half of those with pneumococcal pneumonia . The response to treatment with antimicrobial drugs was comparable in the 2 groups, except that 20% of patients with anaerobic bacterial pneumonitis subsequently developed pulmonary abscesses, despite the use of antimicrobial agents presumed to be active against the infecting flora . There was also a high incidence of bronchogenic neoplasms among patients who had anaerobic bacterial pneumonitis in the absence of an associated condition that would predispose to aspiration . The findings of this review suggest that anaerobic bacterial pneumonitis may be difficult to distinguish from pneumococcal pneumonia on the basis of clinical presentation. Rev Infect Dis, 1979 Jan-Feb, 1(1), 23 - 9 General mechanisms of antimicrobial resistance; Davies J; Bacteria can become resistant to antimicrobial agents by two routes, either by mutation or by the inheritance of new genetic information in the form of resistance plasmids . The mechanisms by which bacteria express resistance are manyfold, and five different biochemical mechanisms have been demonstrated in clinical isolates . The most important mechanisms are alteration of the drug target site, interference with the transport of the antimicrobial agent into the cell, and detoxification (inactivation) of the drug in the immediate environment of the cell. Acta Chir Scand, 1979, 145(4), 263 - 6 The prophylaxis of septic complications in colo-rectal surgery . A controlled trial of metronidazole and oxytetracycline; Watt-Boolsen S et al.; The prophylactic effect of systemic metronidazole on infectious complications following elective colo-rectal surgery was compared with the prophylactic effect of oxytetracycline . Allocation to receive metronidazole or oxytetracycline was random . A total of 137 patients were accepted for the trial, 67 receiving metronidazole and 70 oxytetracycline . The numbers of abdominal wound infections, intra-abdominal infections, fever and deaths were few in both groups, and the differences statistically insignificant . Clinically significant side effects of the antimicrobial agents were not observed . The influence of the antimicrobial agents on colonic flora was also studied . No significant difference in the effect on colonic anaerobic flora was demonstrated, whereas the aerobic flora was significantly suppressed by oxytetracycline . It is concluded that systemic metronidazole, although acting solely on the anaerobic flora, is as effective as oxytetracycline in preventing postoperative infectious complications following elective colo-rectal surgery . The prophylactic use of metronidazole is advocated. Rev Cubana Med Trop, 1979 Jan-Apr, 31(1), 37 - 43 {Biological evaluation of Cuban plants . V}; Jimenez Misas CA et al.; The study of the antimicrobial activity of aqueuos, alcoholic and ketonic extracts from plants growing in Cuba is pursued . Six species of the families Rutaceae, Portulacaceae, Borraglinaceae and Jasminaceae were analyzed, and their activity on bacteria with a human clinical interest was assessed . The best results were obtained from Heliotropium campechianum, Jazminum sambac and Portulaca oleracea. Rev Cubana Med Trop, 1979 Jan-Apr, 31(1), 21 - 7 {Biological evaluation of Cuban plants . III}; Jimenez Misas CA et al.; Aqueous, alcoholic and ketonic extracts were prepared from different parts of species of the families Martiniaceae, Caricaceae, Umbeliferae, Nictaginaceae and Fitolacaceae in order to prove their antimicrobial action on bacteria which have a clinical interest in humans and live in our environment . The gel double-layer diffusion method was applied . The best results were obtained from Carica papaya leave extracts. Rev Cubana Med Trop, 1979 Jan-Apr, 31(1), 13 - 9 {Biological evaluation of Cuban plants . II}; Jimenez Misas CA et al.; The study of the antimicrobial activity of aqueous, alcoholic and ketonic extracts from different parts of five superior, dried, grinded and defatted plants of the families Myrtaceae, Polypodiaceae and Zingiberaceae is pursued . Good results were obtained from Psidium guajaba leave and stem ketonic extracts as well as from Costus spicatus leave and root alcoholic extracts. Folia Microbiol (Praha), 1979, 24(2), 188 - 90 Antimicrobial efficacy of some N,N'-dialkyl-N,N'-dimethyl-1,6-hexanediamine dioxides; Mlynarcik D et al.; A total of 17 N,N'-dialkyl-N,N'-dimethyl-1,6-hexanediamine dioxides were tested for activity against three microorganisms . A relationship was found between the length of the alkyl substituent and antimicrobial activity. Folia Microbiol (Praha), 1979, 24(2), 153 - 6 Antimicrobial and cytolytic activity of N,N-dimethyl-l-methyldodecylamine oxide; Takacsova G et al.; N,N-Dimethyl-l-methyldodecylamine oxide inhibited the growth of bacteria, yeast and filamentous fungi; further it induced lysis of osmotically