Antimicrobial

Medicine (Baltimore), 1978 Jan, 57(1), 83 - 103
Anaerobic osteomyelitis; Raff MJ et al.; We have presented eight case histories of patients with anaerobic osteomyelitis and have reviewed an additional 193 cases from the world literature . The incidence, predisposing factors, clinical localization, bacteriology, modes of presentation and natural history of anaerobic osteomyelitis are discussed . This disease entity appears to be more common than has been previously recognized . Seven distinct clinical syndromes of anaerobic osteomyelitis are described and related to the anatomical locations in which they tend to occur . The signs and symptoms of these entities have been outlined to aid in their recognition by practitioners . An approach to the therapy of anaerobic osteomyelitis is outlined . Emphasis is placed on adequate surgical intervention combined with antimicrobial agents chosen for each particular clinical situation . The lack of definitive data upon which to base a decision regarding dosages and duration of antimicrobial therapy is discussed and the authors' own preferences enumerated.

Arzneimittelforschung, 1978, 28(11), 2058 - 61
Fluorescent analogue of ampicillin; Kusnir J et al.; As the outcome of the reaction of ampicillin with 4-phenylspiro{furan-2(3H),1'-phthalane}-3,3'-dione (fluorescamine), the chemical analogue of ampicillin (F-AMPI) has been prepared . This preparation has manifested strong fluorescence in UV light . Some basic chemical and biological properties of this product such as chemical stability electrophoretic mobility, uniformity during thin-layer chromatography and ion-exchange chromatography, and antimicrobial activity were examined . The results were compared with values of the original antibiotic.

Arzneimittelforschung, 1978, 28(4), 582 - 5
{Semi-quantitative determination of resistance in agar (author's transl)}; Marcenac FM et al.; The sensitivity of microorganisms to antimicrobial preparations is determined--using agar as the test medium--by means of a semi-quantitative method involving two concentrations, i.e . a low concentration relating to serum levels easily attained at the commonly used dosage level of the various antibacterially acting preparations, and a high concentration corresponding to serum levels attainable at increased dosage via the appropriate route of administration . The inoculum is distributed with a multi-inoculator making a simultaneous inoculation of 25 strains possible . For 25 antibiograms with 20 antibiotics 40 Petri dishes are required, inoculation take 15 min . The method described is suited above all for laboratories with large workload where a great number of resistance determinations must be carried out rapidly, precisely at a low cost.

Arzneimittelforschung, 1978, 28(2), 232 - 4
{Determination of antimicrobial activity of a combination of acidamfenicol, clotrimazole and dexamethasone in vitro (author's transl)}; Poitschek C et al.; The in vitro antimicrobial activity of the antieczematic Bay f 4797 was studied . This combination drug contains the three active components acidamfenicol, clotrimazole and dexamethasone (prospective trade name: Baycuten) . Various bacterial and fungal species of importance in dermatology served as test organisms . All the bacterial strains examined were found to be moderately susceptible to acidamfenicol; clotrimazole showed good inhibitory values agaisnt all the fungal species and the gram-positive bacterial strains . Additionally it was checked whether a synergistic or antagonistic interaction occurs with respect to the antimicrobial activity . An interference which could lead to impairment of the therapeutic activity was not observed.

Folia Microbiol (Praha), 1978, 23(1), 12 - 7
Influence of antimicrobial agents on contamination and chlortetracycline production; Welward L et al.; The possibility of shortening the thermal sterilization time for cultivating media was demonstrated in chlortetracycline fermentation with an industrial strain of Streptomyces aureofaciens . The medium was artificially contaminated with a mixture of eight strains of G+ and G- bacteria isolated from contaminated industrial fermentors, and the following chemical agents, either alone or in combination, were added: formaldehyde, phenol . dimethylformamide, p-aminosalicylic acid and nitrofurazone . Dimethylformamide was inhibitory even at 0.08% . formaldehyde concentrations higher than 0.05%, Nitrofurazone stimulated chlortetracycline production . The best combination was 0.01% formaldehyde added before, and 2.10-3% nitrofurazone added after short sterilization at 120 degrees C.

Am Rev Respir Dis, 1978 Jan, 117(1), 153 - 60
Percutaneous drainage of lung abscess; Vainrub B et al.; The availability of effective antimicrobial agents has greatly decreased the need for surgical intervention in patients who have a pyogenic lung abscess . We describe 3 patients with lung abscesses caused by gram-negative bacteria who failed to respond to medical treatment and who were believed to be unable to withstand lobectomy . Percutaneous insertion of a drainage tube directly into the abscess brought about a dramatic clinical response, with prompt closure of the cavity . This procedure provides an alternative to thoracotomy and lobectomy in treating lung abscesses that fail to respond to medical therapy.

Microbios, 1978, 23(92), 83 - 5
Phenols: a review of their history and development as antimicrobial agents; Hugo WB; Phenols were first isolated in crude form at the end of the eighteenth century . Pure phenol was isolated in 1834 and its structure proved in 1842 . In 1860 Kuchenmeister first used phenol as a wound dressing in Germany . Lister was to use it in his classical experiments in antiseptic surgery . Substituted phenols, and to some extent phenol itself, are still in use today as antiseptics, disinfectants and preservatives.

CRC Crit Rev Microbiol, 1978, 7(1), 27 - 91
Cellular antimicrobial immunity; Collins FM; Acquired resistance to infectious disease may be expressed by a predominantly humoral or a cellular mechanism or, more frequently, by a combination of the two . The cellular interactions which are responsible for the induction of the immune response in the skin, lung, intestinal mucosa, genitourinary tract, conjunctiva, and peritoneal cavity are discussed and the role of living or dead vaccines in the induction of acquired resistance is outlined . The host response involves three different cell types: the phagocytic cell (polymorphs or macrophages), the thymus-dependent (T) lymphocyte, and the thymus-independent (B) lymphocyte-plasma cell line . The normal unstimulated phagocytic cell is capable of killing most nonpathogenic bacteria that gain entry to the tissues . However, the presence of opsonic antibodies and activated macrophages is required to eliminate the pathogenic intracellular parasites . Such immunological activation involves the presence of sensitized T-lymphocytes in the lesion . The cellular response is also characterized by the simultaneous development of a state of delayed-type hypersensitivity (DTH), along with the antimicrobial CMI response . A rising humoral response normally develops subsequently . Killed bacterial cells (except when incorporated into Freund's complete adjuvant) induce the humoral response without the CMI reaction so that such vaccines are not able to fully protect the host against the naturally acquired disease . With the development of cell fractionation methods as well as the identification of distinctive cell surface markers, suspensions of B- and T-cells and macrophages can now be prepared for use in increasingly sophisticated transfer and reconstitution studies . The role of the different cell types in the expression of humoral and cellular immunity has been determined, and the effect of various immunopotentiating and immunosuppressive regimens on the immune system as a whole has been evaluated quantitatively . These studies have led to an appreciation of the role played by suppressor B- and T-cells in the interplay of both humoral and cellular components of the host defense system during the development of immune tolerance, desensitization, anergy, autoimmunity, and the expression of an anamnestic immune response following reinfection.

Z Allg Mikrobiol, 1978, 18(6), 389 - 98
Fermentation, isolation, and biological activity of maduramycin: a new antibiotic from Actinomadura rubra; Fleck WF et al.; In a continuing search for new antibiotics, the species Actinomadura rubra (Sveshnikova et al.) J . Meyer et M . Sveshnikova 1974 (strain IMET 13001) was found to produce a red pigment with indicator properties, designated maduramycin . The pigment (C28H22O10; m.w . 518 m/e-; m.p . 305--310 degrees C (dec.); UVmax 225.307 nm) possesses a strong antimicrobial activity against gram-positive bacteria, including strains which produce inactivating enzymes for some commercial antibiotics . Maduramycin forms a complex with serum albumin, but no complex formation with DNA was observed using absorption spectroscopic and polarographic methods . Maduramycin additionally inhibits the action of some enzymes . The LC50 of maduramycin in mice was greater than 250 mg/kg on intraperitoneal administration . Fermentation, isolation, and some of the chemical and biological properties of this new antibiotic are described.

Scand J Infect Dis Suppl, 1978, (14), 251 - 60
Penetration of antimicrobials into tissue culture cells and leucocytes; Brown KN et al.; When exposed to HeLa cells in tissue culture for 72 hr., antimicrobials could be categorised into three groups characterised by cell associated concentrations much lower (ampicillin, cephalexin, cloxacillin, flucloxacillin, streptomycin and trimethoprim, all 14% or less), much higher (tetracycline and polymyxins) or approximating to those extracellularly (erythromycin, lincomycin, fusidic acid and gentamicin) . For kanamycin, neomycin and sulphonamides, cell associated levels were between 24 and 47% and for penicillin G and cephaloridine were 66% of those extracellularly . With mouse peritoneal macrophages and human peripheral blood leucocytes cell associated levels for representative antibiotics were all lower after 3 hr . exposure than in the tissue culture cells . However, studies on the rate of release of cell associated antibiotic and of the effects of surface active agents indicated that the differences between cell types were due to loss of cell association during washing procedures to remove extracellular antibiotic . The effects of bactericidal antibiotics on survival of bacteria phagocytosed by mouse macrophages suggested that the cell association observed in tissue culture cells represented true intracellular penetration rather than mere binding to the cell surface . Within families of antibiotics, alterations to the molecule change cell penetration and the variations observed can not be explained merely in terms of simple diffusion, molecular size, dissociation constants, lipid solubility or protein binding.

Int J Vitam Nutr Res, 1978, 48(2), 159 - 64
Ascorbic acid, neutrophil function, and the immune response; Leibovitz B et al.; The role of ascorbic acid is reviewed with regard to antimicrobial activity, interferon production, and humoral and cellular immune responses . Ascorbic acid appears to play a role in a number of neutrophil functions including increased chemotaxis, increased particulate ingestion, enhanced lysozyme-mediated non-oxidative killing, protection against the toxic effects of superoxide anion radical, inhibition of the halide-peroxide-myeloperoxidase system without a pronounced bactericidal effect, and stimulation of the hexose monophosphate shunt.

Annu Rev Med, 1978, 29, 129 - 36
E . coli meningitis: K1 antigen and virulence; Wilfert CM; It is clear from the preceding material that bacterial infection is a significant threat to the newborn infant . The most common gram-negative organism causing meningitis in the neonate is E . coli, and the invasive capacity of this organism is correlated with its polysaccharide antigen, K1 . Careful studies of supportive care and antimicrobial therapy of these infections are continuing . If antibodies could be generated which protect the infant, it would be theoretically possible to guard against infasive disease by conferring antibody positivity to the mother and hence to the infant . Investigations along these lines are continuing.

Z Exp Chir, 1978, 11(1), 27 - 31
{Experimental studies on the antimicrobial effect of several butylcyanoacrylate tissue adhesives}; Uhlig R et al.; It is dealt with the effects of various butycyano-acrylate type surgical adhesives on gram-positive and gram-negative bacterial species . The experimental results show a growth-inhibiting effect on gram-positive germs . Gram-negative germs are not affected . The growth inhibition produced by SO2-containing adhesives is greater than that caused by SO2-free ones . As compared to Histoacryl blue, the Fimomed variants showed a broader spectrum . Furthermore, it was stated that the adhesive exerts its growth-inhibiting effect not only in the monomeric, but also in the polymeric state . A relationship between the gram-behaviour and the antimicrobic effect of the adhesive is taken into consideration.

Am Surg, 1978 Jan, 44(1), 55 - 8
Does skin have antimicrobial properties? An in-vitro experiment and literature review; Szabo SE et al.; Skin grafts placed over burn wounds were first reported to reduce bacterial growth levels about 20 years ago . Recently, three separate groups of investigators have studied effects of skin in vitro in order to better understand the mechanism of this in vivo phenomenon . Although significant bacterial inhibition was not found, the interaction of host tissue factors with the skin which is possible in vivo was not included in these experiments . Hence, the question of in vitro activity of skin was still not resolved . In this experiment human and pig skin, fresh and preserved, intact and homogenated, were all tested separately with and without active serum against four representative bacteria and one fungus, individually and in mixed cultures . No growth inhibition was observed under any circumstances on daily review for up to three-week periods . In light of conflicting reports related to antibacterial effects of skin grafts used clinically, it now seems important to definitively clarify whether skin really possesses antibacterial properties in vivo.

Arzneimittelforschung, 1978, 28(10), 1665 - 72
Biological assay of potential trichomonacides in vitro using a counter apparatus; Brotherton J; Utilising the accuracy and speed of a Coulter Counter for cell counting and sizing, a new method of antimicrobial assay has been developed in which the potency of inhibitors is calculated on a mol/cell basis . A total of 72 potential trichomonacides were screened against Trichomonas vaginalis and the ED50 value estimated for 27 of the most interesting and potent compounds . The ED50 value for metronidazole was a mean of 5.12 fmol/cell and only 6 compounds were more potent . After the nitroimidazoles, the acridines were the most potent group of compounds . Only chlortetracycline and gramicidin caused an increase in mean cell size.

Scand J Infect Dis Suppl, 1978, (14), 92 - 9
Theory and practical impact of binding of antimicrobials to serum proteins and tissue; Craig WA et al.; Binding of antimicrobials to serum proteins and tissue affects their distribution, elimination and antimicrobial activity . Penetration of drugs into most tissues and interstitial and inflammatory fluids correlates with level of free drug in serum . Serum protein binding can increase or decrease the rate of drug elimination depending on whether total or free drug is available to the excretory or metabolic routes of elimination . Binding to soluble intracellular proteins (ligandin and fatty acid binding protein) appears to be important in the cellular transport and elimination of antimicrobials by renal tubular secretion and hepatic extraction . Although only free, unbound drug is antimicrobially active, the lack of well designed studies has prevented precise quantitation of the influence of binding on therapeutic efficacy in vivo . Pharmacokinetic considerations predict that serum binding greater than 80% would be necessary to significantly reduce free levels of drug in the body . However, extensive protein binding is often compensated for by greater intrinsic activity of lipophilic antimicrobials.

Scand J Infect Dis Suppl, 1978, (14), 47 - 53
The penetration of antibiotics into bacterial cells: significance to antimicrobial action; Hare JD; The penetration of antibiotics into the microbial cell is reviewed from the standpoint of the structure and function of the several types of membranes which constitute permeability barriers to the passage of hydrophilic molecules . It is clear that little is actually known about the mechanisms by which the majority of antibiotics gain access to their site of action within the target cell . Sufficient evidece is at hand to indicate that resistance to several groups of antibiotics is determined by changes in the permeability of the cell membranes, the genes for which are often carried on R-plasmids . The importance of studies to determine the precise mechanisms by which each type of antibiotic permeates the membrane of the bacterial cell is stressed by a discussion of several approaches to enhancing antibiotic permeation through manipulation of either the drug or the target cell based on knowledge of the uptake mechanisms.

Scand J Infect Dis Suppl, 1978, (14), 36 - 46
Kinetics of tissue penetration . Are high plasma peak concentrations or sustained levels preferable for effective antibiotic therapy?
Bergan T.
The experimental evidence and the theory of antibiotic transport into peripheral foci of infection have been discussed . Support is presented in favour of the concept that intermittent dosage with peak concentrations of sufficient size would seem preferable . The duration of plasma concentrations above certain thresholds is a basic requirement for successful antimicrobial therapy.

Scand J Infect Dis Suppl, 1978, (14), 25 - 35
Significance of the pharmacokinetics of antimicrobial drugs; Hinderling PH; Administration of an active drug to the intact human body leads to a "drug-body" interaction: the drug exerts its effect on the body, the body disposes of the drug . Administration of an antimicrobial drug to a human body infected with pathogenic bacteria leads to a "drug-bacteria" interaction in addition to "drug-body" and "bacteria-body" interactions . Of these complex interacting mechanisms only the disposition effect of the human body on antibacterial drugs and the effect of antimicrobial agents on bacteria have been quantified, analyzed, and are thus predictable . Postulates have been derived from the findings of these studies and have given the rationale for proper antimicrobial therapy under clinical conditions: antimicrobial actions are functions of the duration and concentration of the active antimicrobial principle at the physiological site of action . Optimal therapeutic efforts consider the need for individual treatment with respect to the choice and type of dosage regimen of the antimicrobial agent administered.

Scand J Infect Dis Suppl, 1978, (14), 239 - 44
Changes in protein binding during disease; Craig WA et al.; Disease states can alter protein binding of antimicrobials by either a reduction in the concentration of serum proteins or the accumulation of endogenous compounds, such as bilirubin and free fatty acids (FFA), that affect drug-protein interactions . In terms of protein concentration, extremely low levels of albumin (less than 2.5 m/100 ml) are required to markedly reduce binding of antimicrobials . In vitro addition of high concentrations of bilirubin and FFA to normal serum reduces binding of most antimicrobials . However, binding of some antibiotics appears to be enhanced at lower concentrations of FFA probably by an allosteric mechanism . These in vitro observations have been confirmed in sera from patients during heparin administration and patients with hyperbilirubinemia . Reduced protein binding of acidic antimicrobials in uremia appears to be associated with the accumulation of another, as yet unknown, endogenous binding inhibitor . Significant reduction in protein binding can affect the distribution of drugs and results of microbiologic assays.

Scand J Infect Dis Suppl, 1978, (14), 233 - 7
Transfer of penicillin G and ampicillin into human skin blisters induced by suction; Schreiner A et al.; The antibiotic concentrations in untreated and endotoxin-treated suction blisters was studied in 15 healthy adults . In a pilot study, 2 mega units of penicillin G were given as an intravenous bolus injection to two subjects . For further studies, a single dose of 800 mg bacampicillin was given orally to 13 individuals . The penicillin G concentrations in the blister fluid were highest approximately 15 minutes after the dose, and exceeded that of serum after 1.5 hours . With ampicillin the blister fluid concentration reached maximum levels after approximately 2 hours, were equal to serum levels after 3 hours, and were later persistently in excess of serum levels . The ampicillin half-life was 136 and 100 minutes in the two types of blister fluid, as compared to 65 minutes for serum . A marked differences between the antibiotic concentrations in inflammatory and non-inflammatory blisters was seen in the pilot study with penicillin G . However, in the experiments with bacampicillin, no significant difference was demonstrated . This suction blister technique appears to be a useful method for studies on extravascular antimicrobial activity in man.

Scand J Infect Dis Suppl, 1978, (14), 189 - 206
A review of models for the therapy of experimental infections; Bergeron MG; The advent of several new antibiotics able to counter drug-resistant bacteria, the problems in carrying out well-controlled clinical trials and the occasional disparity between in vitro and in vivo activity of antimicrobials compel us to resort to experiments using animal models in order to evaluate different therapeutic regimens . We wish here to discuss the prerequisites of a reliable animal model for the therapy of experimental infections and to analyze the influence of combined antimicrobial therapy on the outcome of non-human infections . The interaction between antibiotics and infected tissues will also be considered . Finally, we shall examine the interrelations between host defenses and antibiotics in models for experimental infections.

Scand J Infect Dis Suppl, 1978, (14), 160 - 3
Factors influencing the penetration of antimicrobial agents into the cerebrospinal fluid of experimental animals; Sande MA et al.; Successful therapy of bacterial meningitis is dependent upon achieving adequate antibacterial activity in the CSF . The percent penetration (CSF concentration/serum concentration X 100) of various antimicrobial agents was determined in a rabbit model of bacterial meningitis . The percent penetration of the penicillin and cephalosporin derivatives was found to vary inversely with the protein binding of the respective drugs . Esterification of ampicillin increased its lipid solubility and likewise increased the penetration into the CSF . Probenecid competitively inhibits the active transport efflux of various organic acids from the CSF and increased the CSF concentrations of penicillin and cephalosporin derivatives . The percent penetration of all drugs was increased in the presence of the inflamed meninges.

Scand J Infect Dis Suppl, 1978, (14), 109 - 17
A critique of animal models in antibiotic research; Barza M; The interactions between microbes and antimicrobial agents in vitro are often markedly different from those in vivo, presumably because of pharmacological factors and host defenses . Although animal models have long been used to evaluate the efficacy of chemotherapeutic agents, there are few guidelines for the conduct of these studies . Therefore, the results of these investigations must be assessed critically in terms of the balance between the infectious challenge and the therapeutic response, and in terms of their relevance to human disease . It has been clearly demonstrated that the "freshness" of the infecting organism, the interval between infection and therapy, the order of administration of drug combinations, and the presence of foreign bodies, may have a crucial impact upon the outcome of animal trials . Less well studied have been the influence of the quantity and growth phase of the infecting inoculum, the use of single- as opposed to multiple-dose therapy, and the anatomical and pharmacological attributes of the particular animal species . Greater understanding of these factors would resolve some of the apparently contradictory results of various investigations, and would permit more rational design of these studies in the future.

Oral Surg Oral Med Oral Pathol, 1978 Jan, 45(1), 116 - 22
Antimicrobial effects of N2 in vitro; Broisman H et al.; The antimicrobial effect of the root canal filling material N2 has been studied in vitro . Pulverized as well as intact set N2 inhibited the growth of the mixed bacterial flora of saliva or pure cultures of S . mutants and A . viscosus on blood agar for at least 100 days . Intact set N2 transferred daily to blood agar inoculated with saliva lost its antimicrobial activity after nine transfers . The antimicrobial effect of N2 against S . mutants was found to be bactericidal . N2 also appeared to possess an antimicrobial "vapor effect".

Scand J Infect Dis Suppl, 1978, (14), 135 - 42
The mini-pig as a model for penetration of penicillins; Bergan T et al.; To be active, antimicrobials must reach the bacteria in the infectious foci in adequate concentrations . Direct measurements of levels in the various foci are difficult to perform, but a number of animal models with artificial extravascular foci have been developed . In many ways, the physiology of pigs resemble that of humans . Consequently, it was thought that pigs might also parallel humans in the handling of penicillins . General pharmacokinetics of ampicillin and flucloxacillin and the penetration of the substances to subcutaneously implanted teflon tistisue chambers were investigated . Ampicillin was given intramuscularly, orally, and as the pro-drug bacampicillin.