stabilized protoplasts of Saccharomyces cerevisiae and human erythrocytes . This effect is based evidently on a change in the organization and function of cell membranes. Dermatologica, 1979, 158(5), 379 - 83 Low allergenicity of triclosan . Predictive testing in guinea pigs and in humans; Lachapelle JM et al.; Allergic predictive testing with triclosan (Irgasan DP 300) has been carried out in guinea pigs and in humans in order to evaluate its potential allergenic properties . Triclosan, an antimicrobial agent increasingly used in the cosmetic industry (concentration 0.5%) has recently appeared on the market at a higher concentration (3%) in association with flumethasone pivalate as an antimicrobial and antimycotic cream (Logamel) . The results of predictive tests for allergy in guinea pigs (1 of 20 positive) and in humans (none of 20 positive) indicate that the sensitization index of triclosan is very low, which is in good accord with some reports from the literature . These underline the rarity of cases of allergic contact dermatitis to triclosan considering its widespread use in the cosmetic industry. Am J Med Technol, 1979 Jan, 45(1), 28 - 30 Cardiobacterium hominis endocarditis; Johnson MG et al.; This report describes the isolation of Cardiobacterium hominis from a patient with a history of rheumatic heart disease . Seven blood cultures yielded the organism . This investigation includes the case history, significant details of the hospital course, and the bacteriological, biochemical, and antimicrobial characteristics of Cardiobacterium hominis, integrated with a brief review of the literature. Medicine (Baltimore), 1979 Jan, 58(1), 1 - 31 Infectious complications of human bone marrow transplantation; Winston DJ et al.; Infections are an almost inevitable complication of human bone marrow transplantation and account for the majority of deaths in transplant recipients . Even prior to the initiation of the transplantation procedure, patients may present with infections complicating previously unsuccessful chemotherapy for hematological malignancy or aplastic anemia . Nevertheless, these pre-transplantation infections should not exclude the possibility of bone marrow transplantation if they can be successfully controlled with specific antimicrobial therapy and necessary adjunctive measures . The immediate post-transplantation period prior to engraftment is characterized by severe marrow aplasia that results from high-dose chemotherapy and total-body irradiation . Infections are primarily septicemias and localized processes caused by bacteria and fungi and their incidence increases as the intensity of immunosuppression is escalated . The high mortality associated with bacterial septicemia makes early, empirical antibacterial therapy mandatory . However, the reduction in mortality from bacterial infection resulting from such an aggressive approach may be offset by a higher mortality from invasive fungal infection, especially in patients with prior fungal colonization and undergoing prolonged conditioning therapy . Thus, until more specific and sensitive tests for the diagnosis of invasive fungal infection become available, empirical intravenous amphotericin should be considered in patients who are persistently febrile and deteriorate clinically in the face of appropriate antibacterial therapy . Interstitial pneumonia associated with severe GVHD is the major infectious complication after successful marrow engraftment and is the most significant barrier to long-term survival . Trimethoprim-sulfamethoxazole is effective prophylaxis against interstitial pneumonia due to Pneumocystis carinii, but one half of the patients still develop a pneumonitis either associated with CMV or of unknown etiology . Mortality from interstitial pneumonia is related to prior radiation therapy while survival is associated with a four-fold rise in CMV CF antibody titer . The latter observation supports the need to investigate passive immunization with CMV antibody as a means of preventing some interstitial pneumonias . Despite the progress made in many areas of human bone marrow transplantation, the majority of graft recipients still die of infectious complications . Thus, new approaches to the management of infections in transplant recipients are urgently needed . Better-tolerated oral nonabsorbable antibiotics, laminar-air-flow rooms, granulocyte transfusions, and chemotherapy and immunotherapy for CMV are among the prophylactic and therapeutic measures that must be critically evaluated in well-controlled, prospective studies . Continued assessment of the infectious complications of bone marrow transplantation is a critical aspect of any ongoing transplant program, not just a research goal... J Neurosurg, 1979 Jan, 50(1), 95 - 9 Intraventricular administration of amikacin for complicated Gram-negative