Infection, 1978, 6(2), 84 - 91
Immune competence in a patient with Hodgkin's disease and relapsing toxoplasmosis; Frenkel JK et al.; A 40 year old woman with Hodgkin's disease twice developed signs of encephalitis while being treated with prednisone and cyclophosphamide for 10 months . Since on both occasions her Toxoplasma dye test titer was 1 : 8000 or higher, she was treated on suspicion of toxoplasmosis with sulfadizine and pyrimethamine . Her tumor therapy was changed to bleomycin with lower doses of prednisone for 12 months . After death from central pontine myelinolysis, Toxoplasma and cytomegalovirus could be isolated, but no lesions attributable to these infectious agents were present . Maintenance of the patient's immune competence suggested an inquiry into the effects of the chemotherapeutic agents and of tumor infiltration for their respective interference with immunity . Using hamsters with chronic latent toxoplasmosis, it was found that both cortisone and cyclophosphamide caused recrudescence of chronic inapparent infection, that vinblastine and bleomycin interfered only slightly with the development of immunity, whereas in infiltrating lymphoma permitted immunity to develop normally . It is concluded that greater attention should be directed to the immunosuppressive effects of tumor treatment . By choice of an effective tumor therapy which is least immunosuppressive, and if necessary under cover of antimicrobial therapy, a patient with Hodgkin's disease can be aided in developing immunities which he may subsequently be able to maintain.

Urol Res, 1978, 6(1), 35 - 42
The influence of pH on antimicrobial substances in canine vaginal and urethral secretions; Hoyme U et al.; Trimethoprim and rosamicin (a new basic macrolide antibiotic) were administered to normal and oophorectomised female dogs by constant intravenous infusion before and after oestrogen and androgen administration . Their concentrations in plasma and in urethral and vaginal secretions were determined by bioassay and correlated with the pH values of vaginal and urethral secretions . Both compounds were concentrated in the vaginal and urethral secretions in reverse correlation with the pH of these fluids . Trimethoprim and rosamicin have antimicrobial spectra well suited for the treatment of bacterial urethritis and vaginitis and require further clinical investigation.

Arch Orthop Unfallchir, 1977 Dec 27, 90(3), 259 - 63
{Bone concentration of a new antimicrobial agent azlocillin (author's transl)}; Vent J et al.; The literature regarding bone level concentrations of different antimicrobial agents is reviewed . The investigation using Azlocillin shows a sufficiantly high concentration in human bone to include this agent among other semisynthetic penicillins.

J Exp Med, 1977 Dec 1, 146(6), 1648 - 62
Hydrogen peroxide release from mouse peritoneal macrophages: dependence on sequential activation and triggering; Nathan CF et al.; Using a specific and sensitive fluorometric assay, the H2O2 release from as few as 2 X 10(5) mouse peritoneal macrophages could be detected continuously and quantitated . It is emphasized that the assay measured H2O2 release, not production . Induction of H2O2 release required sequential application of two stimuli: the administration of an activating agent to the mice from 4 days to 10 wk before all harvest, and the exposure of the cells in vitro to a triggering agent . BCG was most effective as an activating agent, resulting in peritoneal macrophages which could be triggered to release H2O2 almost as copiously (8 nmol/10(6) macrophages per 5 min) as mouse peritoneal PMN (9 NMOL/10(6) PMN per 5 min) . Casein and C . parvum could also serve as activators, but thioglycollate and FCS were ineffective after single injections . PMA was a potent triggering agent, resulting in a maximal rate of H2O2 release after a latency of about 40 s for cells in suspension . Other triggering agents included the ionophore A23187, concanavalin A in the presence of cytochalasin B, and phagocytosis . H2O2 release could be attributed to macrophages and PMN in peritoneal cell suspensions or in preparations of adherent peritoneal cells, but not to lymphocytes . Indirect evidence suggested that the H2O2 detected was formed from superoxide anion . These observations appear to justify renewed interest in the idea that H2O2 may be important in macrohpage antimicrobial and antitumor mechanisms.

Jpn J Antibiot, 1977 Dec, 30 Suppl, 246 - 61
Modern instrumental methods for identification of antibiotics; Mitscher LA et al.; Modern screening for antimicrobial agents and the characterization of their transformation products are not only extremely competitive but highly labor intensive activities . The use of specialized instrumental techniques for rapid identification of molecular species shows promise of becoming an essential part of this process . At the earliest stages, microseparation methods coupled with modern methods of ion production are particularly useful . Applications of various methods of chromatography, including high performance liquid chromatography, with various methods of ion production using mass spectrometers, particularly under computer control, are exceptionally powerful, though expensive, means of addressing this problem . Some present and potential uses of this technique are discussed along with a consideration of the strengths and weaknesses now apparent and a projection is made of the future of this method . A brief review of the use of a variety of physical methods of structural characterization for a variety of specialized purposes is also given along with a bibliography of recent applications to specific antibiotics . The scope and limitations of these methods is also treated.

Am J Clin Pathol, 1977 Dec, 68(6), 769 - 777
Laboratory evaluation of an automated antimicrobial susceptibility system; Stubbs KG et al.; A newly introduced automated method for antibiotic susceptibility testing, AUTOBAC 1, has been evaluated by comparison with the disk agar diffusion method (Bauer-Kirby) . A total of 2,518 strains of gram-positive (540) and gram-negative (1,978) organisms isolated from clinical specimens was examined by both methods with eight or ten antibiotics, including Tobramycin . An overall agreement of 97.4% was obtained when results were compared by individual antibiotic . However, many discrepancies were observed when individual genera or species were analyzed . Of 2,518 strains examined, 651 (26%) showed discrepancies in response to one or more antibiotics . Strains, showing discrepancies were re-examined by the broth dilution susceptibility method . The results obtained favored the disk agar diffusion method . Reproducibility experiments revealed a greater inconsistency in the AUTOBAC 1 system than in the agar diffusion test . It is concluded that although a rapid automated system for antibiotic sensitivity testing is desirable, the conventional disk agar diffusion method is easier to perform, more reliable, and a less expensive procedure for antibiotic sensitivity determination.

J Trauma, 1977 Dec, 17(12), 968 - 71
Rupture of the thoracic esophagus from blunt trauma; Chilimindris CP; A young man with severe multiple injuries following a motorcycle accident was admitted with head and mandible fractures, coma, fracture dislocation at C5-C6 resulting in total leg paralysis, partial paralysis of the right arm and intercostal muscles, and closed chest injury with possible pulmonary contusion . On the fourth day he developed fulminating mediastinitis and massive empyema, and was found to have a ruptured esophagus . Recovery became possible with surgical drainage of the pleural cavity and mediastinum, proximal and distal decompression of the esophagus, antimicrobial therapy, irrigation of the pleural cavity, complete intravenous hyperalimentation, and infusions of salt-poor albumin . The patient was discharged after 95 days, and 7 months after injury is neurologically intact except for a partial right wrist drop . This rare esophageal rupture should be suspected in any chest injury patients, especially those characterized by extreme cyanosis, dyspnea, shock, and prostration incompatible with thoracic cage injury.

Arq Neuropsiquiatr, 1977 Dec, 35(4), 346 - 53
{Bacterial meningitis in the newborn . Study of 20 cases}; Moura Ribeiro V et al.; The cases of 20 patients admitted with purulent meningitis in the neonatal period are reported . The authors analyse the importance in recognizing the minimal signals and symptoms, as weel as the clinical patterns of the manifested disease; Some considerations are draw about the values of the early diagnostic before the high incidence of mortality and the gravity of sequaele that occur besides the high doses and long term antimicrobial therapy.

J Clin Periodontol, 1977 Dec, 4(5), 136 - 43
Outlook for Hibitane in dental caries; Emilson CG; The association between S . mutans and dental caries in humans has focused the interest on the possiblity to suppress or eliminate this microorganism from the oral cavity . In this respect chlorhexidine seems to be a valuable adjunct, since S . mutans is highly sensitive to the drug . In hamsters and rats infected with S . mutans topical applications of chlorhexidine have been highly effective in lowering the caries activity . In long-term studies in students, a certain caries inhibiting effect has also been demonstrated . The decrease in the prevalence of S . mutans by chlorhexidine treatment suggests that the drug can be used for directed and controlled antimicrobial therapy in subjects highly infected with S . mutans.

Am J Med, 1977 Dec, 63(6), 914 - 25
Pulmonary disease caused by Candida species; Masur H et al.; Candida species are often found in sputum specimens . Their role as a possible cause of pulmonary disease is a frequent consideration, particularly in patients receiving immunosuppressive or long-standing antimicrobial therapy . At Memorial Hospital and New York Hospital, 30 patients with histologic evidence of Candida pulmonary infection were identified over a two year period . These infections reached the lungs by hematogenous spread in 10 patients and by aspiration in 16 patients . Most the patients had malignant neoplastic disease . The Candida pulmonary disease appeared to be significant clinical factor in only three cases . Experience from our institutions and from the literature indicates that Candida species rarely cause significant pulmonary disease . When such involvement is extensive, the patient is usually terminally ill from multiple other factors.

J Antibiot (Tokyo), 1977 Dec, 30(12), 1087 - 92
Disruption of the Escherichia coli outer membrane permeability barrier by immobilized polymyxin B; Rosenthal KS et al.; One of the apparent roles of the outer membrane system in gram-negative bacteria is to function as a selective permeability barrier . A number of antibiotics active against gram-positive bacteria are relatively ineffective against gram-negative bacteria presumably because of the implied barrier function of the outer membrane . This interpretation has been strengthened by studies demonstrating synergism between outer membrane perturbing agents such as EDTA or polymyxin B and specific antibiotics . In the case of polymyxin B, it is not totally clear that synergism with other antimicrobials is due to disruption of the outer membrane permeability barrier or to interactions with the inner membrane . In order to resolve this question, polymyxin B was covalently attached to agarose in order to limit interactions with the outer surface of E . coli . These studies demonstrate that immobilized polymyxin B acts synergistically with bacitracin, rifampicin, or lysozyme . It is proposed that synergistic effects exhibited by polymyxin B are due to its interaction with the outer membrane system.

J Gen Microbiol, 1977 Dec, 103(2), 367 - 74
The mode of action of N-(n-Dodecyl)diethanolamine with particular reference to the effect of protonation on uptake by Escherichia coli; Lambert PA et al.; In a homologous series of N-(n-alkyl)diethanolamines antimicrobial activity was related to surface activity and increasing octanol-water partition coefficient . Maximum activity was exhibited by the dodecyl-, tetradecyl- and hexadecyl-derivatives . Dodecyldiethanolamine (DDE) displayed a broad spectrum of activity . Towards Escherichia coli NCIB8277, its bacteriostatic and bactericidal activity increased as the degree of protonation lessened, and may have been influenced by the formation of micelles . Uptake of DDE by washed suspensions of E . coli was more rapid and more extensive at pH 7.0 than pH 4.0 . Within this pH range, bacterial uptake, the octanol-water partition coefficient (lipid solubility) and the proportion of unprotonated DDE all increased . Uptake isotherms at pH values in the range 4.0 to 8.0 are interpreted as signifying different uptake mechanisms for the protonated and unprotonated forms.

Am Fam Physician, 1977 Nov, 16(5), 167 - 72
Outpatient management of minor burns; Miller SF; The overwhelming majority of burns are minor and can be treated on an ambulatory basis if hospitalization is not indicated . Recommended are topical antimicrobial agents in the acute phase and pressure garments after wound healing . Sound principles of burn wound management determine the ultimate outcome of treatment, the degree of function and the cosmetic appearance of the healed wound.

Antibiotiki, 1977 Nov, 22(11), 970 - 4
{Component composition and admixtures of related compounds in commercial preparations with an erythromycin base}; Zak AF et al.; Chromatographic purity of erythromycin base preparations manufactured in the USSR with various technological procedures and those of 4 foreign firms was studied . All the preparations studied in addition to the main component of erythromycin A contained 5 to 7 per cent of erythromycin C and about 1.5 to 3.5 per cent of a non-identified component possessing a somewhat lower chromatographic mobility than erythromycin C . The admixture of 0.5--1 per cent of anhydroerythmycin was found in many erythromycin preparations . The preparations of some foreign firms contained also a number of additional substances . It was shown that the antimicrobial activity of anhydroerythromycin was 50-60 times lower than that of erythromycin . Direct correla;ion between the level of the antimicrobial activity of the market prepaetions of erythromycin and the level of its chemical purity was noted.

J Antibiot (Tokyo), 1977 Nov, 30(11), 908 - 16
New antitumor antibiotics, OS-4742 A1, A2, B1 and B2 produced by a strain of Streptomyces; Omura S et al.; New antibiotics, OS-4742 A1, A2, B1 and B2, were isolated from the culture broth of the strain OS-4742, which was designated as Streptomyces matensis subsp . vineus . These compounds have anthracycline chromophores and sugar moieties, but do not contain nitrogen . They possess antimicrobial activities against Gram-positive bacteria and antitumor activities against S-180 solid tumor on mice.

Res Vet Sci, 1977 Nov, 23(3), 340 - 3
Therapeutic responses of piglets to experimentally induced colibacillosis; Dey BP et al.; The purpose of these experiments was to determine the effects of prior exposure to antimicrobials on subsequent treatment of artificially induced colibacillosis in pigs . One- to two-week-old piglets were given 10(7) multiple antibiotic resistant Escherichia coli orally . Two groups of the piglets received priming doses at different levels of the antimicrobial preparation, ASP-250 before challenge . The remaining group received no antimicrobial . Piglets ill as a result of the challenge were treated with chloramphenicol of chlortetracycline, or received no treatment . Chloramphenicol was significantly more effective than chlortetracycline in terminating colibacillosis in the primed and unprimed groups . There were fewer deaths and relapse cases in those groups which received chloramphenicol treatment . Results in piglets treated with chlortetracycline were not significantly better than those which received no treatment.

Am Rev Respir Dis, 1977 Nov, 116(5), 847 - 51
Detection of penumococcal antigens in the sputum in pneumococcal pneumonia; Leach RP et al.; Forty-seven patients with bacterial pneumonia were grouped by use of clinical criteria according to the relative certainty of a diagnosis of pneumococcal pneumonia . Sputums were tested for pneumococcal antigens by counterimmunoelectrophoresis with polyvalent pneumococcal antiserum . Antigens were detected in the sputum of 29 of 39 patients with evidence of pneumococcal pneumonia, and there was good correlation between the detection of antigens and the degree of certainty of the clinical diagnosis . Antigens persisted briefly in the sputum during therapy with antimicrobial drugs and could be detected during the first 48 hours of therapy in most cases of pneumococcal pneumonia . Pneumococci were isolated from the sputum in only 18 of 39 cases of pneumococcal pneumonia, and sputum cultures did not correlate as well as counterimmunoelectrophoresis with clinical diagnoses . In studies of 27 patients with chronic bronchitis without pneumonia, pneumococci were isolated from sputum in 10 cases, whereas counterimmunoelectrophoresis was positive in 5 cases . Counterimmunoelectrophoresis provides a simple and rapid method for detecting pneumococcal antigens in sputum, and it appears to be more reliable than sputum cultures in establishing a presumptive diagnosis in pneumococcal pneumonia.

South Med J, 1977 Oct, 70 Suppl 1, 8 - 14
Microbiologic basis for the rational use of prophylactic antibiotics; Moellering RC Jr et al.; Appropriate use of antibiotics is enhanced by the effective application of data on antimicrobial susceptibility . A number of methods are currently available for routine determination of susceptibilities, including agar dilution, broth dilution, agar diffusion, and several semiautomated methods . If susceptibility testing is properly done, it can serve as the basis for the generation of statistical data of use to the clinician . Periodically updated tables detailing the antimicrobial susceptibilities of commonly isolated organisms enable the physician to make appropriate choices of antibiotics for prophylaxis and for the initial treatment of serious infections, before the susceptibilities of the infecting organisms are known . With computer assistance, it is possible to use susceptibility data for quality control and for more sophisticated epidemiologic purposes . For the past several years, we have studied a number of potential uses of computer-generated data at the Massachusetts General Hospital . Several of these applications, especially as they might relate to the prophylactic use of antibiotics, are discussed in this paper.

Arch Surg, 1977 Oct, 112(10), 1192 - 7
Pulmonary aspiration: an update; Stewardson RH et al.; Pulmonary aspiration of foreign material occurs in many situations . The morbidity of pulmonary aspiration is astounding . even more staggering is the mortality of massive aspiration of gastric contents . Bewilderment exists among most physicians concerning the treatment of this lethal event . The use of corticosteroids in pulmonary aspiration has received much attention and no data exist to advocate their continued employment . Knowledge of the bacteriology of aspiration has resulted in more judicious use of antimicrobial agents . The most significant advance in the treatment of pulmonary aspiration has been the development of positive end-expiratory pressure as an adjunct to mechanical ventilation . Pulmonary aspiration in hospitalized patients is an entirely preventable disease . All physicians must be made aware of the multitude of instances in which aspiration may occur if any hope of averting this disaster exists.

South Med J, 1977 Oct, 70 Suppl 1, 35 - 7
Gastric surgery; Stone HH; In a prospective, double-blind, randomized study of patients subjected to gastric surgery, parenteral cefazolin begun before operation significantly reduced the would infection rate . Infection developed only when incisional contamination occurred during operation and either when the antibiotic was not present in the tissues of the wound at the time of inoculation or when the offending bacteria were already resistant to the antimicrobial used . To be reliably effective, antimicrobial prophylaxis should always be instituted preoperatively in patients at high risk of infection, ie, those with conditions not associated with gastric hyperacidity . On the other hand, since patients with duodenal ulcer disease and resulting gastric hypersecretion usually have a relatively sterile stomach lumen, antibiotic prophylaxis for gastric operations in these cases is probably not indicated.

Mayo Clin Proc, 1977 Oct, 52(10), 616 - 24
The penicillins; Wilkowske CJ; The penicillins as a group are the most frequently and widely used of the antimicrobial agents because they are effective, low in toxicity, and relatively inexpensive . Effectiveness is due to the bactericidal action, the excellent distribution throughout the body spaces, and the wide spectrum of activity . Knowledge of the variation in spectrum of activity of the various types of penicillins is needed for effective use of the proper drug against individual infections . Allergenicity is the most frequent and serious problem associated with the use of penicillins . However, individual penicillin drugs do have other toxic side effects . The older penicillins are so inexpensive that the cost of their use need hardly be considered, whereas the newer penicillins are expensive and should be used only when they are clearly more effective for treatment than are drugs such as penicillin G.

Am J Med, 1977 Oct, 63(4), 511 - 6
Atypical herpesvirus hominis type 2 infection in uremic patients receiving immunosuppressive therapy; Stone WJ et al.; In four uremic patients (three renal transplant recipients and one with idiopathic thrombocytopenia), painful, initially vesicular lesions developed in the anogenital region while they were receiving immunosuppressive drug therapy . These lesions enlarged, coalesced and ulcerated, presenting a puzzling diagnostic problem . Initial misdiagnoses often resulted in inappropriate antimicrobial therapy . Routine cultures, histologic sections and Tzanck preparations were seldom helpful . The correct diagnosis of herpesvirus hominis (HVH) infection was established within 18 to 48 hours by viral culture of swab or biopsy material . Subsequent identification of isolates as HVH type 2 was confirmed by neutralization kinetics, infectivity titers and ability to plaque in chick embryo cells . Various therapeutic regimens were ineffective . Clinical improvement best correlated with decrease in dosage of immunosuppressive agents.

South Med J, 1977 Oct, 70(10), 1215 - 24
Recent advances in antimicrobial therapy; Pickering LK et al.; Metronidazole is a relatively nontoxic, oral agent which may prove to be useful in the treatment of infections caused by susceptible anaerobic organisms . Use of metronidazole to treat anaerobic infections presently is investigational.

Wien Klin Wochenschr, 1977 Sep 30, 89(18), 632 - 4
{A new type of ointment base: investigations on its antimicrobial properties (author's transl)}; Wewelka G et al.; A new ointment base (PEN 32) consisting of polyalcohols prevents the growth of bacteria and fungi in concentrations above 25% (mg/mg) . In a concentrated form the ointment base exhibited excellent bactericidal and fungicidal effects in vitro . This property enables the ointment base to be employed without preservatives.

Med Klin, 1977 Sep 9, 72(36), 1451 - 4
{Filtration and irradiation of the dialysis fluid to prevent bacteriemia during hemodialysis (author's transl)}; Tolon M et al.; For prevention of bacteriemia caused by contaminated dialysis fluid it is necessary to protect the dialysator by decontamination of the fluid immediately before entering the dialysator . Using filters with a pore size of 0.2 micrometer or 0.45 micrometer sterile samples of dialysis fluid could be obtained, but flow rate and pressure of the fluid could not be kept constant, when the resistance of the filter increased during use . With UV-lamps no problems concerning flow rate or pressure were encountered, but really satisfying results emerged only in laboratory experiments . This was due to causes which can be influenced by technical improvements of the irradiation unit, while the use of filters implies additional measures at the monitor unit to control flow rate and pressure . The success of the applied antimicrobial techniques should be monitored for not inducing a false conviction of safety.

J Antibiot (Tokyo), 1977 Sep, 30(9), 691 - 7
Cephalosporins . I . Cephaloglycin analogs with six-membered heterocycles in the C-3 side chain; Naito T et al.; Cephaloglycin analogs with six-membered heterocycles in the C-3 side chain have been prepared by nucleophilic substitution of 7-aminocephalosporanic acid with appropriate azine thiols followed by 7-N-acylation with phenylglycine by the mixed anhydride method . Seventeen thiols of non-substituted or substituted pyridines, pyridazines, pyrimidines, pyrazines and triazines were used as the S-nucleophiles . In general, pyridazine thiols gave cephalosporins processing good antimicrobial activity against both gram-positive and gram-negative bacteria . Among them 6-hydroxypyridazine-3-thiol gave the most active compound of this series, BB-S 118 (1f), which was significantly more active than cephalexin and cephaloglycin in vitro against gram-positive and gram negative bacteria.

Arch Dis Child, 1977 Sep, 52(9), 740 - 1
Anaerobic infection in a neonate . Early detection by gas liquid chromatography and response to metronidazole; Rom S et al.; A case of presumptive anaerobic infection in a neonate is described to illustrate the use of gas-liquid chromatography in the early detection of these potentially serious pathogens . Metronidazole is suggested as a possibly useful antimicrobial agent in these infections.

Antibiotiki, 1977 Sep, 22(9), 832 - 7
{Actinomyces chromogenes var . graecus var . nov., a producer of a new hexaene antibiotic}; Barashkova NP et al.; Actinomycete LIA-O832 was isolated from a soil sample of Greece . By its antimicrobial spectrum, morphological and cultural properties the actinomycete was most close to Act . chromogenes but differed from the latter by the antibiotic and physiological properties . The actinomycete was classified as Actinomyces chromogenes var . nov . The culture produced an antibiotic complex including 4 antibiotics, i.e . a tetraen antibiotic primaricin, a new hexaen named grecomycim and 2 non-polyenic antibiotics, one of which was close to kikumycin and the other was close to aksenomycin . The physico-chemical characteristics of the antibiotics are presented.

Farmaco {Sci}, 1977 Sep, 32(9), 650 - 64
Synthesis and biological activities of some 7-(1,2,4-oxadiazolylacetylamino) cephalosporins; Malabarba A et al.; The synthesis and the physico-chemical properties of cephalosporin derivatives carrying an (1,2,4-oxadiazol-3-yl)- or (1,2,4-oxadiazol-5-yl)acetylamino moiety in position 7 are described . The effects of the presence of an amino or hydroxyl group on the oxadiazole ring are examined . Selected heterocyclicthiomethyl substituents are also introduced in the 3 position of the cephalosporin nucleus . In vitro antimicrobial activity and effectiveness in protecting against bacterial infection in the mouse are evaluated . Only compound (V b) was found to have slight activity when compared with cephalosporins in clinical use.

Acta Paediatr Scand, 1977 Sep, 66(5), 605 - 10
Treatment of septicaemia in the newborn infant: choice of initial antimicrobial drugs and the role of exchange transfusion; Tollner U et al.; The therapeutic success of antibiotics used at the beginning of treatment and the effect of exchange transfusion in cases of septicaemia were tested in 22 newborn infants . The clinical course of these patients was compared with the outcome of 11 newborn infants who received antibiotic treatment without exchange transfusion . The following results were obtained: 1) All 6 patients initially receiving antibiotics, which were ineffective in vitro, died . In this group of patients the incidence of septic organ involvements (meningitis, ventriculitis, peritonitis) was significantly increased . 2) Following exchange transfusion, an impressive clinical improvement was consistently observed . 3) In patients who had initially received effective antibiotics and exchange transfusion, the lethality was significantly lower than in patients without exchange transfusion . 4) Our bacteriological findings show that continuous monitoring of cultures from blood, CSF and stool is necessary to choose the most effective antibiotic in the prevailing nosocomical circumstances.

Arch Neurol, 1977 Sep, 34(9), 560 - 2
Neonatal meningitis . The ventricle as a bacterial reservoir; Gilles FH et al.; We reviewed autopsies of neonates who had died of meningitis . Plexitis and ventricular exudate were usually present . While the pathogenetic relationship between these two phenomena is uncertain, it is possible that the glycogen-rich choroid plexus of the lateral ventricles not only facilitates local bacterial growth but also acts as a bacterial reservoir relatively resistant to antimicrobial agents . We suggest that more drastic approaches than parenteral antimicrobial therapy may be indicated to reduce further the morbidity and mortality of neonatal meningitis.

Lipids, 1977 Sep, 12(9), 753 - 9
Antimicrobial lipids: natural and synthetic fatty acids and monoglycerides; Kabara JJ et al.; Over 40 natural or synthetic lipophilic compounds were screened for antimicrobial activity . Gram (+) bacteria and yeasts but not Gram (-) bacteria were affected by these agents . Epimino and selena fatty acids are more active than their corresponding straight chain unsubstituted fatty acids . The position of selenium influenced the antimicrobial activity of the fatty acids . The presence and position of a double or triple bond, usually an important factor in long chain fatty acids (greater than C14) had little or no effect in C11 fatty acids . Optimum antimicrobial activity was found for fatty acids and their corresponding monoglycerides when the chain lenght was C12 . The dilaurin derivative was not active.

Am J Pathol, 1977 Sep, 88(3), 711 - 25
Clinical conditions associated with defective polymorphonuclear leukocyte chemotaxis; Quie PG et al.; Impressive numbers of clinical conditions are associated with defective leukocyte chemotaxis . In many, this cellular dysfunction is associated with other abnormalities of the immune response, but in others abnormal chemotactic responsiveness of leukocytes is the only abnormality of function identified in the laboratory . Patients are usually selected for study because of unusually severe, recurrent infections or poor response to antimicrobial agents, and therefore a frequent association between abnormality of chemotaxis and infection would be expected . Many patients demonstrate abnormal chemotaxis during remissions as well as during infections, and there seems little doubt that abnormality of chemotaxis is related to susceptibility to infections . Partial classification of disorders of chemotaxis was attempted . Major abnormalities are found when there is a primary cellular disorder or cell-directed inhibitors of chemotaxis are found . Less marked abnormalities are found when chemotactic factors are deficient.

South Med J, 1977 Sep, 70(9), 1098 - 102
Hemophilus endocarditis: new cases, literature review and recommendations for management; Johnson RH et al.; Rarely is endocarditis attributed to the species of Hemophilus . Most frequently implicated are H aphrophilus and H parainfluenzae, but H influenzae also is seen . We report six cases of endocarditis due to H aphrophilus or H parainfluenzae and review the literature . Emboli to skin, lungs, kidneys, spleen, brain, and other organs are common complications, and acute glomerulonephritis and meningitis often occur . Ampicillin is the mainstay of antimicrobial therapy for patients whose isolates are sensitive to it, but the duration of antimicrobial therapy necessary for eradication of the infection is not clear . Studies of antimicrobial synergism are warranted in instances of endocarditis caused by ampicilin- or penicillin-resistant strains of Hemophilus, or when patients are allergic to penicillin; in these instances, combination antimicrobial therapy must be given when bactericidal synergism can be demonstrated . Intensive management of complications caused by embolization is crucial to patient survival.

Dtsch Zahnarztl Z, 1977 Sep, 32(9), 760 - 2
{Antimicrobial properties of cements with and without copper content}; Schmalz G et al.; Copper-containing cements seem to inhibit bacterial growth better than copper-free materials . Twenty-four hours after insertion, a statistically significant difference is noted . The initial bactericidal effect of copper-free cements declines considerably as compared to copper-containing cements . The results obtained largely correspond to those given in the literature . The method used of including bacterial suspension in a liquid medium is suitable to establish dose-reaction curves for dental materials.

Lloydia, 1977 Sep-Oct, 40(5), 508 - 14
Alkaloids of Thalictrum . XXII . Isolation of alkaloids with hypotensive and antimicrobial activity from Thalictrum revolutum; Wu WN et al.; Sixteen alkaloids were characterized from Thalictrum revolutum DC., namely; thalidasine, O-methylthalmethine, O-methylthalicberine, thalrugosaminine, thalicarpine, thalmelatine, pennsylvanine, palmatine, berberine, thalifendine, columbamine, jatrorrhizine, deoxythalidastine, thalphenine and magnoflorine . The structure of thairugosaminine (1) a bisbenzylisoquinoline type which was previously proposed on partial data was completely established, including the absolute configuration as S,S . Thalphenine, thalidasine, O-methylthalicberine, thalicarpine, thalrugosaminine and thaliglucinone were found to possess hypotensive activity in rabbits . Thalrugosaminine, thalicarpine, thalmelatine, O-methylthalmethine, pennsylvanine and thalphenine were found to be active against Mycobacterium smegmatis.

Blut, 1977 Aug 29, 35(2), 143 - 53
Allogeneic bone marrow transplantation in conventional mice: I . Effect of antibiotic therapy on long term survival of allogeneic chimeras; Heit H et al.; In the present communication the beneficial effect of long term antimicrobial treatment with poorly absorbable antiboitics on the survival of allogeneic bone marrow chimeras was investigated . The combination of C57Bl mice as bone marrow donors and CBA/CA mice as irradiated recipients (800 rad) was used because of their strong histoincompatibility on the H-2 loci . All allografted recipients received 10 X 10(6) bone marrow cells . The majority of the recipients, which were rendered gnotobiotic by an antimicrobial treatment, achieved stable long term chimerism . In contrast, the conventional chimeras died from secondary disease within 9 weeks after transplantation . As early as 14 days after allogeneic bone marrow grafting the gnotobiotic recipients tolerated the reassociation with a conventional microflora without a change in the rate of mortality . Bone marrow cells (8 X 10(6) i.v.) and spleen cells (2 X 10(6) i.v.) collected from allogeneic chimeras failed to induce graft-versus-host-reaction (GVH) in a second lethally irradiated host . The data indicate, that the high rate of mortality in murine allogeneic bone marrow chimeras results from delayed GVH-reaction and systemic infection . The marrow graft, once established seems to exert tolerance against the allogeneic host . The pathogenesis of the systemic infection has not yet been worked out . It is assumed that it originates from bacteremia, induced by radiation dependent lesions of the epithelial integrity and defected lymphatic tissue in the gut.

Z Gesamte Inn Med, 1977 Aug 15, 32(16), suppl 249 - 50
{Allergic side-effects of antimicrobial chemotherapy and possibilities in their diagnosis}; Stiller D et al.; In antimicrobial chemotherapy the allergic reactions are in the first place of the side-effects appearing . The most frequent cause of the iatrogenic contact eczema antimycotics and chloramphenicol are to be taken into consideration . Penicillin and its derivations and chloramphenicol form the main proportion of the allergic in systematic administration . The serologico-nephelometric two-step-method and the lymphocyte transformation test are useful methods for the diagnostics of drug allergies . In a use adequate to indication they are valuable adjuvants in the hand of the clinician.

Science, 1977 Aug 12, 197(4304), 674 - 6
Interferon: an inducer of macrophage activation by polyanions; Schultz RM et al.; Purified mouse fibroblast interferon (IF) directly rendered resting macrophages tumoricidal . The physicochemical properties and species specificity of the stimulatory agent fall within the present definition of IF . Since a number of polyanions induce macrophage IF, the antitumor and antimicrobial activities may result from the ability of newly released IF to modify macrophage activity.

Am J Hosp Pharm, 1977 Aug, 34(8), 835 - 8
Antimicrobial drug use monitoring by a hospital pharmacy; Greenlaw CW; An antimicrobial drug use monitoring program which also provides clinical pharmacy services in a 635-bed hospital is described . The program includes culture sensitivity monitoring, antimicrobial use monitoring, aminoglycoside monitoring, physician consultation and reporting of results to the medical staff . It requires 34 hours of pharmacist time per month, at an estimated annual cost of #4,100.

J Pharm Sci, 1977 Aug, 66(8), 1198 - 200
Factors affecting serum oxytetracycline levels in beef calves; Mercer HD et al.; Fifteen Aberdeen Angus steers, 295-364 kg, were dosed with either 4.4 or 11 mg of oxytetracycline hydrochloride/kg im . The antimicrobial activity of the serum was determined periodically, and the resulting data were treated statistically to determine the sources of variation . Variance in serum levels of oxytetracycline activity was attributed to dose, time of bleeding, order of dosing, animal, and assay . The total variance component was proportionately greater for the 11-mg/kg dose than for the 4.4-mg/kg dose . Animal variance increased with the higher dose level of oxytetracycline . The influence of dose on serum level was tested by applying a t test to the mean serum levels and their standard deviations at each bleeding time . The 4.4- and 11-mg/kg serum levels were significantly different (p less than 0.01) at all bleeding times . The 4.4-mg/kg serum levels mutliplied by 2.5 were not significantly different (p less than 0.05) from the 11-mg/kg serum levels at all bleeding times.

Am Rev Respir Dis, 1977 Aug, 116(2), 325 - 6
Failure of a "prophylactic" antimicrobial drug to prevent sepsis after fiberoptic bronchoscopy; Robbins H et al.; A 53-year-old patient with lymphoblastic lymphoma developed progressive interstitial pulmonary infiltrates . The patient was believed to have Pseudomonas bronchitis and was given parenteral gentamicin . Transbronchial lung biopsy performed through a fiberoptic bronchoscope was complicated by the development of Pseudomonas septicemia . The organism isolated on blood culture, like the one isolated on sputum culture, was fully susceptible to gentamicin in vitro . A prophylactic antimicrobial drug did not prevent bacteremic Pseudomonas infection in our immunosuppressed patient with pre-existent Pseudomonas bronchitis.

Z Gesamte Inn Med, 1977 Aug 1, 32(15), Suppl 233 - 5
{Chemotherapy of microbial diseases of the respiratory tract}; Anger G; It is given a survey on the chemotherapy of the microbial diseases of the respiration tract . A chemotherapy is taken into consideration only for such cases in which a bacterial etiology is ascertained or is assumed with a great probability . The antimicrobial chemotherapy is of particular importance for the acute and chronic bronchitis, bronchiectases, pneumonias, pulmonary abscess and empyema of the pleura . The author deals with the special problems of bacteriological findings of the respiratory tract . The choice of the chemotherapeutic remedy is done in most cases according to the empirical points of view, in which cases development of resistance, side-effects and changing of the infection must be taken into consideration . Apart from the otherwise usual oral and parenteral application special forms of application, such as aerosol therapy and intrapleural instillation are used . It is referred to atypical pneumonias, such as the mycoplasma pneumonia which gives a good response to tetracyclines . Apart from the sulphonamides and trimethoprim penicillins, chloramphenicol, tetracyclines, cephalosporines, more rarely streptomycin and linkomycin are the most important antimicrobiotics.

Am J Clin Nutr, 1977 Aug, 30(8), 1236 - 47
Magnitude of the host nutritional responses to infection; Beisel WR; This review describes the scope, complexity, and magnitude of host nutritional responses throughout the course of an infectious process . These responses include prominent changes in nitrogen and protein metabolism, altered rates of carbohydrate and lipid production and utilization, and changes in mineral, electrolyte, trace element, and vitamin metabolism . It is postulated that these responses develop in a relatively predictable sequence which is influenced by the adequacy of host antimicrobial defense mechanisms, the severity and duration of illness, and specific localization of an infectious process within the body . In addition to hormonal regulatory effects, the metabolic and nutritional responses of the host are also influenced by biologically active substances released when host cells participate in phagocytic activity and local inflammatory responses.

An Esp Pediatr, 1977 Aug-Sep, 10(8-9), 641 - 54
{Antimicrobial factors in milk and colostrum: their importance for the newborn infant (author's transl)}; Brock JH; The antimicrobial activity of various proteins and other substances in milk and colostrum is discussed . These factors include antibodies, complement, lactoferrin and transferrin, lactoperoxidase and lysozyme . The possible importance of these factors in protecting the newborn infant against infectious diseases is discussed.

Am J Clin Pathol, 1977 Aug, 68(2), 279 - 83
A method for determining in-vitro drug susceptibilities of some Nocardiae and Actinomadurae: results with 17 antimicrobial agents; Carroll GF et al.; A simple timesaving method for determining drug susceptibilities in vitro of isolates of Nocardia and Actinomadura is reported . An isolate is considered "susceptible" when the quantity of drug required for inhibition of growth is that concentration which might be obtained in serum by conventional therapy . Sulfonamides remain the drugs of choice for treating disease due to Nocardia species . Although doxycycline and minocycline appear to be very effective against Nocardia species, susceptibility testing may be desirable when a physician is considering substitution of an antibiotic for a sulfonamide . Susceptibility testing also may be desired before a drug is selected for treating disease due to Actinomadura madurae.

JAMA, 1977 Aug 1, 238(5), 408 - 10
Thrombotic thrombocytopenic purpura-like syndrome associated with infective endocarditis . A possible immune complex disorder; Bayer AS et al.; A thrombotic thrombocytopenic purpura (TTP)-like syndrome was the chief presenting feature in two patients with infective endocarditis . Clinical and laboratory aberrations of the syndrome were rapidly reversed by specific antimicrobial therapy . Hypocomplementemia and high levels of circulating immune complexes were detected initially in both patients . Because these returned to normal as the TTP syndrome abated, an immunopathologic mechanism may have been operative.

Z Gesamte Inn Med, 1977 Jul 15, 32(14), Suppl: 209 - 14
{Classes of antibiotics and their mechanisms of action}; Thrum H; The antibiotics used in the chemotherapy of microbial infections are considered with respect to their antimicrobial spectra and their mechanisms of action, respectively . The sites of action of the different groups of antibiotics interfering with the same cellular processes are discussed . According to their primary actions on sensible cells the antimicrobial antibiotics are divided into four groups: 1 . Inhibitors of the biosynthesis of the bacterial cell wall 2 . Inhibitors of the bacterial protein synthesis 3 . Inhibitors of the nucleic acid metabolism 4 . Membrane-active antibiotics.

J Pharm Sci, 1977 Jul, 66(7), 1009 - 12
Reactions of benzenesulfonohydrazides and benzenesulfonamides with hydrogen chloride or hydrogen bromide in acetic acid; Yung DK et al.; Benzenesulfonohydrazides capable of yielding a sulfinic acid intermediate by virtue of a basic nitrogen atom in the second position of the hydrazide moiety produced thiosulfonates when treated with 1 N hydrogen chloride in acetic acid and produced disulfides when treated with 1 N hydrogen bromide in the same solvent . In two cases, a crystalline mixture of P-nitrophenyl p-nitrobenzenethiosulfonate and bis(p-nitrophenyl) disulfide was isolated from the hydrogen chloride reactions . No reaction product was obtained from either the hydrogen chloride or hydrogen bromide reaction with benzenesulfonohydrazides that were unable to form a sulfinic acid intermediate . Reduction of benzenesulfonamides to disulfides appeared to be possible only with hydrogen bromide in acetic acid . No thiosulfonate was isolated from the treatments of benzenesulfonamides with 1 N hydrogen chloride in acetic acid . p-Nitrophenyl p-nitrobenzenethiosulfonate and p-bromophenyl p-bromobenzenethiosulfonate exhibited some antimicrobial activities against Gram-positive bacteria . The latter compound also showed analgesic properties in the phenylquinone test.

Chest, 1977 Jul, 72(1), 92 - 3
Pulmonary mucormycosis: another cure; Hauch TW; Pulmonary mucormycosis in an ill patient with poorly controlled chronic lymphocytic leukemia was diagnosed with open lung biopsy without excision . He improved on medical management and became ambulatory . At autopsy one year later, no residual mucormycosis was present . Better control of leukemia and more specific antimicrobial therapy are discussed as potentially important factors in patient management.

Am J Ophthalmol, 1977 Jul, 84(1), 112 - 9
Pseudomonas-induced corneal ulcers associated with contaminated eye mascaras; Wilson LA et al.; Seven Pseudomonas-induced corneal ulcers were associated with the use of four brands of mascara contaminated with P . aeruginosa . In laboratory studies, preservative systems of three of the four brands were inadequate in comparison with a control mascara of known antimicrobial activity . If the corneal epithelium is scratched during the application of mascara, particularly if the applicator is old, the cornea should be treated immediately and the mascara cultured to detect Pseudomonas . The high incidence of recurrent corneal ulceration in cases of Pseudomonas-induced keratitis indicates that initial chemotherapy should be intensive and maintained until the lesion stabilizes.

J Clin Microbiol, 1977 Jul, 6(1), 46 - 9
Automated, rapid identification of bacteria by pattern analysis of growth inhibition profiles obtained with Autobac 1; Buck GE et al.; A scheme for identifying bacteria has been devised which utilizes the inhibition patterns obtained by Autobac 1 with routine and unusual antimicrobial agents and with other differentially inhibitory chemical compounds . Over 600 compounds were initially identified from the literature, and over 125 of these were selected for further testing on the basis of antibacterial activity most conducive to the instrument-generated differential scheme . Numerical growth index information derived by light scatter comparisons from the instrument were analyzed by computer, utilizing the quadratic discriminant function statistical technique . In comparison with conventional methods, accuracy for the 10 bacterial genera studied was 95% or greater . Results indicate a potential for both bacterial identification and antimicrobial agent susceptibility testing in the clinical laboratory within 3 to 5 h when using this automated approach.

J Reprod Med, 1977 Jul, 19(1), 21 - 30
Diagnosis and treatment of acute salpingitis; Sweet RL; PIP: This paper discusses the problem of acute salpingitis, one of the most common gynecologic problems . The goal in management of this problem is to prevent sequelae such as infertility and chronic residual of inflammation . Thus, in management it is important that proper diagnostic methods and appropriate treatment based on microbiologic data be developed and utilized . Presently, culdocentesis is the only practical and reliable means of obtaining meaningful microbiologic data in cases of acute salpingitis . Microorganisms such as N . gonorrhea have been implicated in the etiology of salpingitis . It is clear that sexual transmission is involved in the pathogenesis of gonococcal salpingitis . It is unclear how the gonococci get to the endosalpinx from the endocervix; however, it is possible that menstruation plays a part in the breakdown of local host defense mechanisms which prevent the ascent of microorganisms from the endocervix . The pathogenesis of nongonococcal salpingitis is not yet clearly understood . While antibiotics have helped to alter the prognosis for infertility significantly, more must be done . Previous investigations indicate that the effectiveness of therapy is dependent upon the interval between onset of symptoms and the initiation of treatment . The treatment regimen must also take into account the polymicrobial etiology of acute salpingitis . Most cases are treated on an outpatient basis and the Center for Disease Control has promulgated a set of recommendations for the outpatient treatment of acute salpingitis . Treatment is briefly described . It has come to the attention of researchers recently that the presence of an IUD may ultimately lead to pelvic infection and increased risk of acute salpingitis . However, no particular type of IUD has been associated with an increased risk of pelvic infection in nonpregnant women . More research must be initiated to determine the role of IUDs in pelvic infection and to discover the true microbiologic etiology of salpingitis .

Ann Sclavo, 1977 Jul-Aug, 19(4), 864 - 75
{Basic procedure for blood cultures (author's transl)}; Magliano EM; The Author summarizes the basic routine procedure for blood cultures first examining different factors that can influence it (blood coagulation, antimicrobial agents, natural bacterial inhibitors of blood cell wall deficient bacteria) and then describing culture media, atmospheric conditions, incubation time, and modalities for inspection, staining of cultures and subcultures . Finally new rapid automated methods are briefly pointed out.

Arzneimittelforschung, 1977 Jul, 27(7), 1391 - 2
1-Methyl-2-nitroimidazol-5-yl derivatives . IVth Communication; Cavalleri B et al.; The chemico-physical data and antimicrobial activities are described of a new series of 2-nitroimidazole derivatives prepared by condensing 1-methyl-2-nitroimidazole-5-carboxaldehyde with N-substituted hydroxylamines, N-aminopiperazines and N-aminopiperidines.