meningitis and ventriculitis; Wirt TC et al.; Four pediatric neurosurgical patients with Gram-negative meningitis and ventriculitis were treated with parenteral and intraventricular amikacin, a new aminoglycoside . The organisms infecting these patients were resistant to multiple antimicrobial drugs but were sensitive to amikacin . Treatment was continued for 14 days after cerebrospinal fluid cultures became negative . All four patients were cured and have demonstrated no nephrotoxicity, ototoxicity, or evidence of persistent infection on follow-up examination. Rev Infect Dis, 1979 Jan-Feb, 1(1), 152 - 7 Treatment of significant bacterial infections in adults with cefoxitin; Ribner BS et al.; Cefoxitin is a new antimicrobial agent derived from cephamycin C . Fifty-four hospitalized patients with 63 clinically significant infections were treated with cefoxitin . Fifty-four infections (86%) were cured by therapy with cefoxitin alone or together with local therapy (i.e., heat, elevation, or surgical drainage) . Six infections (10%) were not eradicated by the therapy used . Three patients could not be evaluated . Addition of oral probenecid therapy produced increases in levels of cefoxitin in serum and increased the inhibitory and bactericidal levels of cefoxitin in serum to more favorable ratios . Adverse side effects were seen in 19 patients and included positive direct Coombs' tests, increased eosinophil counts, skin rashes, vasculitis, phlebitis, elevation of liver enzymes, and drug-induced fever. Pharmacol Ther Dent, 1979, 4(2-4), 65 - 72 The evaluation of tiodonium chloride as an antiplaque and anticaries agent . II . In vitro antimicrobial activity and in vivo anticaries activity in animals; Schuster GS et al.; The efficacy of tiodonium chloride as an antimicrobial, antiplaque, and anticaries agent was examined . It proved to be an effective antibacterial agent and reduced in vitro plaque formation at concentrations below its bacteriostatic level . It reduced caries in rats when used in the food at 600 microgram/gm but was not effective as a mouthrinse at up to 0.3%. Curr Med Res Opin, 1979, 6(3), 221 - 8 Preliminary experience with parenteral mecillinam; Menday AP et al.; Case reports are reviewed of 26 patients, mainly with severe Gram-negative infections, treatment with parenteral mecillinam . Twenty-three patients received other antibiotics in addition to mecillinam . In 19 patients, potentially synergistic antimicrobial therapy was given . Overall, a beneficial clinical effect was recorded in 17 (68%) of the 25 patients assessed . A better response was observed in those patients who had not received other antibiotics before treatment with mecillinam was instituted . It is concluded that parenteral mecillinam may have an important role in the treatment of severe Gram-negative infections. J Exp Med, 1979 Jan 1, 149(1), 27 - 39 Bactericidal activity of a superoxide anion-generating system . A model for the polymorphonuclear leukocyte; Rosen H et al.; The acetaldehyde-xanthine oxidase system in the presence and absence of myeloperoxidase (MPO) and chloride has been employed as a model of the oxygen-dependent antimicrobial systems of the PMN . The unsupplemented xanthine oxidase system was bactericidal at relatively high acetaldehyde concentrations . The bactericidal activity was inhibited by superoxide dismutase (SOD), catalase, the hydroxyl radical (OH.) scavengers, mannitol and benzoate, the singlet oxygen (1O2) quenchers, azide, histidine, and 1,4-diazabicyclo{2,2,2}octane (DABCO) and by the purines, xanthine, hypoxanthine, and uric acid . The latter effect may account for the relatively weak bactericidal activity of the xanthine oxidase system when purines are employed as substrate . A white, carotenoid-negative mutant strain of Sarcina lutea was more susceptible to the acetaldehyde-xanthine oxidase system than was the yellow, carotenoid-positive parent strain . Carotenoid pigments are potent 1O2 quenchers . The xanthine oxidase system catalyzes the conversion of 2,5-diphenylfuran to cis-dibenzoylethylene, a reaction which can occur by a 1O2 mechanism . This conversion is inhibited by SOD, catalase, azide, histidine, DABCO, xanthine, hypoxanthine, and uric acid but is only slightly inhibited by mannitol and benzoate . The addition of MPO and chloride to the acetaldehyde-xanthine oxidase system greatly increases bactericidal activity; the minimal effective acetaldehyde concentration is decreased 100-fold and the rate and extent of bacterial killing is increased . The bactericidal activity of the MPO-supplemented system is inhibited by catalase, benzoate, azide, DABCO, and histidine but not by SOD or mannitol . Thus, the acetaldehyde-xanthine oxidase system which like phagocytosing PMNs generates superoxide (O.2-) and hydrogen peroxide, is bactericidal both in the