Lloydia, 1977 Jul-Aug, 40(4), 384 - 94
Alkaloids of Thalictrum . XXI . Isolation and characterization of alkaloids from the roots of Thalictrum podocarpum; Wu WN et al.; Thirteen alkaloids, hernandezine, thalidezine, N-desmethylthalidezine, isothalidezine, thalistyline, thalistyline methodiiodide, N-desemethylthalistyline, berberine, columbamine, jatrorrhizine, palmatine, thalifendine, magnoflorine and the artifact, 8-trichloromethyldihydroberberine were isolated from the roots of Thalictrum podocarpum Humb . In addition, oxyberberine and thaliglucinone were obtained in very minor amounts and identified by tlc . Of these compounds, N-desmethylthalidezine and isothalidezine are new bisbenzylisoquinoline alkaloids . Sucrose was isolated from the alcoholic extract . Hernandezine, thalistyline, thalidezine, thalistyline methodiiodide and N-desmethylthalistyline were found to possess antimicrobial activity against Mycobacterium smegmatis at concentrations of 100 microgram/ml or less.

Am J Med Technol, 1977 Jul, 43(7), 683 - 92
Enteric pathogens: use of flow diagrams for identification; Pezzlo M et al.; A protocol is presented for the cultural processing of stool specimens . Flow diagrams were developed which allow all stool cultures to be processed in a consistent and efficient manner . Criteria have been established to indicate when definitive identification and antimicrobial susceptibility testing are required . A review of the food-poisoning syndrome and infective gastrointestinal disease due to bacterial agents is included.

J Am Geriatr Soc, 1977 Jul, 25(7), 308 - 13
Incidence of polypharmacy in a long-term care facility; Kalchthaler T et al.; The incidence of polypharmacy was investigated in a 200-bed long-term care facility . One hundred residents were drawn at random for the study . The average number of drugs prescribed per patient was 3.33, and the average number of pills was 6.34 daily . The most frequently prescribed drugs were the analgesics, followed in order by antihypertensive agents, cardiotonic preparations and antimicrobials . The literature is reviewed with respect to the incidence, causes and end-results of polypharmacy . It is recommended that long-term care facilities develop enlightened and aggressive pharmacy committees to monitor and evaluate drug use routinely in an institutional setting.

Jpn J Antibiot, 1977 Jul, 30(7), 505 - 10
{The combination effect of ampicillin and dicloxacillin on the strains of Bacteriodes fragilis isolated from clinical specimens (author's transl)}; Okada J et al.; The antimicrobial activities of ampicillin (ABPC) and dicloxacillin (MDIPC) alone were tested in 100 strains of B . fragilis isolated from clinical specimens, and combined activity of ABPC and MDIPC was investigated employing a chequer board titration method (Box method) with agar plates and liquid media . The following results were obtained . 1 . Of the 100 strains tested, approximately 33% were shown to have MICs of ABPC greater than 100 mcg/ml, whereas 92% of strains were greater than 100 mcg/ml to MDIPC . 2 . In the combination, antimicrobial activities were demonstrated additive or synergistic action in almost strains tested . 3 . A combined effect of these drugs was proved by agar dilution method for the strains, for which the same effect was shown by the tube dilution method . 4 . For ABPC-resistant strains, no increase in antibacterial activity of these drugs by combination was demonstrated.

Blood, 1977 Jul, 50(1), 65 - 70
Myeloperoxidase--H2O2--halide system: cytotoxic effect on human blood leukocytes; Clark RA et al.; Myeloperoxidase, H2O2, and a halide form a potent antimicrobial and cytotoxic system of the polymorphonuclear leukocyte . A cytotoxic effect of this system on human blood leukocytes is demonstrated, employing 51Cr release and dye exclusion assays . Cytotoxicity is dependent on enzymatically active myeloperoxidase, H2O2, or a peroxide-generating enzyme system and either chloride or iodide . Cell damage is rapid, with maximal levels of 51Cr release occurring within 30--60 min . Approximately equal sensitivity to the peroxidase system is observed for polymorphonuclear leukocytes and mononuclear leukocytes . Since myeloperoxidase and H2O2 are released from polymorphonuclear leukocytes under certain conditions, such as during particle ingestion, it is suggested that peroxidase-mediated leukocyte injury may be an important feature of the inflammatory response.

Lancet, 1977 Jun 25, 1(8026), 1351 - 3
Prophylactic antimicrobial drug therapy at five London teaching hospitals . A report by the Study Group on the Use of Antimicrobial Drugs; Kensit J et al.; We report some findings of a survey of antimicrobial prophylaxis in 5 London teaching hospitals . It is practised predominantly in surgical patients, both before and after operations, penicillins being by far the commonest drugs . Striking differences were found, particularly in the duration of treatment in different hospitals in the same specialty, and also between consultants in the same hospital . The findings raise important questions that need to be answered by clinical trials.

Br Med J, 1977 Jun 18, 1(6076), 1561 - 3
Use of medicines in general practice; Skegg DC et al.; The prescriptions issued by general practitioners to a population of about 40 000 people were studied . During one year 53-8% of all males and 65-7% of all females had at least one drug dispensed . The proportion receiving medicines increased with age and was higher among females at all ages . Psychotropic drugs were prescribed more often than any other group and accounted for almost one-fifth of all prescriptions . Altogether 9-7% of the males in the population and 21-0% of the females received at least one psychotropic drug during the year . Among women aged 45-59 33-0% received a psychotropic drug, and 11-2% were given an antidepressant . Althoug antimicrobial drugs were prescribed less often than psychotropic drugs, they were given to more people.

Pharmazie, 1977 Jun 6, 32(6), 323 - 5
Synthesis of some N-substituted salicylamides structurally related to certain antimicrobials; Soliman LN et al.; The condensation of 5-nitrosalicoylchloride and 5-sulphamoylsalicylic acid with certain amines is described . Reacting the acid chloride with 3-amino-2-oxazolidone, 4-aminophenazone, thiosemicarbazide, 1-aminohydantoin and 2-aminopyridine yielded the correspondong N-substituted 5-nitrosalicylamides (1a-c), while with semicarbazide a disubstituted product type 2 was obtained . On the other hand, when 5-sulphamoylsalicylic acid was condensed with o-chloroaniline, m-chloroaniline and 4-aminophenazone in the presence of phosphorus trichloride, instead of affording the expected condensation products type 3, it yielded N1N5-disubstituted 5-sulphamoylsalicylamides (4a-c) . The synthesized compounds were screened for antimicrobial activity.

Int J Dermatol, 1977 Jun, 16(5), 413 - 7
New uses for benzoyl peroxide: a broad-spectrum antimicrobial agent; Kligman AM et al.; Benzoyl peroxide is a useful agent in the treatment of acne, chronic ulcers, tinea pedis, and tinea versicolor, probably because of its antimicrobial power . 2.5% concentration is almost as active as 5% . Although potential irritancy and allergic reaction have not been a problem on the face, benzoyl peroxide should be used judiciously in chronically inflamed or ulcerated skin . Several potential uses are mentioned.

Arch Surg, 1977 Jun, 112(6), 699 - 704
A trial of silver-zinc-allantoinate in the treatment of leg ulcers; Margraf HW et al.; Three hundred thirty-nine of 400 chronic cutaneous ulcers in 264 patients (including some with multiple or bilateral ulcers of both) were healed with silver-zinc-allantoinate creamed (AZAC 1%) . Some of the patients treated had failed to respond to medicated wrappings, saline dressings, and various other therapeutic agents, including antibiotics . In one week of treatment with AZAC 1%, bacterial counts were reduced on the average from approximately 2 X 10(7) to 2 X 10(5) (99%) . Silver-zinc-allantoinate cream also demonstrated a wide spectrum of antimicrobial activity . It did not give rise to resistance by the infecting organisms, was nonallergenic, debrided necrotic tissue, and stimulated healthy granulation . Treatment was well tolerated, side effects being limited to a burning sensation in three patients . Most patients cared for themselves at home with minimal interference in their usual daily activities.

J Pediatr, 1977 Jun, 90(6), 965 - 70
Amniotic fluid infections in an African city; Naeye RL et al.; PIP: Congenital pneumonia, originating in an amniotic fluid bacterial infection, is a common cause of perinatal death in industrial societies . A study of perinatal mortality was undertaken in Addis Ababa, Ethiopia, in 1974-1975 in the hospitals and clinics affiliated with the Addis Ababa University Faculty of Medicine . 72% of the perinatal deaths had postmortem examinations and the pregnancies associated with the 1019 autopsied infants were compared with 586 systematically selected successful pregnancies drawn from a cross section of the delivery population by using the 1st deliveries after 7:00 a.m . each day . Hospital and clinic records in conjunction with a detained maternal interview and physical examination on the day following delivery provided 124 separate items of information for analysis . Autopsy prosections and gross placental examinations were performed by 1 Ethiopian and 4 US medical students . Amniotic fluid infection syndrome was identified as the prime diagnosis responsible for deaths in 339 cases for a frequency of 21.8/1000 live births . The fatal disorder had a frequency of 0.10%/week at midgestation with little subsequent change until 39 weeks when it markedly increased . 69% of the deaths were stillborn and the rest neonatal . 76% of lung and 66% of placental cultures were positive for 1 or more organisms in the amniotic fluid infection cases . Only 17% of the placentas from control cases had positive cultures . Fatal amniotic fluid infections had a frequency of 1.75% in single born infants and 12.9% in twins . The fatal infections had a frequency of 1.2% when women made clinic visits for prenatal medical care, and 4.2% when they made no such visits . The disorder was 5 times more frequent in the gravid women who had no education than in those who had 12 or more years of education . The influence of mother's education on the frequency of the fatal infections was largely independent on the influence of poverty . There was an excessive frequency of the fatal infections when women reported prior fetal losses . Acute inflammation of the extraplacental fetal membranes was present in 31% of the control cases, acute funisitis in 11%, and acute inflammation of the chorionic plate of the placenta in 13% . Among the perinatal deaths attributed to amniotic fluid infections, all had congenital pneumonia, 86% acute inflammation of the extraplacental fetal membranes, 61% acute funisitis, and 84% acute inflammation of the chorionic plate of the placenta .

Acta Ophthalmol (Copenh), 1977 Jun, 55(3), 539 - 47
Toxoplasmic chorioretinitis affecting the macula; Saari M; To study macular changes in toxoplasmic chorioretinitis 41 patients with ocular toxoplasmosis were reviewed . Of the 41 patients, seven had central, large, deep, pigment ringed scars of congenital toxoplasmosis with poor central vision; squint was seen in two and nystagmus in two; 32, including 11 cases with a macular lesion, had recurrent active toxoplasmic chorioretinitis with a focal, yellowish-white, elevated lesion with indistinct borders mostly at the margin of an old scar and associated with vitreous opacities in all, secondary anterior uveitis in 28, macular oedema in 22, papilloedema in 14, and retinal perivasculitis in 16 cases; two had rare acquired toxoplasmic chorioretinitis affecting the macula . The results show that active toxoplasmic chorioretinitis often causes a widespread intraocular inflammation with vitritis, macular oedema, papilloedema, retinal perivasculitis and secondary anterior uveitis, and suggest a combined treatment of active lesions with antimicrobial agents and corticosteroids.

J Gen Microbiol, 1977 Jun, 100(2), 283 - 98
The mechanism of action of nitro-heterocyclic antimicrobial drugs . Metabolic activation by micro-organisms; Goldstein BP et al.; Although the target of the antimicrobial drug 1-methyl-2-nitro-5-vinylimidazole (MEV) has been shown to be DNA (Goldstein et al., 1977) the drug was ineffective in cell-free systems because it was not activated . Both the rate of metabolic activation of MEV and its antibacterial activity were increased when bacteria were grown in limiting oxygen . Mutants of Escherichia coli which were conditionally resistant to nitroimidazoles and nitrofurans were defective in drug activation . The activities of these drugs against E . coli correlated with their rates of metabolism . The antimicrobial spectrum of the drugs appeared to be related to their reducibility by different species.

J Gen Microbiol, 1977 Jun, 100(2), 271 - 81
The mechanism of action of nitro-heterocyclic antimicrobial drugs . Primary target of 1-methyl-2-nitro-5-vinylimidazole is DNA; Goldstein BP et al.; The antimicrobial drug 1-methyl-2-nitro-5-vinylimidazole (MEV) preferentially blocked DNA synthesis, was mutagenic and induced coliphage lambda in Escherichia coli . The antibacterial effects of MEV are the consequences of repairable damage to DNA, as shown by hypersensitivity of recA and uvr strains to MEV and related drugs, stimulation by MEV of DNA turnover which was dependent on the product of the uvrA gene, and the presence of cross-links in DNA from MEV-treated bacteria.

Am J Hosp Pharm, 1977 Jun, 34(6), 621 - 9
Antimicrobial spectrum, pharmacology and therapeutic use of antibiotics . Part 3: cephalosporins; Barza M et al.; Various aspects of the cephalosporin antibiotics are reviewed, including mode of action and mechanisms of bacterial resistance, antibacterial activity, clinical pharmacology, adverse reactions, and therapeutic use . There are no important therapeutic differences between the two oral agents, cephalexin and cephradine . For intramuscular injection, cephaloridine has largely been replaced by cefazolin which is equally well tolerated and not as nephrotoxic; further, cefazolin has a relatively long half-life which permits its administration three or four times daily . There are no substantial therapeutic differences among the cephalosporins most commonly used intravenously--cephalothin, cefazolin and cephapirin . However, cefazolin is administered in a lower dosage and somewhat less frequently.

J Lab Clin Med, 1977 Jun, 89(6), 1198 - 1207
Immunologic studies in pneumococcal disease; Dee TH et al.; Many patients die from pneumococcal disease despite the availability of effective antimicrobial agents . Immunologic studies including detection, typing, and quantitation of serum pneumococcal capsular polysaccharide (PCP) antigen by counterimmunoelectrophoresis (CIE), quantitation of PCP antibody by radioimmunoassay (RIA), and quantitation of serum complement components C3, C4, and C3PA and serum immunoglobulins IgG, IgM, and IgA by the radial immunodiffusion technique of Mancini were performed with the sera of 18 patients . Five patients died (group I), and 13 survived (group II) pneumococcal infection . Both groups were comparable in age, underlying disease, and leukopenia on admission . All patients of group I and 10 of 13 (77%) of group II patients were bacteremic . Two patients in each group had an extrapulmonary focus infection . PCP antigen was detected in the sera of all group I and nine of 13 group II patients . PCP antigen levels were larger than or equal to 15 microng/ml in four of five group I and two of 13 group II patients (p = 0.022) . Levels of antibody to PCP exceeded 100 ng/ml of antibody nitrogen (AbN) in 10 of 12 group II and one of five group I patients (p = 0.027) during the course of illness . All group I patients and three of 12 group II patients had decreased levels of one or more complement components on admission (p less than 0.01) . One or more complement components remained decreased until death in four group I patients but returned to normal or elevated levels in all group II patients . No difference in serum immunoglobulin concentrations were found.

Am J Obstet Gynecol, 1977 May 15, 128(2), 187 - 9
Failure of bacterial growth inhibition by amniotic fluid; Tafari N et al.; The bactericidal properties of amniotic fluid normally protect fetuses from late gestational infections by bacteria . Recently, such infections were found responsible for nearly a third of the perinatal deaths in Addis Ababa, Ethiopia . This prompted an analysis of the antimicrobial activity of amniotic fluid in patients in that city . The antimicrobial activity of fluid from 53 women, collected at term, was measured by a semiquantitative plate-count technique . Only one of the fluid samples was bactericidal, 12 were bacteriostatic, and 40 were noninhibitory to bacterial growth.

Fortschr Med, 1977 May 5, 95(17), 1118 - 24
{Pulmonary mycoses; laboratory diagnosis, antimycotic therapy}; Bartmann K; The microscopic, cultural and serological techniques for the diagnosis of European and non-European systemic mycoses involving the respiratory tract are reviewed . The antimicrobial, therapeutic and toxic properties of those antimycotic drugs are discussed, which can be used in the treatment of pulmonary mycoses . Data on biotransformation, kinetics and dosage are reported.

Br J Surg, 1977 May, 64(5), 315 - 21
Prevention of wound sepsis in gastro-intestinal surgery; Keighley MR; After gastro-intestinal operations wound infection is usually caused by the inoculation of bacteria present within the intestinal tract into the incision during the surgical procedure . In theory, wound sepsis may be minimized by the following methods: (a) avoiding intestinal contamination of the incision; (b) altering the normal flora of the intestinal tract by adding oral antimicrobials to bowel preparation; (c) using topical or systemic prophylactic antibiotic administration for certain high-risk patients . The relative importance of these methods of prophylaxis is described.

Am Rev Respir Dis, 1977 May, 115(5), 777 - 82
Diagnostic accuracy of transtracheal aspiration bacteriologic studies; Bartlett JG; The diagnostic accuracy of transtracheal aspiration bacteriologic studies was examined in 488 patients . Twenty-three patients had bacteremic pneumonia, and in each instance the blood culture isolate was also recovered from the transtracheal aspirate . Clinical correlations in 119 patients with negative cultures of transtracheal aspirate indicated that 71 had an alternative diagnosis to explain an abnormal chest radiograph, and 44 appeared to have a bacterial infection but had received antimicrobial drugs before specimen collection . According to clinical parameters and final diagnosis, the incidence of false-negative cultures was 1 per cent among patients sampled before administration of antimicrobial drugs, and the incidence of false-positive cultures was 21 per cent.

J Pediatr, 1977 May, 90(5), 703 - 6
Outcome of unsuspected pneumococcemia in children not initially admitted to the hospital; Bratton L et al.; The records were reviewed of 97 episodes of unsuspected pneumococcemia in children not initially admitted to the hospital . Antimicrobial agents were prescribed at the first visit for 46 children; at the second visit 37 of them were improved and nine were not . No antimicrobial agents were prescribed at the first visit for 51; at the second visit 16 of these patients were improved and 35 were not . Pneumococcemia persisted in two treated children and in 13 untreated children . Meningitis was identified later in four children (two treated and two untreated) . Although pneumococcemia in children may be a transient event, it may also persist or result in meningitis or other localized infections.

Surg Gynecol Obstet, 1977 May, 144(5), 668 - 72
Topical chemotherapy for burns using cerium salts and silver sulfadiazine; Fox CL Jr et al.; These experimental data indicate that cerium compounds exert a measurable antimicrobial action in vitro . In vivo the simultaneous use of cerium sulfadiazine and silver sulfadiazine was more effective than silver sulfadiazine alone or the combination of cerous nitrate and silver sulfadiazine . When cerous nitrate was used clically, gram-positive bacteria predominated . In contrast, wounds exposed to silver salts alone harbor a predominately gram-negative flora . The combination of cerous nitrate and silver sulfadiazine appears to provide a broad spectrum inhibitory to both types of organisms . It is apparent that a sampling problem exists in any attempt to monitor wounds that may exceed a square meter in extent . These bacteriologic data pertain only to the surface flora . The need to culture tissue samples of burn wounds has been emphasized . Our experience, however, is that invasion of deep tissue without dense surface colonization, greater than 10(5), is infrequent . Furthermore, fragments of eschar were submitted regularly for culture; those results confirmed the surface culture findins . The characteristic yellow-green color of cerium nitrate treated eschars may results from oxidation of trivalent cerium to yellow ceric ions . Free silver and sulfadiazine ions are available also in small amounts because of limited ionization of the highly insoluble silver sulfadiazine . This might promote the in vivo formation of cerous sulfadiazine and would provide a continuous source of ionic cerium for microbial inhibition . The modification of silver sulfadiazine cream by incorporating cerous nitrate into it strikingly enhances its topical antiseptic effect in burn wounds without increasing toxicity.

J Med Chem, 1977 May, 20(5), 732 - 6
Structure-activity relationships among the O-acyl derivatives of leucomycin . Correlation of minimal inhibitory concentrations with binding to Escherichia coli ribosomes; Omura S et al.; The synthesis, antimicrobial activity, and binding to ribosomes of leucomycin and leucomycin derivatives are described . In general, the binding of the leucomycins and the leucomycin derivatives to ribosomes correlated with their antimicrobial activity . Some 2'-O-acyl derivatives apparently underwent gradual hydrolysis during antimicrobial assays, for their binding to ribosomes was poor compared to their relatively good antimicrobial activies . Correlation between antimicrobial activity and binding to ribosomes, their molecular site of action, provides some insight into the nature of the active molecular moieties.

Am J Surg, 1977 May, 133(5), 609 - 11
Antimicrobial prophylaxis of contaminated tissues containing suture implants; Rodeheaver G et al.; Neomycin sulfate was the only antibiotic tested that significantly reduced the incidence of infections around suture implant sites . The therapeutic efficacy of this antibiotic was related to the chemical and physical configuration of the sutures.

Laryngoscope, 1977 May, 87(5 Pt 1), 792 - 816
Physiological principles of therapy in head and neck cutaneous wounds; Simpson WR; It is essential that surgeons treating soft tissue wounds about the head and neck have a basic understanding of skin anatomy and physiology . The quality as well as the rate of healing is usually dependent on the type and extent of the original injury . Having a practical working knowledge of the pathophysiology of the various types of head and neck soft tissue injuries allows an intelligent choice of the most appropriate approach to a particular wound . The best functional and cosmetic results routinely are achieved by the wound's undergoing primary healing . Skin tapes and various sutures each exhibit certain benefits and disadvantages in primary closure of wounds . Skin tapes cause less inflammatory reaction but fail to close the subepithelial wound spaces . The inflammatory reaction and subsequent scarring caused by the various sutures depends upon the size of the suture needle, the diameter of the suture material and whether it is a monofilament or a woven suture . The essential nutrition of the wound must be maintained with the body providing adequate amounts of carbohydrates, proteins, trace elements and vitamins . The lack of adequate wound tissue perfusion by a normal or reversed oxygen gradient will lead to tissue necrosis and infection . The size of the inoculum of micro-organisms, the virulence of the organisms and host antimicrobial defense mechanisms determine if an infection will develop . The pharmacological action of each antibiotic must be understood in order to choose the proper antibiotic, its route of administration and to avoid unwanted side effects . Crushing tissue injuries, high velocity projectile tissue injuries and major burns of tissue may require several days to exhibit the true scope of the original injury . Most of these injuries must be treated by the open delayed method of wound treatment until the proper tissue conditions exist for healing . The proper timing and correct choice of autografts and tissue flaps from the surgeon's personal experience, study and conferring with other qualified surgeons . Upon gaining insight into the cellular and humoral antimicrobial defense system, the surgeon is able to provide the best conditions to allow these systems to function properly . Studies in the ultrastructures of skin along with the recently developed microbioassay techniques will allow a closer monitoring during the process of wound healing that will provide the basis for future techniques in the beneficial manipulation of wound healing.

J Pharm Sci, 1977 May, 66(5), 702 - 5
Antimicrobial action of compound 48/80 against protozoa, bacteria, and fungi; Lenney JF et al.; Compound 48/80 inhibited the growth of protozoa, bacteria, and fungi but had no effect on the multiplication of viruses . All susceptible organisms were inhibited by 10 microgram/ml of crude compound 48/80, and some were inhibited by as little as 0.1 microgram/ml . Against Tetrahymena pyriformis, this drug was seven times more potent than quinine . Separation of compound 48/80 into different fractions indicated that some antimicrobial activity could be separated from the histamine-liberating activity . It was found that compound 48/80 is not surface active at 500 microgram/ml.

J Med Chem, 1977 May, 20(5), 656 - 60
Synthesis and biological activity of some vinyl-substituted 2-nitroimidazoles; Cavalleri B et al.; In previous studies 1-methyl-2-nitro-1H-imidazole-5-carboxaldehyde and 1-methyl-2-nitro-5-vinyl-1H-imidazole were found to posses interesting antimicrobial activities . We have now prepared some 2-nitro-1H-imidazoles in which the 5-vinyl chain bears selected functional groups (CHO, COCH3, NO2) as well as nitrogen-condensation derivatives of the carbonyl functions . Furthermore, 5-methyl-2-nitro-1-vinyl-1H-imidazole has been synthesized . All the compounds, and some intermediates, have been assayed for antimicrobial activity . Several of them exhibited significant antibacterial and antitrichomonal activity in mice.

J Clin Microbiol, 1977 Apr, 5(4), 481 - 4
Allescheria (Petriellidium) boydii sinusitis in a compromised host; Gluckman SJ et al.; The first case of Allescheria (Petriellidium) boydii sinusitis is reported . The organism was isolated from the maxillary sinus in an elderly, diabetic, chronic alcoholic man on maintenance hemodialysis who developed a syndrome resembling mucormycosis . Infections with A . boydii are infrequent and are most commonly limited to Madura foot . In addition, several cases of pulmonary and central nervous system involvement have been described . There is no established therapy for A . boydii, since the published data on antimicrobial sensitivity are limited . Our organism was inhibited by 1.25 mg of amphotericin B per ml and 0.15 mg of miconazide per ml.

Jpn J Antibiot, 1977 Apr, 30(4), 285 - 94
The clinical effect of antibiotics in the macrolide family on bronchial asthma . Non-antimicrobial actions of oleandomycin {author's transl}; Mizutani A et al.; Non-antimicrobial actions of oleandomycin (triacetyloleandomycin and oleandomycin phosphate) were studied in patients with bronchial asthma . Twenty-one cases of the disease without associating infections entered the study, and they were given 750mg of oleandomycin or triacetryloleandomycin in three divided doses daily for two weeks . Clinical manifestations and laboratory findings were compared to assess the effectiveness of the antibiotic therapy between the three 2-week periods before, during and after the therapy . Improvements in clinical manifestations were attained in 11 of 21 cases (52.3%), and last after discontinuance of the therapy in 8(38.1%) . The blood level of 11-OHCS as determined by the Demoorr's fluorescence method increased by greater than 20% at the end of thearpy in 7 of 18 cases (38.9%) . In 5 of the 7 cases favorable responses were seen clinically to the oleandomycin therapy . The serum IgE level determined by the radioimmunosorbent test was compared before and after the therapy to reveal that oleandomycin caused decrease of IgE in 10 and increase in 9 of 20 cases examined . The oleandomycin therapy resulted increases by greater than 20% of the vital capacity and FEV 1.0 in 2 and 3, respectively, of 15 cases . Jaundice in association with elevations of the GOT, GPT and alkaline phosphatase developed in one patient, and generalized skin eruption in another . Both of these cases were given triacetyloleandomycin.

J Antibiot (Tokyo), 1977 Apr, 30(4), 275 - 82
A new alkaloid AM-2282 OF Streptomyces origin . Taxonomy, fermentation, isolation and preliminary characterization; Omura S et al.; AM-2282, a new alkaloid has been isolated from cultures of Streptomyces sp . AM-2282 by solvent extraction and silica gel chromatography . The compound exhibits a strong absorption maximum at 292 nm and shows antimicrobial activity against fungi and yeast . The LD50 of its hydrochloride (i.p . in mice) is 6.6 mg/kg . The molecular formula of AM-2282 has been determined as C28H26N4O3 . The producing strain, AM-2282 was classified as a new species and the name, Streptomyces staurosporeus AWAYA, TAKAHASHI and OMURA, nov . sp . is proposed.

Can J Comp Med, 1977 Apr, 41(2), 166 - 8
Susceptibility of Fusobacterium necrophorum to antimicrobials . Part I: as determined by the disc method; Simon PC; The susceptibility of 25 isolates of Fusobacterium necrophorum to 37 antimicrobials was tested using the disc method . F . necrophorum was susceptible to 15 antimicrobials, resistant to 12 . To the remaining ten antimicrobials some isolates were completely resistant whereas others showed partial resistance.

J Clin Microbiol, 1977 Apr, 5(4), 471 - 80
Bacteriological variation among Bordetella bronchiseptica isolates from dogs and other species; Bemis DA et al.; Bacteriological properties of 50 isolates of Bordetella bronchiseptica were compared . Phase variation, which involved colonial morphology and its associated characters of hemagglutination, hemolysis, acriflavine agglutination; crystal violet staining, flagellation, and fimbriation, occurred among these isolates . Organisms representing the three observed morphotypes did not have different growth rates, nor were any differences in their bacteriological characteristics observed after repeated subculture on agar . There were also variations in antimicrobial drug susceptibility, especially to sulfonamide-trimethoprim, and in nitrate reduction . The relationships among these variable parameters were not apparent . None of the observed variations could be attributed to differences in the species of origin.

Cancer, 1977 Apr, 39(4), 1704 - 9
The relationship of fever, granulocytopenia and antimicrobial therapy to bacteremia in cancer patients; Gill FA et al.; The relationship of fever, granulocytopenia, and antimicrobial therapy to bacteremia was studied retrospectively in 53 cancer patients . Severe granulocytopenia was present at the time blood cultures were positive in 27 to 31 episodes of bacteremia . Twenty-five episodes of bacteremia documented before the initiation of antimicrobial therapy in patients who were granulocytopenic and febrile . No bacteremia occurred in the absence of fever . Only two bacteremias occured while patients were receiving parenteral antimicrobials . Antimicrobial therapy was terminated 30 times in the presence of granulocytopenia and fever, and subsequent bacteremia occurred in 14 patients within 4 days . Patients who died with fungal disease did not receive more antibiotics than patients who died without fungal disease . These data suggest a rationale for long-term use of antimicrobial therapy in patients with persistent granulocytopenia and fever.

J Infect Dis, 1977 Apr, 135(4), 568 - 76
Disk diffusion susceptibility testing of Nocardia species; Wallace RJ Jr et al.; The effectiveness of 13 antimicrobial agents against 51 clinical isolates of Nocardia was determined with use of agar dilutions and disk diffusion method . Amikacin inhibited less than 90% of isolates and, like the other aminoglycosides, showed good correlation between minimal inhibitory concentrations and sizes of zones of inhibition around the disks . Both sulfisoxazole and trimethoprim-sulfamethoxazole were very active, although they required a 2- to 3-log lower inoculum for demonstration of susceptibility . Results with the two sulfa disks were variable, but they did allow distinction between sensitive and intermediate strains . All of the isolates of Nocardia were inhibited by 6.3 microng of minocycline; however, the degree of susceptibility could not be determined by zone diameters . Only two-thirds of these clinical isolates of Nocardia grew rapidly enough to be assayed by either susceptibility method.

Invest Ophthalmol Vis Sci, 1977 Apr, 16(4), 273 - 80
Effect of the ophthalmic preservative thimerosal on rabbit and human corneal endothelium; Van Horn DL et al.; Widespread use of the mercurial-containing preservative thimerosal as an antibacterial agent in ophthalmic drugs and solutions warranted an investigation into its possible cytotoxic effects on the functional and ultrastructural integrity of the corneal endothelium . No changes in corneal thickness were observed during 5 hours' perfusion of the endothelium of rabbit and human corneas with 0.0001 and 0.0005 percent thimerosal in glutathione bicarbonate Ringer's solution (GBR) . Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) of the endothelium of the 0.0001 percent group revealed normal ultrastructure . SEM and TEM of the endothelium of corneas perfused with 0.0005 percent thimerosal for 5 hours revealed condensed mitochondria, cytoplasmic vacuoles, and cytoplasmic flaps at the apical end of the cellular junctions . Perfusion of higher concentrations (0.001 and 0.005 perecnt) of thimerosal in GBR resulted in increases in corneal thickness after 2 hours and irreversible ultrastructural damage to the endothelial cells by 5 hours . Corneas perfused with 0.01 and 0.1 percent thimerosal in GBR showed a rapid and immediate increase in corneal thickness and endothelial cell death and necrosis within 1 hour . It is postulated that the mercury in thimerosal becomes bound to the cell membrane protein sulfhydryl groups, causing an increase in cellular permeability; These results suggest that the prolonged exposure of the corneal endothelium to thimerosal in the accepted antimicrobial dosage of 0.005 to 0.001 percent may result in functional and structural damage to the endothelium.

J Am Osteopath Assoc, 1977 Apr, 76(8), 605 - 16
Rational antimicrobial therapy; Haselby RC; Rational antimicrobial therapy depends on the identity of the causative organisms, the location of the infection, and the condition of the host . Selection of antimicrobial therapy is often started before identification of the causative organism is complete . Certain cultural and staining procedures must be instigated prior to therapy in order to isolate the causative organism . Knowledge of the host's physiologic state is necessary to minimize toxicities and/or failures of therapy . Knowledge of synergistic and antagonistic actions of some antimicrobial agents is necessary for optimal results.

Zh Mikrobiol Epidemiol Immunobiol, 1977 Apr, (4), 99 - 106
{Standardization of chemical cholerogen-toxoid cholera vaccine according to the content of somatic O-antigen}; Sumarokov AA et al.; The authors discuss the results of studies on the choice of highly-reproducible and sufficiently informative methods of 9-antigen standardization in a new chemical vaccine against cholera (cholerogen-toxoid); materials were collected under conditions of controlled epidemilogical trial . Titration of O-antigen in industrial batches of the preparation with the aid of precipitation in gel against standard O-cholera serum could be used for its standardization . Quantitative limits of O-antigen responsible for the formation of vibration (antimicrobial) antibodies in the persons vaccinated were found by studying the immunogenicity and reactogenicity of a number of cholerogen-toxoid batches contrast by O-antigen content described by means of the precipitation test.

Ann Thorac Surg, 1977 Apr, 23(4), 333 - 6
Cephalothin Prophylaxis and valve replacement; Austin TW et al.; In a study of antibiotic prophylaxis in adults undergoing heart valve replacement, we found that a 2 gm dose of cephalothin given intraoperatively produced adequate antimicrobial activity in the bloodstream throughout the period of cardiopulmonary bypass . A dosage of 1 gm every four hours postoperatively did not lead to significant accumulation of the antibiotic . With prophylaxis restricted to the intraoperative and early postoperative period, adverse drug reactions and superinfections were not a problem . Further, no cases of prosthetic valvulitis were encountered.

Zentralbl Bakteriol {Orig A}, 1977 Apr, 237(4), 548 - 58
{Newer antimycotics . III . Halogen- and nitro-substituted anilines and phenols (author's transl)}; Zsolnai T; The author produced a number of halogeno- and nitro-derivatives of anilines and phenols, investigated their antimicrobial efficiency in vitro, further the toxicity on mice of their most effective representatives . From the author's results it can be concluded that trihalogenoanilines and tetrachloroaniline exerted a relatively strong fungistatic activity with a broad spectrum of efficiency (Tab . 2) likewise to the polyhalogenophenols and halogenonitrophenols (Tab . 3) . The acute toxicity of the most effective halogenoanilines was relatively small; they were found to be significantly less toxic than halogenophenols and tetramethyl-thiuramdisulfide (Tab . 5) . On the basis of the intensive fungistatic activity and small toxicity of the tri- and tetrahalogenoanilines, it seems that a number of representatives of these types of chemical compounds could be given a role in the chemotherapy of superficial human and animal dermatomycoses, and also in the chemoprophylaxis of certain phytomycoses.

Clin Plast Surg, 1977 Apr, 4(2), 191 - 8
Management of soft tissue injury; Edlich RF et al.; The fate of a surgical wound is held in a delicate balance between the host's resistance to infection and the causal factors of infection . Considerable insight into this relationship between the host and pathogen can be gained from the results of quantitative bacteriologic measurements . Newer rapid slide techniques have been developed which provide the surgeon with this information within 20 minutes . In most soft tissue injuries, the wound bacterial count gives an accurate prediction of subsequent infection . Wounds combining greater than 10(5) bacteria per gram of tissue are destined to develop infection . When the bacterial count is below that level, the wounds will usually heal per primam without infection . This large number of bacteria required to elicit infection reflects the remarkable ability of soft tissues to resist infection . This state of high resistance to infection can be reduced by several factors which include circulatory embarrassment, tissue injury, dead space, and the presence of foreign bodies (dirt, sutures, drains, etc.) . When treating soft tissue injuries, the surgeon must employ specific therapeutic modalities that allow the wound to heal per primam without infection . On the basis of experimental studies supported by clinical experience, the following treatment protocol for soft tissue injuries is recommended . Using strict aseptic technique, the wound must be first anesthetized with 1 per cent Xylocaine to permit painless sound cleansing . All wounds should be subjected to high pressure syringe irrigation to remove bacteria, foreign bodies, and blood clots . When necessary, debridement of all devitalized tissue should be performed with a stainless steel scalpel . Many wounds caused by sharp wounding agents contain no foreign bodies and few bacteria and exhibit considerable resistance to infection . In these wounds, primary closure can be initiated after irrigation without the development of infection . Wounds resulting from impact forces have a diminished resistance to infection and are susceptible to infection by low level of bacterial contamination . Immediate antibiotic treatment of patients with impact injuries subjected to meticulous debridement and cleansing will permit a safe primary closure . In wounds contacted by pus or feces, open wound management followed by delayed primary closure is usually indicated . Antimicrobial prophylaxis is also recommended for patients with such wounds . Ideal postoperative care of all traumatic wounds includes a surgical dressing and immobilization and elevation of the site of injury.

Am J Hosp Pharm, 1977 Apr, 34(4), 376 - 82
Antimicrobial and other properties of a new stabilized alkaline glutaraldehyde disinfectant/sterilizer; Miner NA et al.; The properties of stabilized alkaline 2% glutaraldehyde solution (SGS) are discussed . SGS is discussed with regard to its chemistry, antimicrobial properties, organic soil resistance, toxicity, corrosivity and chemical stability . SGS retains the maximum antimicrobial activity of alkaline glutaraldehyde solutions and the chemical stability heretofore observed only with acidic glutaraldehyde solutions . These improvements, along with the inherent resistance of glutaraldehyde to neutralization by organic soil, allow SGS to be continuously used for 14 days in situations of high dilution, or 28 days in situations of low dilution.

Wien Klin Wochenschr, 1977 Mar 18, 89(6), 185 - 92
{Photoallergy: results of photo patch testing in dermatological patients (author's transl)}; Mischer P; 150 patients with light sensitivity of unknown aetiology were photo patch tested at the 2nd Department of Dermatology University of Vienna . 22 patients showed photoallergy . The identified photoallergens were mostly halogenated salicylanilides and other phenolic compounds . These substances are used as antimicrobials in soaps and cosmetics and as antimycotics in dermatological preparations . Four of the patients showed allergic contact photosensitivity to chlorpromazine . In two patients a new photoallergen has, perhaps, been discovered, namely a derivative of phthalic acid which is employed as fungicidal pesticide . The problems and consequences of photoallergy are discussed.

JAMA, 1977 Mar 7, 237(10), 1001 - 2
Guidelines for peer review . Veterans Administration Ad Hoc Interdisciplinary Advisory Committee on Antimicrobial Drug Usage.
{Relationship between the structure and biological activity of a series of N-arylbutenyl derivatives of piperidine}
Pis'ko GT, Buriak VS, Ganushchak NI.

A total of 74 compounds were synthetized and their biological activity studied on 3888 animals and on 347 strains of various microorganisms and fungi . The drugs have a moderate toxicity . The compounds containing an ester grouping of the alkyl radical with an odd number of carbon atoms are less toxic than are those with their even number . Most toxic are drugs that carry a chlorine atom in the orthoposition of the benzene nucleus and are less so the ones containing the bromine atom in this position . The toxicity of bis-quaternary salts diminishes with the rising molecular weight of the radical, this not being found to happen in the series of monoquaternary compounds . Most drugs display a locally anesthetizing and marked antimicrobial and antifungal properties . The antimicrobial activity appears with R-CH3, gradually increasing and becoming maximal with R-C10H21.

J Infect Dis, 1977 Mar, 135(3), 414 - 22
Quantitation of amphotericin B with use of high-pressure liquid chromatography; Nilsson-Ehle I et al.; A chemical method for determination of concentrations of amphotericin B in serum and cerebrospinal fluid (CSF) is described . After extraction with methanol, the antibiotic was separated by reverse-phase, high-pressure liquid chromatography and quantitated by absorption at 405 nm . The lower limit of detection of this assay was 0.02 microng/ml . Relative standard deviations of less than 3.6% were noted for multiple determinations of sera containing 0.20 and 1.00 microng of amphotericin B/ml . No interfering peaks were found in extracts of serum or CSF from normal humans or in extracts of serum from patients treated with other drugs and antimicrobial agents, including 5-fluorocytosine . Comparison of the method with microbiological assays showed correlation coefficients of 0.90 and 0.83 for serum and CSF determinations, respectively . This chemical assay is very rapid (less than 30 min), sensitive, accurate, and specific and appears to be suitable for routine clinical use.

J Hand Surg {Am}, 1977 Mar, 2(2), 85 - 9
Bacterial colonization of mutilating hand injuries and its treatment; Fitzgerald RH Jr et al.; A total of 120 hand injuries were reviewed . Sixty-seven occurred between 1965 and 1972 and were analyzed retrospectively, and 53 occurred between 1972 and 1974 and were analyzed prospectively . The bacterial colonization was determined in 86 injuries . Injuries sustained while handling farm implements tended to be colonized by mixed gram-negative and gram-positive isolates . The gram-negative isolates usually were resistant to all antibiotics, with the exception of gentamicin . However, nine bacterial isolates were resistant to all agents tested . Injuries sustained in the home or industry were colonized by gram-positive organisms . Most were susceptible to semisynthetic penicillinase-resistant penicillins such as methicillin and its congeners . The use of parenteral prophylactic antimicrobial agents in the treatment of mutilating hand injuries was not significant in preventing infection, and their use does not seem to be indicated in farm implement-related injuries . Antimicrobials are of value in home- and industrial-related injuries only when the status of the wound so indicates.

Acta Paediatr Scand, 1977 Mar, 66(2), 229 - 32
Antimicrobial factors in human milk; Reddy V et al.; PIP: Lower incidences of infection among breastfed vs . bottlefed infants have been attributed, not only to bottle contamination, but to the presence of various antibacterial factors in breast milk . 3 of these factors, immunoglobulins, lysozyme, and lactoferrin, were quantitated from milk samples from well-nourished and under-nourished Indian women in various stages of lactation . An ancillary concern of this study was to determine whether iron supplementation in under-nourished lactating women might abolish the bacteriostatic mechanism of lactoferrin by altering its saturation in milk, thus interfering with its biological function . 250 women gave breast milk samples for study . In addition, 11 lactating women were given 200 mg of iron intramuscularly, and their milk samples were assayed . In the nonsupplemented women, the concentration of immunoglobulin A (IgA) was high in colostrum, with a mean level of 350 mg/100 ml, and fell rapidly during the first 4 weeks of lactation, to a mean level of 110 mg/100 ml . IgG concentration was slightly higher in colostrum than in mature milk . Lactoferrin concentration was very high in colostrum, with a mean level of 600 mg/100 ml, and fell progressively up to 5 months of lactation, stabilizing at a mean level of 180 mg/100 ml . Lysozyme content of colostrum was lower than that of mature milk and showed a progressive increase with duration of lactation; its highest level of 42 mg/100 ml was reached at 12 months . No significant differences in levels of immunoglobulins, lactoferrin, and lysozyme were found between well-nourished and under-nourished mothers . In women who received the iron supplements, at first the mean level of total lactoferrin was 240 mg/100 ml, 9% of which was saturated . No significant changes in concentrations of either total or saturated lactoferrin were found after administering the iron supplement .

Surv Ophthalmol, 1977 Mar-Apr, 21(5), 429 - 35
Endogenous E . coli endophthalmitis; Shammas HF; A case of Escherichia coli septicemia with associated metastatic en dophthalmitis and endocarditis is presented . The ocular signs and symptoms were the initial manifestations of sepsis . Irreversible damage to the eye occurred in less than 24 hours . The pattern of metastatic bacterial endophthalmitis has changed since the introduction of potent antimicrobial agents, with an increased incidence of Gram-negative bacillemia . E . coli endophthalmitis carries a poor prognosis . Early diagnosis and systemic treatment will prevent the life-threatening complications of sepsis.

Am J Med Sci, 1977 Mar-Apr, 273(2), 157 - 67
Significance of antimicrobial synergism for the outcome of gram negative sepsis; Klastersky J et al.; Amikacin plus penicillin (A+P) was compared to amikacin plus carbenicillin (A+C) in a double-blind study . Therapy with one of these combinations was given, as soon as servere infection was suspected, to 117 patients with proved gram negative infection, none of whom was granulocytopenic . Gram negative bacteremia was documented retrospectively in 52 patients; 25 had received A+P and 27 had been treated with A+C . All the isolated gram negative pathogens were sensitive to amikacin (MIC less than 12 microng/ml) . In the A+P group, 55 per cent of the patients responded favorably while in the A+C group 63 per cent did respond; the difference was more striking for bacteremic patients: 52 per cent responded in the A+P group and 70 per cent in the A+C group . This difference, however, was not statistically significant . The outcome of patients whose infection was treated by synergistic combinations against the offending pathogen was better (66 per cent) than that observed in patients who received nonsynergistic combinations (48 per cent) (p less than 0.05) . Once again the results were more striking in the bacteremic patients (p less than 0.01) . A favorable outcome was associated also with a high (larger than or equal to 1/8) bactericidal activity of the diluted serum of the treated patient against the offending pathogen (p less than 0.05) . This study suggests that the optimal therapy in gram negative septicemia might be the administration of synergistic combinations of antibiotics.