presence and absence of MPO and chloride . The MPO-supplemented system is considerably more potent; however, when MPO is absent, bactericidal activity is observed which may be mediated by the interaction of H2O2 and O.2- to form OH . and 1O2. Infection, 1979, 7 Suppl 6, 584 - 8 {Positive side-effects of antibiotic and antimicrobial drugs in therapy (author's transl)}; Illig L; Since about 1950 especially, dermatologists world-wide have been utilizing the positive side-effects, discovered by chance, of all groups of antibiotic and antimicrobial drugs . These drugs are used to treat certain non-microbially induced dermatoses, without any knowledge of the mechanisms involved . A short history is given and the most important drugs and the indications for their use are described . The following drugs are undoubtedly effective and sometimes even the therapy of choice: tetracyclines in acne vulgaris and rosacea (including rosacea keratitis); penicillin G in acrodermatitis atrophicans and cold urticaria; dapsone in dermatitis herpetiformis and - as a powerful adjuvant - in acne vulgaris and rosacea . Before the discovery of the socalled immunodepressive drugs, tetracycline was the only alternative to - or at least a highly effective adjuvant of - cortisone in dermatomyositis and chloroquine in localised and systemic lupus erythematosus . Finally, clioquinole was life-saving in acrodermatitis continua in children until this condition was recently identified as a zinc-deficiency syndrome . Therapeutical mechanisms have been found only in the case of acne, rosacea and dermatitis herpetiformis . In most other diseases the nature of the therapeutical effectiveness of antibiotic and antimicrobial drugs still remains a mystery. Microbios, 1979, 26(103), 37 - 44 Effect of varying concentrations of EDTA on the antimicrobial properties of cutting fluid preservatives; Izzat IN et al.; The potentiating effects of EDTA and its disodium, trisodium and tetrasodium salts were studied in combination with several cutting fluid preservatives . It was found that a ratio of 1 part preservative to 2 to 4 parts chelating agent produced marked increases in antimicrobial action. Arzneimittelforschung, 1979, 29(7), 990 - 2 Antimicrobial agents in rats . II . Serum levels of oral cephalosporins; Marre R et al.; Cephalexin, cephradine and 7 beta-(D-2-amino-2-{(1,4-cyclohexadienyl)-acetamido})-3-methoxy-3-cephem-4-carboxylic acid (CGP 9000) were tested for their pharmacokinetic behaviour in rats . The cephalosporin serum concentrations were determined at certain times after oral administration of 150 mg/kg by the agar-well-diffusion method . The experiments revealed that the serum levels of cephalexin and cephradine did not differe essentially from one another . They maintained maximum serum concentrations of 30 microgram/ml to 40 microgram/ml during the first hour and than declined with a half-life of 2.5 h . CGP 9000 reached peak concentrations 60 to 90 min postdose and was eliminated with a half-life of 3.5 h . The area under the curve was double as large as those of cephalexin and cephradine . This may be a reason of favourable results in experimental chemotherapy with CGP 9000. Acta Otorhinolaryngol Belg, 1979, 33(2), 235 - 41 {Etiology and therapy of Ludwig's angina}; De Heyn G et al.; After two case reports of Ludwig's angina, the pathogenesis, the bacteriology and the treatment of this syndrome is reviewed . The initial antimicrobial therapy should be broad enough to inhibit the gram-negative and anaerobic organisms . The antibiotherapy should be completed by the incision and the drainage of the submandibular region . The sudden airway obstruction will be prevented by a tracheotomy under local anesthesia. Arch Mal Coeur Vaiss, 1979 Jan, 72(1), 86 - 91 {Systemic arterial spasms . Ergotamine tartrate}; Dupuy JC et al.; The problem of the toxic effects of ergotism is raised by two cases of acute lower limb ischaemia observed in young patients . Although commonly encountered up to the 20th century, the problem is now reappearing sporadically from iatrogenic causes . The clinical features and treatment of ergotism are discussed . Prophylaxis is based on two main principles: the respect of contraindications, the most important being hypertension, coronary insufficiency, arteriopathies, acrocyanosis and thrombophlebitis, and less importantly, the association of tetracycline type antimicrobials, triacetyloleandomycin and phenothiazine; on the other hand, attention must also be paid to the instructions on its use, particularly with respect to the maximum dosage, 4 mg/day per os, 10 mg/week per os . The treatment should be given intermittently and not continuously . Full knowledge of the composition of composite drugs is required as many drugs are commercialised with their ergotamine content masked . This justifies, if