Am J Dig Dis, 1977 Mar, 22(3), 195 - 200
Treatment of toxic megacolon . A comparative review of 29 patients; Hartong WA et al.; A review of 29 patients with toxic megacolon complicating ulcerative colitis was undertaken to (1) compare the results of medical and surgical treatment; (2) determine the optimal timing for surgical intervention, and (3) identify possible precipitating factors . Twenty-one patients were treated medically with nasogastric suction, steroids, parental fluids, blood transfusions, and antimicrobial agents . Of the 21 patients, 11 (53%) showed improvement by subjective and objective criteria and 10 (47%) failed to respond . Sixteen patients were treated surgically . This group was subdivided into 8 patients who failed to respond to medical treatment and 8 treated surgically . Total proctocolectomy with ileostomy was performed in 8 and subtotal colectomy and ileoproctostomy in 8, with subsequent proctectomy and ileostomy in 6 patient . Six of 8 patients (75%) treated primarily surgically improved, and 2 (25%) died . Seven of 8 patients (87.5%) treated surgically after failure of medical trial showed definite postoperative improvement, and 1 (12.5%) failed . Those who were operated on within the first 48-72 hr after the diagnosis of toxic megacolon was made responded uniformly well . Anticholinergics, opiates,, barium enema, and colonoscopy were identified as possible precipitating factors in 70% of cases . The results of this tudy in this patient population indicate that early surgical therapy in toxic megacolon is associated with better results than medical therapy (P less than 0.025) . Although intensive, optimal medical therapy plays a significant role in the management of toxic megacolon, failure to induce rapid improvement within 48-72 hr constitutes an indication for definitive surgical treatment.

Can Med Assoc J, 1977 Feb 5, 116(3), 253 - 6
Antimicrobial drug use in three Canadian general hospitals; Perry TL et al.; Total amounts of antimicrobial drugs used to treat inpatients during 1975 were calculated for three Canadian general hospitals, one of them the principal teaching hospital of a medical school . Use of drugs was compared with that reported for Boston City Hospital during periods when antimicrobial therapy was and was not supervised by infectious disease consultants . Ampicillin, tetracyclines, cephalosporins, erythromycin and aminoglycosides for prophylactic oral administration were used excessively in the three hospitals . The degree of overuse was comparable to that at Boston City Hospital during years when drug use was uncontrolled . Overuse or improper choice of antimicrobial drug decreases the quality of patient care and increases its cost . More rigorous education is needed for both medical students and practising physicians in the rational use of antimicrobial drugs . Informal consultation with an infectious disease unit should be required before certain overly popular or toxic antibiotics are administered to hospitalized patients.

Clin Nephrol, 1977 Feb, 7(2), 81 - 4
Antimicrobial dosage in renal failure: a unifying nomogram; Bryan CS et al.; A concise method is presented for calculating the dosage of commonly used anti-microbial agents in patients with impaired renal function.

South Med J, 1977 Feb, 70(2), 215 - 8, 221
An educational program for the rational use of antimicrobial agents; Smith JW et al.; A rational approach to the proper use of antibiotics must include knowledge of microbial sensitivities to various agents, proper alternative choices, pharmacologic considerations, and the cost to patient and hospital of drugs prescribed . A logical program for analysis of use of antibiotics and proper administration is presented . Since the largest misuse of antibiotics is for no infection or for prophylaxis before surgery, situations in which prophylactic use of antibiotics is of value have been reviewed . Such an educational program designed to improve the physician's use of antimicrobial agents must be a continuing effort in improving patient care.

Carbohydr Res, 1977 Feb, 53(2), 239 - 46
Chemical modification of neamine; Suami T et al.; The aminocyclitol antibiotic neamine has been modified chemically by removing one or two hydroxyl groups from the 2-deoxystreptamine moiety to give 5- and 6- deoxyneamines (5 and 10), as well as 5,6-dideoxyneamine (15) . Their antimicrobial activities were determined against several microorganisms, including kanamycin-resistant strains.

Zentralbl Bakteriol {Orig A}, 1977 Feb, 237(1), 117 - 23
{Comparative studies on the antimicrobial activity of S-alkylthiuroniumhalides (author's transl)}; Weigand N et al.; S-alkylthiuroniumhalides according to formula I (table 1) have been tested under standardized conditions with respect to their antimicrobial activity against bacteria, yeasts and fungi . In table 2 the bacteriostatic and fungistatic efficiency and in table 3 the microbicidal efficiency of 8 different S-alkylthiuronium compounds are compared with the efficiency of N,N-dimethyl-coconutoilalkyl-benzyl-ammonium-chloride . The germ inhibitory effect of the quaternary ammonium compound has been superior to the S-alkylthiuronium salts in almost all respects . The germicidal effect of the S-alkylthiuroniumhalides depends on the alkyl chain length bound to the S-atom and gets the optimum with S-dodecylthiuronium-chloride . Already a 0.0005% concentration is sufficient to kill all test germs within 30 minutes . S-dodecylthiuroniumchloride proved to be just as effective as the known well effective quaternary ammonium compounds . It seems to be possible to increase the microbicidal efficiency by additional alkylating - specially methylating - of both nitrogen atoms.

Drugs, 1977 Feb, 13(2), 124 - 36
Anthelmintics; Katz M; This article describes the drugs used in helminthic infections and their therapeutic indications, mode of action, toxicity and other details of each of the recommended drugs, and discusses the nature and treatment of infection by helminths important in human medicine . Infestation due to the roundworms Enterobius vermicularis, Ascaris lumbricoides and the hookworms, Ancylostoma duodenale and Necator americanus can all be treated effectively with pyrantel pamoate . For Enterobius vermicularis, however, a newer drug, mebendazole, is equally as effective . The advantage of these drugs in the indicated circumstances is that they can be administered in a single dose . Unfortunately, pyrantel pamoate is not a panacea and in the case of Necator it is not as effective as in the other roundworms . In that situation the use of tetrachlorethylene is preferable . For treatment of Strongyloides stercoralis, and important human parasite, because it can become disseminated and lead to fatal infections in immunoincompetent hosts, the only effective drug is thiabendazole . In treatment of Trichuris trichiura infection, mebendazole, administered over a period of 3 days, is the most effective available drug . For the roundworms inhabiting tissues--either as aberrant infections of man or as the normal part of their life cycle in man--therapy tends to be largely non-specific . For example, in visceral larva migrans, caused by the dog roundworm Toxocara canis, only palliative therapy with systemic anti-inflammatory agents and corticosteroids may be helpful . Cutaneous larva migrans, caused by the dog hookworms Ancylostoma brasiliensis and Ancylostoma caninum, is also treated primarily with symptomatic measures, but there is a suggestion that thiabendazole may kill the larvae and thus be effective . Trichinella spiralis may cause severe, even fatal infections in man, but only symptomatic therapy can be offered . Therapy for filarial infections is regrettably complicated and not completely effective . Diethylcarbamazine remains the best available drug, but in some of these infections local surgical excision may also be used . It is important to bear in mind that release of antigens from dying or dead worms may cause systemic inflammatory and allergic reactions that may require therapy with corticosteroids . Therapy for Cestodes is achieved most effectively with niclosamide, but the antimicrobial agent paromomycin has also been effective . For the aberrant cestode infections of man, such as echinococcal cysts or Taenia solium cycticerci, treatment is surgical if the affected areas are accessible . Treatment of schistosomal infections is quite toxic and, therefore, it is mandatory to determine viability of the worms before recommending therapy . If therapy is required, then Schistosoma mansoni infections are treated with stibophen and S . japonicum with antimony potassium tartrate, taking care in both of these instances to watch for the early signs of antimony toxicity; therapy of S . haematobium infections is based on administration of niridazole...

South Med J, 1977 Feb, 70(2), 205 - 7, 212
Reevaluation of neonatal Hemophilus influenzae infections; Pickering LK et al.; Hemophilus influenzae infections are increasing in frequency in the general population . As a result this organism must be considered an etiologic agent of disease in the neonate . Proper culture technics must be routinely employed to isolate this fastidious organism, and appropriate antimicrobial therapy must be instituted in infants suspected of having sepsis or meningitis . Three cases of H influenzae infection occurring in neonates are presented.

Eur J Clin Pharmacol, 1977, 11(5), 377 - 80
A contribution to a new test method for dandruff-inhibiting and "keratolytic" action of drugs; Gloor M et al.; Free cholesterol in lipids from the scalp and hair is predominantly a constituent of epidermal lipids . Therefore, a reduction in cholesterol content induced by a drug indicates a reduction in cell turnover in the epidermis . As, according to the literature, increased cell turnover in the epidermis results in formation of dandruff, a reduction in the proportion of cholesterol should indicate inhibition of the formation of dandruff . Conversely, an increase in free cholesterol should generally indicate a "keratolytic" effect . So unequivocal an interpretation has not so far been possible in persons with dandruff, as it was not known whether free cholesterol was increased or decreased . In addition, this interpretation was not possible after use of antimicrobial substances, as in vitro investigations had failed to exclude microbial esterification of cholesterol on the scalp . The present investigation has shown that correlation of free cholesterol level with cell turnover is permissible in patients with dandruff, even if antimicrobial drugs are being tested.

Sex Transm Dis, 1977 Jan-Mar, 4(1), 9 - 11
Gonococcal meningitis and ventriculitis in the presence of a ventriculoperitoneal shunt; Noble RC et al.; This report describes a young woman with a ventriculoperitoneal shunt who developed gonococcal meningitis and ventriculitis . Her infection responded to treatment with antimicrobial agents without removal of the shunt.

Trans Sect Otolaryngol Am Acad Opthamol Otolaryngol, 1977 Jan-Feb, 84(1), 68 - 74
Povidone-iodine: an adjunct in the treatmen of wound infections, dehiscences, and fistulas in head and neck surgery; Dedo DD et al.; Extensive research has been done to elucidate the cellular and biochemical events of a healing wound . Similarly, new techniques are continually being investigated which would stimulate and augment the reparative process . This paper describes the uses and biochemistry of povidone-iodine which has gained widespread acceptance as a surgical preparation . However, its use as a topical agent for treating head and neck wound infections, dehiscences, and salivary fistulas has gained little recognition . Povidone-iodine is a unique compound formed by binding free iodine to polyvinylpyrrolidone . Previously, the toxic effects of iodine limited its use to preparation of the skin for surgery . When bound to the pyrrolidine molecule, iodine becomes water soluble and markedly less toxic . As a result, the broad antimicrobial spectrum of iodine may be used topically to control wound sepsis . It can be applied to mucosal surfaces without producing burns . The brown color acts as an indicator of its clinical effectiveness . When the dressings become light yellow or pale, free iodine is no longer being released and the dressing should be changed . Povidone-iodine is not a panacea for correcting interruption in the healing process during the postoperative period . The basic management of wound infections, dehiscences, and fistulas remains unchanged . Incision and drainage, debridement and flap contracture, lateralization, and diversion are necessary to initiate the healing process . Familarity with each phase of healing provides the basis for managing each of these surgical problems . Topical povidone-iodine not only controls wound sepsis but augments wound healing . The physiologic correlation with each phase of wound healing for these various surgical problems is elaborated and clinical cases presented.

Scand J Infect Dis, 1977, 9(1), 40 - 5
Antimicrobial in vitro susceptibility of actinomyces israelii and arachnia propionica; Holmberg K et al.; 46 reference strains and clinical isolated of Actinomyces israelli and 8 strains of Arachnia propionica--the causative microorganisms of actinomycosis in man--were tested for their in vitro susceptibility to penicillin, sulfaisodimidine, erythromycin, tetracycline, lincomycin, clindamycin, metronidazole and tinidazole by the agar dilution method . All strains were susceptible to benzylpenicillin (minimum inhibitory concentrations, MICs of less than or equal to 0.064 mug/ml) . Many strains were resistant in vitro to sulfaisodimidine (MICs 4.0-32.0 mug/ml) . Erythromycin, tetracycline, clindiamycin and lincomycin possessed in vitro activity at concentrations readily attainable in serum . Due to adverse side-effects associated with clindamycin and lincomycin therapy, erythromycin and tetracycline may be the best alternative drugs to penicillin in the treatment of actinomycosis . In contrast, in vitro resistance (MICs greater than or equal to 4.0 mug/ml) of the pathogenic actinomycetes to metronidazole and tinidazole implies that these drugs may not be valuable in the therapy of human actinomycosis.

J Antibiot (Tokyo), 1977 Jan, 30(1), 25 - 30
A new aminoglycoside antibiotic complex--the seldomycins . II . Isolation, physicochemical and chromatographic properties; Sato S et al.; An antibiotic complex consisting of four components, seldomycin factors 1, 2, 3 and 5 was isolated from the fermentation broth of Streptomyces hofunensis sp . nov . by use of a cationic exchange resin . After silica gel column chromatography, the purified components were characterized as new aminoglycoside antibiotics by their physicochemical, chromatographic and antimicrobial properties.

Am J Dis Child, 1977 Jan, 131(1), 46 - 8
Bacterial meningitis . Limitations of repeated lumbar puncture; Jacob J et al.; A retrospective chart review of 47 pateints with bacterial meningitis was conducted with respect to current guidelines used to define an adequate duration of antimicrobial therapy . Fifty percent (19/38) of patients had an inadequate response to therapy as defined by repeated lumbar puncture (LP) findings (ie, a cerebrospinal fluid (CSF) blood cell count greater than 50/cu mm and/or a CSF glucose value less than 45 mg/100 ml) at the end of therapy . No cases of relapse were seen . Persistent CSF abnormalities were not associated with the presence of complicating disease but were associated with prolongation of antimicrobial therapy beyond 13 days . Patients having persistent CSF abnormalities at the time antibiotics were stopped had a higher CSF blood cell count and a lower glucose value on initial lumbar puncture than those not having persistent abnormalities (P less than .001) . These results emphasize the limitations of the role of repeated LP in defining an adequate duration of antimicrobial therapy.

Pahlavi Med J, 1977 Jan, 8(1), 45 - 64
Pharmacology and clinical use of silver sulfadiazine and related topical antimicrobial agents; Fox CL Jr; Silver sulfadiazine (Silvadene(R), US; Flamazine UK; Flamazine, Netherlands; Sulplata South America) is proving to be a highly successful topical antimicrobial agent for control of burn wound infections . The advantages of wide spectrum of activity, painless application, negligible toxicity and ease of application contribute to the usefulness of this compound . These advantages have led to its use for wound infections other than burns, for skin ulceration and for certain dermatologic lesions; also for the prevention and treatment of various vaginal infections . Described also are zinc sulfadiazine which can provide zinc for wound healing and cerous sulfadiazine which contains the rare earth metal cerium . Their unique effects on cell biology may determine their specific roles in topical therapy.

Health Lab Sci, 1977 Jan, 14(1), 17 - 21
Experience with a microscopic screening program for sputum specimens; Porschen RK; Microscopic examination of almost 2,000 sputum specimens was performed over a 3 1/2-month period . The specimens were categorized into 6 groups based on numbers of leukocytes (PMN's) and squamous epithelial cells (SEC's) observed at low magnification (X 100) . Bacteriologic evaluation of specimens consisted of identification and antimicrobial susceptibility tests of potential pathogens when growth was equal or predominant to the growth of oropharyngeal flora . Specimens containing greater than 25 PMN's and less than 25 SEC's had potential pathogens identified in 51% of the samples . Specimen containing greater than 25 SEC's and any number of PMN's showed a rate on only 19% . Specimens containing less than 25 PMN's and SEC's had a rate of 13% . Since initiating the screening program in which sputum specimens containing greater than 25 SEC's were unacceptable for culture, the per cent of acceptable specimens received by the laboratory nearly doubled.

Br Med J, 1977 Jan 1, 1(6052), 12 - 4
Antimicrobial proteins in sterilised human milk; Raptopoulou-Gigi M et al.; Human milk contains factors such as IgA and lactoferrin that increase the newborn infant's resistance to infection . Preterm infants are fed pooled milk, which is normally sterilised by heating . After standard heat sterilisation IgA and lactoferrin were undetectable in milk samples . Pasteurisation also sterilised milk samples even after heavy artificial contamination and did not damage the proteins . Gamma-irradiation sterilised equally effectively but caused some denaturation of IgA and lactoferrin . Since most of the milk samples were sterile or had only light contamination with skin bacteria, there seems to be no need for routine sterilisation . If sterilisation is necessary, the method used should be chosen to minimise damage to milk proteins.

J Thorac Cardiovasc Surg, 1977 Jan, 73(1), 23 - 30
Infective endocarditis . An analysis of 54 surgically treated patients; Boyd AD et al.; One hundred seventy-seven patients were admitted to the New York University Medical Center from 1970 through 1975 with infective endocarditis . Fifty-four of these patients required surgical treatment . The over-all mortality rate was 28 per cent . Two thirds of the deaths were early (10 patients) and one third late (5 patients) . The mortality rate was 90 per cent in 10 patients treated for 4 to 6 weeks in whom the infection was uncontrolled and the clinical condition was deteriorating . However of the 12 patients with uncontrolled infection who were operated upon promptly within 10 days, 83 per cent survived . The fact that fungal and gram-negative infections responded poorly to medical therapy suggests the need for prompt, early surgical intervention . The mortality rate in the 32 patients operated upon in whom the infection was controlled was 12.5 per cent . It is our conclusion that all patients with infective endocarditis who develop progressive congestive failure, recurrent embolization, or progressive sepsis, despite treatment, shold have prompt valve replacement within 7 days of the institution of appropriate antimicrobial therapy.

G Batteriol Virol Immunol, 1977 Jan-Jun, 70(1-6), 100 - 7
{Fosfomycin . I . Antimicrobial action in vitro}; Carlone NA et al.; The results obtained from the test of the in vitro activity of Fosfomycin by a concentration of 104 bacteria/ml and by Nutrient Broth with 5% defibrinated blood, have shown that the drug has a capacity of action on both Gram-negative and Gram-positive germs, also on beta-lactamase producing bacteria . Fosfomycin is a bactericidal antibiotic . infact the M.I.C . values are simjlar to M.B.C . values.

Acta Otorhinolaryngol Belg, 1977, 31(6), 554 - 65
{Antimicrobial and surgical treatment of tonsils . Bacteriological and histological data collected on 44 tonsillectomized children}; Caers G et al.; The tonsils of 44 operated children were submitted to bacteriological and histological examination . 22 children were given an oral penicillin during 5 days before tonsilectomy . Histological data and bacteriological cultures of pharyngeal exsudate and tonsillar material were very similar in the two groups of treated and non treated patients . These data suggest that, when preventive penicillinic treatment is given, it is worthy to consider the dose, the lasting and the route of administration of the prophylactic antibiotic therapy . Its unreliable activity, and the danger of bacteriemy at the moment of the operation plead for an adequate per-operative antibiotherapy.

Arzneimittelforschung, 1977, 27(9), 1652 - 5
Synthesis and pharmacological properties of some 4-amino-5-substituted thiazole-2(3H)-thiones and thiazolo(4,5-d)pyrimidin-7(6H)-one-2(3H)-thiones; Devani MB et al.; 4-Amino-5-substituted thiazole-2(3H)-thiones and thiazolo(4,5-d)-pyrimidin-7(6H)-one-2(3H)-thiones have been synthesized and screened for antimicrobial and pharmacological activities . Significant analgesic, antiinflammatory, anticonvulsant and antimicrobial properties have been found in some of the compounds synthesized . Analgesic and antiinflammatory activities are reported for the first time in thiazole-2(3H)-thiones.

Arzneimittelforschung, 1977, 27(10), 1889 - 95
Synthesis and biological activity of some 2-aminoimidazoles; Cavalleri B et al.; A review of the literature showed that 2-amino-imidazoles have not benn taken into consideration as antimicrobial agents . Our preliminary data indicating that 2-amino-4(5)-phenylimidazole possessed a moderate in vitro activity prompted us to prepare a limited series of 2-amino-4(5)-arylimidazoles and of some related derivatives . In vitro atimicrobial screening gave evidence of a broad spectrum activity for some of them . Several compounds have been tested also against S . mutans . In particular, 2-amino-4(5)-(4-biphenylyl)-imidazole hydrochloride showed substantial activity in this test, confirmed also against defferent representative strains of S . mutans . When submitted to a plaque inhibition test, it strongly inhibited the plaque forming ability of a S . mutans strain.

Arzneimittelforschung, 1977, 27(6), 1131 - 34
1-Methyl-2-nitroimidazol-5-yl derivatives . IIIrd communication; Cavalleri B et al.; A series of 1-methyl-2-nitroimidazole-5-carboxaldehyde derivatives (substituted hydrazones, oximes and Schiff bases) have been prepared and tested for their antimicrobial activity.

Antibiotiki, 1977 Jan, 22(1), 3 - 7
{New antibiotic no . 792 formed by Actinomyces bottropensis}; Fedorova GB et al.; An actinomycetes strain 792 producing a new antibiotic was isolated under the programme of antitumor antibiotic screening . By its morphological and cultural properties strain 792 was classified as belonging to species Actinomyces bottropensis . Antibiotic 792 was recovered from the culture fluid of the strain by the extraction method in the form of a crystalline orange substances . lambda max 235, 305, 410 nm (E 1% 1cm 705, 105, 168), m . p . 232-255 degrees (dec), molecular weight 340, C 67 per cent, H 4.8 per cent, no nitrogen, sulphur or halogens . The antibiotic was inactivated in alkaline solutions forming a hardly soluble compound crystallizing in the form of red needles, lambda max 256, 485 nm (E 1% 1ct 800, 195), m . p . 202-204 degrees (dec), molecular weight 320, C 69.5 per cent, H 4.7 per cent . Antibiotic 792 had antitumor and antimicrobial activity.

J Antibiot (Tokyo), 1977 Jan, 30(1), 66 - 70
Synthesis and biological activity of (2-hydroxy-1-naphthyl)-methylamino acetamido-epicillin and cephradine, and (2-hydroxy-1-naphthyl)-methylacetamido 6-APA; Ryu DD et al.; Two new penicillins and a new cephalosporin have been synthesized by condensing 2-hydroxy-1-naphthaldehyde with epicillin, 6-aminopenicillanic acid and cephradine, and subsequently reducing the SCHIFF bases with NaBH4 . The antimicrobial activities of these compounds are also described.

J Antibiot (Tokyo), 1977 Jan, 30(1), 1 - 10
Streptomyces novoguineensis sp . Nov., an amipurimycin producer, and antimicrobial activity of amipurimycin; Iwasa T et al.; A taxonomic study of Streptomyces strain T-36496, which produces an antibiotic effective against rice blast, revealed that it represented a new taxon and it was named Streptomyces novoguineensis sp . nov . The antibiotic, which was named amipurimycin, showed antifungal activity in vitro and considerable curative effect onleaf blast both in green house and field tests at concentrations ranging from 10 to 20 ppm . It was also effective against neck and panicle blast at the same concentration range.

J Neurosurg, 1977 Jan, 46(1), 97 - 103
Cranial zygomycosis caused by Saksenaea vasiformis . Case report; Dean DF et al.; A previously healthy youth who had sustained severe head trauma and had received steroids and broad-spectrum antimicrobial agents developed a cranial zygomycotic infection with Saksenaea vasiformis . This is the first time this zygomycete has been implicated as a disease agent . Early identification of the fungal infection and subsequent vigorous medical and surgical therapy led to recovery.

Infection, 1977, 5(4), 248 - 54
Protective isolation and antimicrobial decontamination in patients with high susceptibility to infection . A prospective cooperative study of gnotobiotic care in acute leukemia patients . II . Organizational and statistical concept; Gaus W et al.; The organizational and statistical concept of the cooperative randomized controlled clinical trial on gnotobiotic care and its effect in acute leukamia patients is described . The purpose is the clarification of the concept of the study and the comparison with other studies on the same subject . It is concluded that the value of the results and of the decisions based on them depend mainly on the statistical design, the protocol, and the performance of a study . The performance of a controlled study depends on its organizational details, its monitoring, documentation, and appropriate biometric evaluation . In this particular study it proved fruitful that a statistician was engaded in the evaluation and also in developing the protocol and in carrying out the study.

Zentralbl Bakteriol {Orig B}, 1977, 164(4), 390 - 6
Blood poisonings at slaughter and their consequences; Labadie J et al.; Contamination of pig blood by Str . faecium and P . fluorescens realized either through the bleeding knife or through intravenous injection . Bacterial counts made in the organs and muscles showed a large contamination of the organs and a smaller contamination of the muscles . In the case where Str . faecium and P . fluorescens were injected into the blood circulation, only Str . faecium could be re-isolated in muscles and organs . Study of the bactericidal activity of total blood and plasma showed a marked antimicrobial activity against P . fluorescens and a slightly activity against Str . faecium.

J Antibiot (Tokyo), 1977 Jan, 30(1), 83 - 7
A new type of inactivation of streptomycin by E . coli; Diedrichsen A et al.; Previously described cases of streptomycin inactivation by R-factor carrying strains of E . coli have not lead to any measurable decrease in antimicrobial potency in the bulk substrate toward the culture . In these cases each cell inactivates only a few molecules . Out of 1,800 strains of E . coli we have isolated five strains which inactivate streptomycin in large amounts giving a final concentration of the inactivation product of 0.25 mg/ml in 36 hours . Unlike all other streptomycin-resistant strains in investigated these five strains were sensitive to butyl-streptomycylamine, a streptomycin derivative acting in the same way as streptomycin . The crude inactivation product has been isolated . Inorganic phosphate is liberated by treatment with alkaline phosphatase resulting in a streptomycin-like compound without any antimicrobial activity.

Chemotherapy, 1977, 23(5), 324 - 36
Cyclacillin-induced potentiation of Escherichia coli immunogenicity in vivo and in vitro; Friedman H et al.; The efficacy of cyclacillin as an antimicrobial agent against Escherichia coli was assessed in vivo in mice infected with low numbers of bacteria and compared to the relative effectiveness of the antibiotic against the same organisms in vitro . Treatment of mice with cyclacillin resulted in a rapid clearance of E . coli from the blood and their greater killing in the spleen and liver . Furthermore, a significantly higher antibody plaque response against E . coli developed in cyclacillin-treated mice than in untreated mice or in those given ampicillin . The increased immunogenicity of the E . coli in the antibiotic-treated mice appeared to be due to high levels of cyclacillin in the animals and rapid killing of the bacteria in vivo . In vitro experiments showed that injection of normal mouse peritoneal exudate macrophages which had been incubated with E . coli together with cyclacillin resulted in a greater immunogenicity of the bacteria than when the injection mixture was composed of E . coli which had been incubated alone or only with macrophages . These results suggest that the in vivo effectiveness of an antibiotic such as cyclacillin against a gram-negative organism such as E . coli may be due in part to an effect on the immunogenicity of the bacteria.

Annu Rev Med, 1977, 28, 371 - 91
Prophylaxis of infective endocarditis: a reevaluation; Sipes JN et al.; Established practice dictates that physicians and dentists give antimicrobial agents at the time of procedures associated with bacteremia in an effort to prevent IE in persons with underlying cardiovascular diseases . Although prospective controlled study has not been established efficacy, very few cases of IE have been reported in patients at risk who have been treated with regimens recommended by the American Heart Association . Furthermore, studies in rabbits in recent years have shown that IE can be prevented by antimicrobials . The results in rabbits have raised some theoretical questions regarding efficacy of currently recommended regimens for man and have led some investigators to propose revisions of the American Heart Association recommendations . We feel that direct translation of results from experimental IE in rabbits into recommendations for prophylaxis of IE in man is subject to question . It is unlikely that a prospective study comparing placebo with antimicrobials will be undertaken, but it is possible and reasonable to undertake studies to document the occurrence of IE in patients at risk who are given established antibiotic regimens . With such data, modifications of established regimens could be proposed and tested . Regimens that are found to be totally effective in a large number of patients at risk might be modified toward simpler programs--for example, modifying parenteral therapy to oral therapy or changing multiple doses of antibiotic to a single dose . If regimens fail, even once in several thousand patients at risk, the factors responsible might be determined and a clear rationale for modification achieved.

Clin Pharmacokinet, 1977 Jan-Feb, 2(1), 45 - 60
Drug absorption in gastrointestinal disease with particular reference to malabsorption syndromes; Parsons RL; There is a considerable range in the dose of many drugs that is required to produce a given pharmacological effect in an individual patient . This individual variation in dose requirement is sometimes reflected in the wide scatter in the steady state plasma concentration that follows the same oral dose of a drug given to any group of subjects . Such individual differences are largely due to variation in the rate of elimination of drugs . Gastrointestinal disease may also alter oral dose requirements by producing variation in both the amount and rate of drug absorption . These changes may be reflected in the plasma concentration/time curve that follows an oral dose . The amount of drug abosorbed is simultaneously affected by many factors . These include the physicochemical properties of the drug and the physiological factors that operate within the gut, as well as the presence of other substances such as food, or interaction with other drugs in the gut . The availability of the drug within the intestinal lumen is largely governed by its dissolution characteristics, particularly factors which can interfere with dissolution of the drug product in the gut . Physiological factors within the gut that affect oral drug absorption include gastric emptying rate and intestinal motility, the pH of the gastrointestinal fluids, the activity of gastrointestinal drug metabolising enzymes (e.g . monoamine oxidase and dopa decarboxylase) or drug metabolising bacteria and the surface area of the gut . Many factors affect gastric emptying . These include disease, surgery and other drugs . A change in the rate of gastric emptying alters the rate of drug delivery from the stomach to the duodenum and upper small intestine . This may profoundly alter the plasma concentration/time curve that follows oral administration of many drugs . For some drugs, proximal jejunal disease may reduce, delay or increase the apparent amount of drug absorbed . Reduced absorption of an antibiotic leads to a fall in the peak plasma concentration . If the peak falls below the minimum inhibitory concentration for a particular organism then therapeutic failure may occur, if it is assumed that the peak plasma concentration is all important for antimicrobial activity . Excessive drug absorption may lead to drug toxicity . Abnormal drug absorption is a feature of lower small intestinal conditions such as Crohn's disease . This suggests that drug absorption is not confined to the jejunum but continues throughout the small intestine . It is not always possible to predict the pattern of drug malabsorption from a knowledge of the physicochemical and pharmacokinetic properties of the drug and the pathophysiology of the disease . The rate and amount of drug absorbed be one patient may differ from that in another patient with the same condtion . Although these differences reflect normal individual variation, they are also related to the extent and activity of disease at the time of study...

Am J Hosp Pharm, 1977 Jan, 34(1), 49 - 57
Antimicrobial spectrum, pharmacology and therapeutic use of antibiotics . Part 1: tetracyclines; Barza M et al.; The mode of action, bacterial resistance, in vitro activity, pharmacology, dosage, adverse reactions, interactions and indications for tetracyclines are reviewed . Suggestions for the selection of a particular tetracycline are provided . It is concluded that there is only one pertinent difference among the tetracyclines, namely, that doxycycline, and probably minocycline, can be given in full dosage and with minimal risk to patients with renal impairment.

Am J Ophthalmol, 1977 Jan, 83(1), 16 - 8
Keratitis and endophthalmitis caused by Petriellidium boydii; Elliott ID et al.; A 26-year-old man sustained burns of the left eye and eyelids from molten aluminum . Antimicrobial and anti-inflammatory therapy was instituted . Cultures of conjunctival material collected 14 days after the burn grew abundant colonies of Petriellidium boydii . Because of severe pain and impending corneal perforation, the eye was enucleated.

Acta Pathol Microbiol Scand Suppl, 1977, (259), 61 - 6
High-pressure liquid chromatography as a tool for determination of antibiotics in biological fluids; Nilsson-Ehle I; The toxicity of some antibiotics used today necessitates rapid, specific and accurate determinations of antibiotic concentrations in biological fluids . Microbiological assays do not fulfill these needs and new procedures have recently been developed, for instance, fluorimetric assays, radioimmunoassays and radioenzymatic assays . However, these techniques have not been generally applicable to various antimicrobial agents . - The technique for high-pressure liquid chromatography (HPLC) has recently been applied to determination of antibiotics in biological fluids . The methods involve extraction of drug from the biological samples, separation by HPLC and detection by ultraviolet spectrophotometry of fluorimetry . Results obtained with tetracycline, amphotericin B, and cephalothin show that this procedure meets the demands for rapid, specific and accurate monitoring of antibiotic concentrations in body fluids . Because of its versatility, the HPLC technique seems to be applicable to the determination of a variety of antibiotics and other drugs in clinical and experimental medicine.

Community Dent Oral Epidemiol, 1977 Jan, 5(1), 1 - 6
Clinical trial in mentally retarded of chlorhexidine dental gel: bacteriology; Gallagher IH et al.; A dental gel containing 1 % chlorhexidine was applied daily to the teeth of mentally retarded patients for a period of 6 months . Although possible antimicrobial effects were noted, the gel had no practical value in reducing the numbers of different plaque bacteria . It is suggested that the lack of effect may be due to changes in susceptibility of the oral flora surviving in the mouth, allowing subsequent recolonization of the teeth.

Arzneimittelforschung, 1977, 27(11), 2179 - 81
{On the reduction of free fatty acids in skin surface lipids as a criterium for the therapeutic efficacy of antimicrobial acne drugs . Studies on film masks containing ethyl lactate and ethanol (author's transl)}; Gloor M; Thin-layer chromatographic investigations of the skin surface lipids have been performed on 10 healthy subjects before and after treatment with film masks containing 1% ethyl lactate and 50% ehtanol . From the results obtained it can be assumed that there is a reduction in the fraction of free fatty acids on the skin surface . Clinical studies with the same mask on 23 patients with acne vulgaris over a period of 3 weeks proved that this treatment led to a significant reduction in comedones and inflammatory acne efflorescences . No side effects whatsoever were obtained . This therapy, therefore presents a valuable element in the treatment of acne vulgaris . These investigations show also that a decrease in the free fatty acids of the skin surface lipids points to a favourable therapeutical effect on inflamed and not-inflamed efflorescens of acne vulgaris when testing antimicrobial agents.

Microbios, 1977, 20(81-82), 153 - 72
Quantitative aspects of phenyl substituted alcohol and ether bacteriostatic interaction with Escherichia coli B/5; Lovrien R et al.; It is well established that compounds of the class phenylalkane alcohols and ethers exert their antimicrobial action on the bacterial envelope--probably on the membrane . However, the overall stoichiometry, the number of molecules bound vs those merely added per cell, and the kinds of equilibria involved (site binding vs equipartitioning) are not clear . This work examines antimicrobial action on E . coli B/5 with eight such compounds . Directly determined binding data, plate counting viabilities, radiorespirometry, and microcalorimetry of glucose utilization were evaluated . The compounds mostly bind by simply equipartitioning, up to some threshold level, short of kill . That level depends sharply on the number of alkane carbons in the phenyl alkane derivative, but not on the precise structure . Past the threshold, bacteriostatic action is sudden and complete, probably reflecting cooperative behaviour in the cell envelope . The amount of bound compound at the threshold level is only about 0.5 to 3% of the weight of the bacterial envelope hydrocarbon, when bacteriostasis occurs . There is an unexpectedly small dependence on cell concentration . The principal governors on where the monooxygen phenylalkanes kill cells seems to be merely their concentration or chemical potential, the number of aliphatic carbons, and the binding mechanism . Because of the cell concentration independence, the cells act as if they constituted a second phase, relative to the solution . Results from the microcalorimetric method for assay of bacteriostasis correlate well with those from plate counting or viability assays.

Prog Clin Biol Res, 1977, 13, 103 - 31
Bactericidal mechanisms of the granulocyte; Spitznagel JK; Antimicrobial action of polymorphonuclear leukocytes depends on an array of substances carried in their cell membranes and cytoplasmic granules . These substances mediate killing in several systems . Some depend on molecular oxygen while others are independent of it . Some of the systems that depend on oxygen also require myeloperoxidase . The different systems seem able to act in primary or in reserve capacities backing each other up in times of stress or failure . Thus a deficiency in one system does not necessarily leave the polymorphs completely incapable of antimicrobial action although impairment may be severe as in chronic granulomatous disease . In general a poorly functioning polymorph is better than no polymorph at all.

Urol Res, 1977, 5(4), 215 - 8
Secretion of various antimicrobial substances in dogs with experimental bacterial prostatitis; Baumueller A et al.; Bacterial prostatitis in dogs was induced by injection of an E . coli 06 suspension into a branch of the prostatic artery . Three to six days later, secretion from the inflamed glands was obtained by pilocarpine stimulation and the concentrations of trimethoprim, sulphamethoxazole, erythromycin, doxycycline and ampicillin were measured during constant infusion of these drugs . In the prostatic secretion, only the concentrations of the lipid soluble substances trimethoprim and erythromycin exceeded the corresponding plasma levels . These two substances may therefore be of value in the treatment of bacterial prostatitis.

N Engl J Med, 1976 Dec 30, 295(27), 1500 - 5
Circulating immune complexes in infective endocarditis; Bayer AS et al.; To examine further the role of immune-complex deposition in infective endocarditis, we studied 29 patients with infective endocarditis for presence of complement-containing circulating immune complexes . Ninety-seven per cent (28 of 29) had serum levels of immune complexes greater than 12 mug per milliliter . Mean levels in these patients were significantly higher than in patients with sepsis without endocarditis or in normal controls (P less than 0.05) . Circulating immune-complex levels were correlated with longer duration of illness (P less than 0.025), extravalvular manifestations of endocarditis (P less than 0.025) and hypocomplementemia (P less than 0.05) . Patients with right-sided endocarditis had significantly higher circulating immune-complex levels than patients with left-sided involvement (P less than 0.025) . In general, levels fell to zero with successful antimicrobial or surgical therapy . This drop was concurrent with disappearance of extravalvular signs, blood cultures becoming sterile, and rise in serum complement levels . These findings support the concept that immune complexes may be important in the pathogenesis of infective endocarditis.

J Pharm Sci, 1976 Dec, 65(12), 1743 - 6
N-Halo derivatives VI: Microbiological and chemical evaluations of 3-chloro-2-oxazolidinones; Kosugi M et al.; Comparative antimicrobial activity of 3-chloro-2-oxazolidinone (I), 3-chloro-4-methyl-2-oxazolidinone (II), 3-chloro-4,4-dimethyl-2-oxazolidinone (III), and N-chlorosuccinimide (IV) was evaluated in aqueous buffers in the absence and presence of 5% horse serum . All four compounds had similar bactericidal activity in the absence of horse serum, but I and III had superior activity relative to IV when serum was present . Compound III was considerably more stable with respect ot loss of positive chlorine and bactericidal activity than I and II when stored in 0.1 M sodium dihydrogen phosphate buffered to pH 7.0 at 40 degrees . Thus, III is potentially the most useful bactericidal agent of those evaluated . The chlorine potentials of I, II, and III, the rate constants for transfer of positive chlorine from I and III to morpholine in aqueous solutions, and the hydrolytic stabilities of I and III with respect to loss of positive chlorine were evaluated . These data, together with previously calculated data for IV, are used to rationalize the observed bactericidal activities.

Antibiotiki, 1976 Dec, 21(12), 1094 - 8
{Experimental data on the penetration of gentamicin into the media of the eye}; Shchekotova IG; Penetration of Soviet gentamicin into the humor of the anterior chamber and vitreous body of the eye with aseptic inflammation was studied after the antibiotic administration by various routed, i.e . instillations of 8 per cent antibiotic solution and 8 per cent antibiotic solution methylcellulose into the conjunctival sac, injections of 20 mg of gentamicin subconjunctivally and retrobulbarly, injections of gentamicin intramuscularly in doses of 0.6 mg/kg . The studies showed that gentamicin penetrated into the humor of the anterior chamber and vitreous body of the eye after all the administration routes mentioned above in concentrations sufficient for the antibiotic antimicrobial effect and persisted in the eye media for prolong periods of time (24--48 hours) . The highest concentrations of the antibiotic in the tumor of the anterior chamber were achieved after its administration subconjunctivally or after instillation of its 8 per cent on methylcellulose, while in the vitreous body its highest concentrations were achieved after injections subconjunctively, retrobulbarly or intramuscularly . Instillations of gentamicin solution on methylcellulose provided higher and more persistant concentrations of the antibiotic in the humor as compared to instillations of its aqueous solutions . Retrobulbar injections of gentamicin had no advantages as compared to subconjunctival administration with respect to providing higher concentrations of the antibiotic in the eye media.

J Antibiot (Tokyo), 1976 Dec, 29(12), 1286 - 96
Chemical modification of sorbistin . I . N-acyl analogs of sorbistin; Naito T et al.; Sorbistin A1 (1b) and sorbistin B (1a), bioactive components of a new type of aminoglycoside antibiotic produced by a strain of Pseudomonas species, have been converted into a key intermediate 3 by blocking of the 1- and 4-amino groups of sorbistins with dimedone and subsequent deacylation of the 4'-N-acyl group . Some 4'-N-acyl analogs of sorbistin (1e approximately 1t) have been synthesized by 4'-N-acylation of 3 with an appropriate reactive derivative of carboxylic acids (mixed anhydride, acid chloride or activated ester) followed by deblocking of the protected group with bromine or sodium nitrite . Chemical interconversion of three natural sorbistins A1 (1b), A2 (1c) and B (1a) has been performed by this procedure . The 1-N-acyl (4a approximately 4c) and the 1,4'-N,N-diacyl analogs (6a approximately 6c) have been prepared by direct N-acylation of sorbistin D (1d) (the 4'-desacyl derivative) and sorbistin A1, respectively . On the other hand, the 4-N-acyl (5a and 5b) and the 4,4'-N,N-diacyl derivatives (7a and 7b) have been prepared by acylation and subsequent hydrogenolysis of 1-N-Cbz-sorbistin D (4b) and 1-N-Cbz-sorbistin A1 (6b), respectively . Determination of in vitro antimicrobial activity showed that the 4'-N-propionyl (1b) and the 4'-N-cyclopropylcarbonyl (1s) derivatives are the most active members of the 4'-N-acyl derivatives . Elongation and shortening of the side chain and introduction of functional groups decreased the activity . N-Acylation of the amino group at C-1 or at C-4 gave virtually inactive products.

J Am Vener Dis Assoc, 1976 Dec, 3(2 Pt 1), 84 - 6
Treatment of uncomplicated gonorrhea with Polycillin-PRB; Kleris GS et al.; Penicillin has remained the choice drug for the treatment of gonorrhea . Its cure rate has been relative, and because cure rates are not as good as one would wish, an additional increase in dosage has been advised . Despite an improved cure rate with increased dosages, we are rapidly approaching a dose requirement beyond that which can be administered practically on an outpatient basis . Therefore other antimicrobial agents have been evaluated for the treatment of gonorrhea . Ampicillin 2 gm (IM) with 1 gm probenecid was evaluated in 1969 with a 99% plus cure rate . It also has been found that 3.5 gm of ampicillin orally (7 capsules of 500 mg) and probenecid (2 tablets of 500 mg) is an effective treatment for gonorrhea . We undertook the present study to evaluate the efficacy of a new single oral combination treatment, Polycillin-PRB.

Am Rev Respir Dis, 1976 Dec, 114(6), 1129 - 36
Pulmonary aspiration of gastric contents; Bynum LJ et al.; A retrospective analysis of 50 patients who had been observed to aspirate gastric contents was performed to define better the course of patients with this syndrome . The patients invariably had a disturbance of consciousness, most commonly due to sedative drug overdose or general anesthesia . The onset of clinical signs occurred prompty after aspiration and tended to be similar in all patients, irrespective of their subsequent course or outcome . These findings usually included fever, tachypnea, diffuse rales, and serious hypoxemia . Cough, cyanosis, wheezing, and apnea were each seen in approximately one third of the cases . Apena, shock, and early severe hypoxemia were particularly ominous events . Initial roentgenograms revealed diffuse or localized alveolar infiltrates, which progressed during the next 24 to 36 hours . Subsequent clinical courses followed 3 patterns: 12 per cent of the patients died shortly after aspiration; 62 per cent had rapid clinical and radiologic improvement, with clearing, on average, within 4.5 days; 26 per cent demonstrated rapid improvement, but then had clinical and radiographic progression associated with recovery of bacterial pathogens from the sputum and a fatal outcome in more than 60 per cent . Treatment from the outset by adrenocortical steroids or antimicrobial agents had no demonstrable effect on the outcome . The clinical features of aspiration of gastric contents are characteristic and distinguish it from other forms of aspiration-related lung disease.