there is still need, constant pharmacovigilance. Am J Clin Pathol, 1979 Jan, 71(1), 88 - 92 In-vitro methods for determining minimal lethal concentrations of antimicrobial agents; Barry AL et al.; To determine the minimal lethal concentration of an antimicrobial agent, broth dilution tests may be performed and then a sample from each tube showing no visible growth may be subcultured onto a drug-free agar medium . By counting the number of viable cells recovered from each tube, the minimal concentration of drug required to kill 99.9% of the cells in the initial inoculum can be determined . Studies were undertaken to determine the circumstances under which false-negative tests could occur as a result of continued inhibition of growth by the antimicrobic carried over in the sample . Drug carryover did significantly reduce the number of viable cells recovered from broth containing relatively high concentrations of antimicrobic: the larger the sample, the greater the effect of drug carryover . The effect was minimal with samples of 10 microliter or less . Furthermore, the effect of drug carryover was reduced by spreading the sample over the surface of an agar medium . The relative precisions of four methods for performing subcultures with such small-volume samples were determined; coefficients of variation were 16-25% . Sampling errors inherent in the procedure for subculturing broth tubes should be taken into consideration when interpreting results of individual tests, and replicate subcultures will improve the reliability of the colony counts. Ann Anesthesiol Fr, 1979, 20(6-7), 549 - 52 {The use of intravenous gamma globulins in pediatrics}; Mattei M et al.; In pediatrics, intravenous Gamma Globulin therapy is extremely valuable when combined with other antimicrobial therapy or when employed on its own especially in cases of viral infection . The use of the intravenous route allows the injection of large amounts of drug, intramuscular injections, which are often counter-indicated in children, particularly in children suffering from malignant blood dyscrasias, are thus avoided . Furthermore with the intravenous route, a high blood titre of gamma globulins is achieved immediately and the treatment can be maintained as long as necessary . The tolerance to this drug, in our experience, at least with the preparation used, was found to be excellent in the vast majority of cases . These preparations ought to be widely employed in all of the serious digestive disorders and in paediatrics. J Antibiot (Tokyo), 1979 Jan, 32(1), 36 - 42 Biological studies on the degradation products of 3-{(S)-1'-phenylethylamino}propylaminobleomycin: a novel analog (pepleomycin); Takahashi K et al.; Pepleomycin (PEP), 3-{(S)-1'-phenylethylamino}propylaminobleomycin has potent activity and is less pulmonary toxic than bleomycin (BLM) . Biological activity and toxicity of the following degradation products of PEP have been studied in detail: the product of carbamoyl migration (ISO), the product of decarbamylation (DC), the product of ring closure of the side chain on the pyrimidine moiety (RC), the depyruvamide product (DP) and the product of an enzymatic inactivation (DA) . These degradation products showed much lower activity than PEP in vitro: antimicrobial and anti-HeLa activities, inhibition of DNA synthesis in AH66 cells and the DNA strand cleavage . Acute toxicity and pulmonary toxicity were tested in mice . Results indicated much lower acute toxicity corresponding to the decreased in vitro activity when compared to PEP . DP and RC did not cause lung fibrosis in mice, while ISO and DC showed 1/2.6 and 1/5.7 degree of pulmonary toxicity, respectively, in comparison with PEP. Zentralbl Bakteriol {Orig A}, 1979, 245(3), 373 - 6 {Hexacyanoferrate-compounds as indicator substances for the efficacy of antimicrobial agents to desulfuricants (author's transl)}; Stubner G; Hexacyanoferrate-compounds are suitable to indicate the efficacy of antimicrobial substances to sulfate-reducing bacteria . They act as a cytochemical indicator system . (Stubner, 9), e . g . K3FeIII(CN)6 showes FeS formation before any visible blackening of the medium . By using hexacyanoferrate compounds it is easier to determine the efficacy of antimicrobial agents . In addition a microscopical control is recommended to detect damaged or avital bacteria in the limiting concentrations of the agents. Infection, 1979, 7(2), 88 - 98 Neutrophil function and host resistance; Zakhireh B et al.; The part played by the phagocytic cells against invading pathogens has been known since the work of Metchnikoff nearly a century ago . This review deals primarily with the role of the neutrophilic polymorphonuclear leukocyte in host defense against microbial infections . The overall function of these cells in protection from infection is dependent on a number of steps . First, an adequate number of functionally mature neutrophils have to be produced and released into the circulation by the bone marrow . Cells must circulate normally and be capable of adhering to capillary and venule walls overlying inflammatory sites . The next step involves the exit of phagocytes from the blood stream through the capillary wall and emigration into the tissues to establish contact with the invading pathogens . This process is accomplished by the locomotive characteristics of these cells and chemotaxis . Most organisms must then be phagocytized to be killed . Two discrete phases are involved in phagocytosis; the "recognition" and attachment phase followed by the ingestion phase . After phagocytosis a series of coordinated morphologic and biochemical events are set into motion which leads to eventual death and lysis of the ingested microbes . A variety of antimicrobial mechanisms are involved in this final step and indicate that these cells have an appreciable reserve capacity if one mechanism is impaired . Recent evidence which clarifies mechanisms involved in all these stages is discussed. Pharmazie, 1979 Jan, 34(1), 43 - 4 Antimicrobial activity of chloramphenicol in solid dispersion systems; Kassem AA et al.; The effect of solid dispersion techniques on the antimicrobial activity of chloramphenicol has been studied and it was proven that the antimicrobial activity of chloramphenicol is not affected when the drug is present as a coprecipitate with carbowaxes (4.000, 6.000, 12.000), and PVP 11.000 and 40.000) also in fusion systems with these polymers . In contrast, the antimicrobial activity of the drug is enhanced when it is present in the from of a solid dispersion system. Vet Rec, 1978 Dec 23-30, 103(26-27), 587 - 9 Transmissible drug resistance in Escherichia coli isolated from healthy dogs, cattle, sheep and horses; Nazer AH; The antibiotic resistance patterns and the distribution of R-factors among Escherichia coli isolated from apparently healthy dogs, cattle, sheep and horses were studied . It was found that 102 strains (16.48 per cent) of a total of 619 isolates were resistant to one or more drugs . Twenty-six per cent (27 strains) of the resistant strains were capable of transferring either a part or the entire resistance patterns to the sensitive recipient strain . These results indicates that antibiotic resistance and R-factors are not particularly widespread among animals whose diet does not cotain antimicrobial drugs. J Antibiot (Tokyo), 1978 Dec, 31(12), 1296 - 8 Anaerobic susceptibility tests . Evaluation of the stability of antimicrobials in Wilkens-Chalgren broth and the effect of media prereduction; Murray PR et al.; The stability of eight antimicrobial agents in WILKENS-CHALGREN broth was evaluated . The activities of only carbenicillin and benzyl penicillin were significantly decreased after storage for eight weeks at--20 degrees C . Anaerobic reduction of the susceptibility testing broth prior to inoculation was found to be unnecessary. Obstet Gynecol, 1978 Dec, 52(6), 656 - 61 Infectious morbidity following cesarean section . Comparison of two treatment regimens; Cunningham FG et al.; During a 4-month period 265 women delivered by cesarean section were studied to determine what effect membrane rupture has on the incidence and severity of postoperative infection . There was a definite correlation between the duration of ruptured membranes and the incidence as well as severity of postoperative infections . Only 29% of women with intact membranes subsequently developed endometritis with pelvic cellulitis, in contrast to 85% of those whose membranes were ruptured for less than 6 hours . Wound and pelvic abscesses were encountered in less than 1% of women delivered with intact membranes, yet these complications developed in over 30% of women with membranes ruptured for less than 6 hours . The incidence of septicemia was four times greater in those women whose membranes were ruptured for less than 6 hours . Women with endometritis were treated with one of two empirical antimicrobial regimens chosen randomly . Intravenous penicillin and tetracycline was found to be as effective as, and perhaps slightly more effective than, the combination of intravenous penicillin and intramuscular tobramycin. Am J Clin Pathol, 1978 Dec, 70(6), 909 - 13 Reassessment of the "class" concept of disk susceptibility testing . Cephalothin disks versus minimal inhibitory concentrations with eleven cephalosporins; Barry AL et al.; Reassessment of the "class" concept of disk susceptibility testing . Cephalothin disks versus minimal inhibitory concentrations with eleven cephalosporins . Am J Clin Pathol 70: 909--913, 1978 . Studies were carried out to determine whether susceptibility or resistance to 11 cephalosporins could be predicted reliably from th