J Urol, 1976 Dec, 116(6), 776 - 7
The controversy of treatment of asymptomatic bacteriuria in non-pregnant women--resolved; Gleckman R; Data derived from longitudinal studies demonstrate that asymptomatic bacteriuria in non-pregnant women without stones or obstructive uropathy is a benign pathological condition . Evidence has accumulated that untreated asymptomatic bacteriuria in otherwise healthy women does not result in hypertension and/or a decline in renal function, and that this condition required neither detection nor antimicrobial therapy.

Int J Clin Pharmacol Biopharm, 1976 Dec, 14(4), 245 - 54
Use of antimicrobial drugs in medical wards; Levy M et al.; Antimicrobial usage patterns in 17,750 consecutive medical in-patients, monitored between 1966 and 1972 are described . 36.4% of all patients were exposed to one or more antimicrobials and about half of them received more than one antimicrobial agent . Penicillins accounted for 49% of all exposures and use of ampicillin rose steadily over the years . Concomitant receipt of more than one antimicrobial was common (22% of all exposed patients) . Of 171 possible two-drug combinations involving 19 drugs, 126 were actually encountered . Apart from combinations, 60% of antimicrobial recipients received more than one agent at different times.

Am J Hosp Pharm, 1976 Dec, 33(12), 1304 - 8
Computerized consultation system for selection of antimicrobial therapy; Wraith SM et al.; Mycin, a computer-based consultation system which provides to physicians antimicrobial therapy recommendations for patients with bacterial infections, is described . The consultation program arrives at therapeutic decisions using a built-in knowledge base as well as patient data entered by the physician . The system is capable of explaining its recommendations and answering questions about its reasoning process . The system's knowledge can be updated and corrected easily by infectious disease experts . At present the system is operational within a research setting; its routine use in a clinical setting will require further evaluation of its reliability and effectiveness.

Int J Oral Surg, 1976 Dec, 5(6), 276 - 84
Effect of two antimicrobial rinses and oral prophylaxis on preoperative degerming of saliva; Altonen M et al.; Two degerming mouthrinses, a 1% povidone-iodine and a 0.2% aqueous solution of chlorhexidine gluconate, were tested with regard to their degerming effect on the saliva . The study comprised two parts . In the first part 19 dental students with good oral hygiene rinsed their mouths at weekly intervals with 10 ml of the povidone-iodine and 10 ml of the chlorhexidine solution . A control group of 12 students and nurses with healthy teeth and gums rinsed their mouths with 10 ml of plain water . In the second part 11 adult patients with periodontal disease used the two test rinses at weekly intervals both before and after periodontal prophylaxis including scaling of the teeth . Non-stimulated saliva was simpled immediately before and 5, 30, 60, and 120 min after each rinse . Part of the saliva was cultured on blood agar plates to show the growth of aerobic microbes . The remainder of the saliva was poured over a Dentocult dip-slide for determination of the number of acidophilic bacteria . The results showed that in the water control group the bacterial count increased in spite of the rinse . When compared with the prerinse values, both test rinses clearly reduced the amounts of bacteria . Chlorhexidine reduced the bacterial count 5 min after the rinse about one logarithm more than povidone-iodine, did, and the degerming effect of chlorhexidine was also of longer duration than that of the povidone-iodine solution . The periodontal prophylaxis in the adult group did not seem to lower the pre-rinse bacterial counts but did slightly improve the duration of the effect of both test solutions . The dip-slide tests showed that 28% of the subjects had no growth of acidophilic bacteria . This absence was not dependent on the other bacterial flora of the saliva . In the cases with a positive dip-slide test, the number of acidophilic bacteria decreased with both test solutions according to the pattern revealed by the blood agar plate cultures.

Ann Surg, 1976 Dec, 184(6), 717 - 22
Tuberculous peritonitis: 43 years' expereince in diagnosis and treatment; Dineeen P et al.; The clinical course of 70 patients with tuberculous peritonitis seen over a 43 year period has been reviewed . Thirty-seven patients were diagnosed prior to the advent of anti-tuberculous chemotherapy and 33 after . Clinical manifestations remained unchanged over the period of study . Abdominal pain (93%), fever (63%), gastrointestinal upset (60%), weight loss (60%), and ascites (59%) continue to be the most common findings . Females outnumbered males 2:1 . In 89% of patients the duration of symptoms prior to diagnosis was a week or longer, and in 47% it was longer than a month . Diagnosis was confirmed by histologic examination of intra-abdominal tissue in 44% of cases, by clinical suspicion with an extraperitoneal site of tuberculosis in 29%, by bacteriology of peritoneal fluid in 24%, and by autopsy alone in 3% . An extraperitoneal site of tuberculsis was present in 83% of patients . The importance of obtaining a definitive diagnosis, and of instituting immediate antimicrobial therapy is emphasized by the mortality of 49% in the pre-antibiotic era, and of 7% in patients receiving anti-microbial therapy . The conclusions from this review are that: 1) with suggestive clinical manifestations and bacteriologic proof of active tuberculosis anywhere in the patient, operation is not mandated; 2) in the presence of the above clinical manifestations, and in the absence of definitive bacteriologic proof, exploratory laparotomy is indicated for diagnostic purposes; 3) antituberculous chemotherapy is highly effective, and is the treatment of choice.

J Antibiot (Tokyo), 1976 Dec, 29(12), 1314 - 7
Effect of the leucomycin-like macrolide antibiotic turimycin on ribosomal peptidyltransferase from Eschericha coli; Haupt I et al.; The relationship between the effect of different turimycin components on ribosomal peptidyltransferase of E . coli, antimicrobial activity and chemical structure were studied . Inhibition of peptidyltransferase as well as antimicrobial activity increased with the length of the aliphatic side chain in 4''-position of mycarose and decreased with acylation in 3-position of the lactone ring . Inhibition of peptidyltransferase is paralleled by inhibition of acceptor substrate binding.

J Pediatr, 1976 Dec, 89(6), 872 - 84
Erythromycin: a review of its uses in pediatric practice; Ginsburg CM et al.; Erythromycin continues to be a valuable and useful antimicrobial agent in children . Its low index of toxicity, freedom from sensitization, and reliable absorption and when administered orally contribute to make it an attractive agent in the treatment of a variety of minor respiratory and skin infections, especially in those situations where real or potential allergy to penicillin exists . Additional major uses are in the eradication of the carrier state in whooping cough and in diphtheria, especially in those instances when oral therapy can be tolerated . Dispite use over more than two decades, resistance developing in formerly susceptible organisms has not been a problem and thus seems unlikely to become so in the future.

J Pharm Sci, 1976 Dec, 65(12), 1737 - 42
N-Halo derivatives V: Comparative antimicrobial activity of soft N-chloramine systems; Kaminski JJ et al.; Comparative antimicrobial activity studies for certain new classes of soft N-chloramines derived from alpha-aminiisobutyric acid and 2-amino-2-methyl-1-propanol were examined using the minimum inhibitory concentration (MIC) and/or the contact germicidal efficiency (CGE) procedures . Several factors significantly aliphatic chain length in a homologous series, (b) the degree of chlorination of thenitrogen atom, (c) the solution pH, (d) the presence of a denaturant, and (e) the nature of a positive charge.

Lancet, 1976 Nov 27, 2(7996), 1155 - 7
Comparative efficacy of chloramphenicol, ampicillin, and co-trimoxazole in the treatment of typhoid fever; Snyder MJ et al.; Two clinical trials were conducted to compare the efficacy of 3 antimicrobial agents often recommended for the treatment of typhoid fever . Chloramphenicol was more effective than parenteral ampicillin or oral co-trimoxazole (trimethaprim/sulphamethoxazole) in reducing the duration of fever . Oral chloramphenicol was more effective than parenteral chloramphenicol probably because oral doses resulted in higher blood concentrations of the drug . However, parenteral chloramphenicol was given during the initial period of acute illness, without loss of efficacy.

J Dent Res, 1976 Nov-Dec, 55(6), 1088 - 91
Enhancement of the antiplaque value of antibacterial agents by enamel conditioning methods: III . Animal results; Katz S et al.; A 1:1 water-paste slurry of a placebo and several experimental dentifrices was swabbed daily for six weeks on the teeth of albino rats, and the plaque collected on the teeth was measured in vivo first before the treatments began and one, two, three, and six weeks after . The results indicate that adding a suitable antimicrobial agent to a placebo dentifrice markedly reduced plaque accumulations on the teeth brushed with that product . When an enamel-conditioning vehicle was used instead of the placebo, the antiplaque effectiveness increased severalfold . It was concluded from the two first articles of this series 1,2 that adding antibacterial agents to enamel-conditioning systems resulted in the incorporation of the antimicrobial compound into enamel treated with these systems, and that enamel treated in such a fashion acquired marked antibacterial properties of its own . The data reported in this article support a third conclusion, namely, that the enamel-conditioning-antibacterial systems have a considerable antiplaque effect in laboratory rats.

Vopr Pitan, 1976 Nov-Dec, (6), 50 - 3
{Effect of the alimentary factor on the immunobiologic reactivity of children's bodies}; Voznesenskaia FM et al.; Observations covered 66 healthy six-year old children of a childrens' home . The actual alimentation of the children was studied according to tabulated values for one year and 112 apportionoments . In the rations of actual nutrition a disturbed correlation of proteins, fats and carbohydrates was noted . Seasonal variations of the salival lysozyme activity were revealed against the background of the actual alimentation . The lowest antimicrobial activity of the lysozyme was recorded in the winter and spring seasons of the year . The low lysozyme activity of the saliva in spring may be explained by deficiency of the animal protein in the ration . In winter time added to the insufficient content of the animal protein were features specific for the day's routine, typical of this season . An addition of the animal protein to the actual nutritional rations of the children, in the form of eggs and nonfat dry milk and a correction of the proteins, fats and carbohydrates proportions in the rations led to a statistically significant rise in the lysozyme activity in the saliva of children during all the months of observation.

Anaesthesia, 1976 Nov, 31(9), 1261 - 6
The immediate use of antimicrobial agents; Andrews HJ; The use of antimicrobial agents in the surgical period is discussed with reference to the role of the anaesthetist in prophylaxis against the spread of infection in the patient, the treatment of established infection, the protection of the anaesthetist against infection from the patient and of the patient against the side-effects of the antimicrobial agents themselves.

J Antibiot (Tokyo), 1976 Nov, 29(11), 1226 - 9
7-(2-aminomethylphenylacetamido)-3-(1-carboxymethyltetrazol-5-ylthiomethyl)-3-cephem-4-carboxylic acid; Gottstein WJ et al.; The synthesis of 7-(2-aminomethylphenylacetamido)-(1-carboxymethyltetrazol-5-ylthiomethyl)-3-cephem-4-carboxylic acid (BL-S786) is described and the antimicrobial activities are compared with cefazolin and cefamandole . The compound exhibits broad antimicrobial spectrum, produces high intramuscular blood levels in mice and demonstrates a high degree of therapeutic efficacy in experimental bacterial infections in rodents.

J Antibiot (Tokyo), 1976 Nov, 29(11), 1203 - 8
Biological glycosidation of macrolide aglycones . I . Isolation and characterization of 5-O-mycaminosyl narbonolide and 9-dihydro-5-O-mycaminosyl narbonolide; Maezawa I et al.; Glycosidation of narbonolide with mycaminose was attempted by feeding narbonolide during the fermentation of a parent or a mutant strain of Streptomyces platensis, a producer of 16-membered macrolide antibiotics, platenomycins . As a result, two new compounds I and II were isolated from the fermentation broth and identified as 5-O-mycaminosyl narbonolide (I) and 9-dihydro-5-O-mycaminosyl narbonolide (II), respectively . Physicochemical and antimicrobial properties of I and II are also referred to.

J Antibiot (Tokyo), 1976 Nov, 29(11), 1182 - 8
The description and antibiotic production of Streptomyces hygroscopicus var . Geldanus; BeBoer C et al.; A new variety of Streptomyces hygroscopicus was isolated from a Kalamazoo soil . This isolate is described and identified as var . geldanus . When fermented in preferential media it produces geldanamycin, nigericin, nocardamine, and a libanamycin-like activity . Fermentation conditions, chromatographic separation, and antimicrobial spectra of the antibiotics are given.

J Antibiot (Tokyo), 1976 Nov, 29(11), 1163 - 70
Studies on juvenimicin, a new antibiotic . I . Taxonomy, fermentation and antimicrobial properties; Hatano K et al.; An actinomycete, strain No . T-1124, was found to produce new macrolide antibiotics, juvenimicins . Based on the results of taxonomic studies, the strain was considered to be a new variety of micromonospora chalcea and the name Micromonospora chalcea var . izumensis is proposed . This strain also produced everninomicin . The production of juvenimicins was stimulated by addition of ferrous sulfate and magnesium sulfate in the fermentation medium . Among juvenimicins, juvenimicin A3 exhibited the most potent antimicrobial activities against gram-positive bacteria and furthermore was active against gram-negative bacteria.

Am J Med, 1976 Nov, 61(5), 632 - 40
Visceral fungal infections due to Petriellidium boydii (allescheria boydii) . In vitro drug sensitivity studies; Lutwick LI et al.; Four patients with visceral infections due to the fungus Petriellidium boydii, who were recently hospitalized in our institutions, are described . Three of the patients were compromised hosts; in the fourth patient, infection occurred after trauma . All had received prior steroid and antibiotic therapy . Studies of patients with mycetoma or secondary infection of a pulmonary cavity due to this organism and of patients with visceral infections are reviewed . Because of histologic similarities to Aspergillus species, infections due to P . boydii may have been misdiagnosed in the past if the infecting fungus was not isolated in culture . The fungus has been shown to be resistant in vitro to currently available antifungal agents . Resistance to amphotericin and 5-fluorocytosine is demonstrated in our studies . There are few reports of successful chemotherapy of any manifestation of this infection, and no such reports of visceral disease . We demonstrate in vitro sensitivity of isolates in our cases and in others to micronazole, a new antimicrobial agent; this drug may be indicated for treatment of disease due to P . boydii.

J Infect Dis, 1976 Nov, 134 SUPPL, S242 - 8
Discovery, chemistry, and activity of amikacin; Kawaguchi H; Elucidation of the mechanism of R-factor-mediated resistance to aminoglycoside antibiotics was a noteworthy scientific achievement that led to the search for and design of new structural modifications of aminoglycosides that would render them resistant to inactivation by bacterial enzymes and increase their activity against resistant organisms . Amikacin is a derivative of kanamycin A, obtained through acetylation with the L(-)-gamma-amino-alpha-hydroxybutyryl side chain at the C-1 amino group of the deoxystreptamine moiety . Its antibacterial activity is generally equal to or greater than that of kanamycin against sensitive organisms, and it is also active against aminoglycoside-resistant strains of various species . The special significance of the site of acylation and the configuration of the acid side chain were established by obtaining all possible positional and configurational isomers . Studies of a series of amikacin analogs indicated that the alpha-hydroxyl group and the terminal basic function in the side chain both play a very important role in the antimicrobial activity of amikacin.

J Antibiot (Tokyo), 1976 Nov, 29(11), 1189 - 98
Biotransformation of antibiotics . II . Investigation of the chloramphenicol acetyltransferase in Streptomyces griseus; El-Kersh TA et al.; Additional parameters for the chloramphenicol acetyltransferase (CAT) activity in spores of S . griseus are substantiated . A linear increase in activity was observed with increasing spore number up to a concentration of 5 x 10(10) spores/ml . Similarly an increase of the chloramphenicol concentration up to 500 mug/ml increased the activity . However, a drastic decrease in activity was noted above this level suggesting inhibition of the enzyme by the substrate . The CAT activity in the spores was highly influenced by the pH of the medium reaching a maximum at pH 6.5 . This may suggest that CAT is apparently located to the outer surface of the spores and therefore very sensitive to variations in pH of the medium . The CAT showed a marked specificity for D-threo and D-erythrochloramphenicol, while no activity was observed with L-isomers . The enzyme acetylates D,L-erythrodechlor-chloramphenicol with a yield of 45% as compared to the D-threo parent antibiotic . While the tyrosinase characteristics (melanin formation) of S . griseus was eliminated by acriflavine or ethidium bromide treatment the CAT characteristic was persistent . The melanin negative variants retained all otherproperties of the parent strain including the production of antimicrobial agents; and revertants were not detected . The results suggest that the tyrosinase determinant gene is apparently located on an extrachromosomal element (plasmid) . On the other hand, the location of the gene for CAT is not assigned yet . The nature of CAT in growing cells and the spores of S . griseus was investigated . The results show that CAT accumulated during the sporulation phase or the vegetative growth is inducible in nature; therefore the morphogenetic sequence in the strain bears no influence on CAT induction.

Scand J Dent Res, 1976 Nov, 84(6), 377 - 80
Antimicrobial effect of four different toothpastes; Sjoblom M et al.; The study was undertaken to evaluate the antimicrobial effect of a commercial toothpaste, claimed to contain active chlorhexidine gluconate . Two traditional toothpastes and a 0.5% chlorhexidine gel were used as negative and positive control pastes . To exclude the effect of mechanical cleaning, all the agents were applied twice daily to the tooth surfaces by means of individually constructed acrylic cap splints . Ten dental students used each paste in a 4-week cross-over double-blind study comprising four test periods of 4 d duration . The students were allowed normal mechanical oral hygiene during the 3 d between the test periods . At the beginning and the end of each test period the tooth surfaces in the right halves of the jaws were scored for the Plaque Index, after which disclosing solution was used and the teeth of the left halves of the jaws were scored for stained plaque . Of all the toothpastes tested, only the chlorhexidine gel exhibited an antimicrobial effect comparable to that of efficient mechanical oral hygiene measures . The effect of the toothpaste with claimed chlorhexidine content did not differ from that of the two traditional toothpastes.

Am Rev Respir Dis, 1976 Nov, 114(5), 1021 - 5
Trimethoprim-sulfamethoxazole therapy of pulmonary melioidosis; John JF Jr; A 21-year-old-airman stationed in the Philippines presented with cavitary pulmonary melioidosis . When treated with trimethoprim-sulfamethoxazole, there was prompt resolution of his symptoms and the left upper lobe abscess cavity . It is suggested that this antimicrobial combination is an effective alternative regimen for pulmonary melioidosis.

Kosm Biol Aviakosm Med, 1976 Nov-Dec, 10(6), 73 - 6
{Hygienic evaluation of experimental samples of antimicrobial underwear containing hexachlorophene}; Borshchenko VV et al.; The hygienic examination of 12 samples of knitted underwear which contained hexachlorophene added during fiber formation allowed the selection of four types that can be used under poor sanitation conditions . Taking into consideration possible changes in the proportion of various micoorganisms during prolonged space flights, it is recommended to carry out a complex investigation in order to allow the use of the antimicrobial underwear by specific crewmembers during a certain period of time.

Natl Cancer Inst Monogr, 1976 Oct, 43, 187 - 91
Pulmonary and extrapulmonary support for patients with Pneumocystis carinii pneumonia; Geelhoed GW; Temporary extrapulmonary oxygenation may benefit selected patients with Pneumocystis carinii pneumonia who exhibit severe respiratory insufficiency . Four persons were considered candidates for extrapulmonary oxygenation with a membrane lung while under treatment for pneumocystis pneumonia . In one patient, attempts to institute membrane lung circulation were postponed until his condition was terminal . In another individual, membrane lung support was discontinued prematurely because of complications of anticoagulation . A third patient died of cardiac failure even though her oxygenation had improved during respiratory assistance . In the fourth, the membrane lung was used successfully to maintain the patient through therapy until lung recovery was adequate to resume vital function . The four cases presented are examples of the immunosuppression that creates susceptibility to pneumocystis pneumonia: In two patients, immunodeficiency was caused by lymphoma and combination chemotherapy for the underlying disease; in two others, immunosuppression was induced for the purposes of transplantation . Two patients underwent veno-venous perfusion for prepulmonary oxygenation, and one underwent venoarterial bypass with the membrane lung . Indications for, and techniques of, membrane lung bypass are reviewed . This method of extrapulmonary membrane lung support may save some patients with transient severe pulmonary insufficiency due to P, carinii pneumonia, and the membrane lung may be an adjunct to antimicrobial therapy.

Antibiotiki, 1976 Oct, 21(10), 867 - 72
{Development of an automated information retrieval system for the identification of antibiotics}; Fishman VM et al.; The basic points in the development of a specialized computer information search system providing ientification of new antibiotics at early stages of their investigation are described . The system of coding the physico-chemical properties of the agents and the spectra of their antimicrobial activity presenting the substance in the information bank is developed . The task of identification is to find in the reference bank according to some specially organized keys such antibiotics which are identical or close by their properties to the substance being identified . Mini-computer of M-6000 type is used as the technical base of the information search system . Preliminary organization of the bank specified by the coding system markedly reduces the requirements to the computer operative memory.

J Pharm Sci, 1976 Oct, 65(10), 1551 - 3
Antimicrobial activity of newly synthesized isothiocyanate derivatives against pathogenic plant microorganisms; Kojima M et al.; Fifteen reaction products of isothiocyanates with cysteine, seven reaction products of isothiocyanates with 2,3-dimercapto-1-propanol, and four reaction products of isothiocyanates with sulfanilamide were synthesized . Their antimicrobial activity against pathogenic plant microorganisms was investigated.

Health Lab Sci, 1976 Oct, 13(4), 267 - 70
The antimicrobial activity of embalming chemicals and topical disinfectants on the microbial flora of human remains; Burke PA et al.; The antimicrobial activity of embalming chemicals an topical disinfectants was evaluated to determine the degree of disinfection achieved during the embalming of human remains . The administration of arterial and cavity embalming chemicals resulted in a 99% reduction of the postmortem microbial population after 2 hours of contact . This level of disinfection was maintained for the 24 hours test period . Topical disinfection of the body orifices was also observed . Therefore, it is probable that present embalming practices reduce the hazard from transmission of potentially infectious microbial agents within the immediate environment of embalmed human remains.

Ann Microbiol (Paris), 1976 Oct, 127B(3), 337 - 50
{Experimental pyelonephritis in rats: value in the comparison of antibiotics (author's transl)}; Videau D; The author discusses the conditions which an experimental pyelonephritis must fulfill to provide therapeutic results which will allow the assessment of new therapeutic agents . He subjects the chosen model to the therapeutic effect of four antibiotics and three antimicrobial drugs . A numeric value is given to the bacteriuria recession slope observed during the experiment . A comparison of the results being obtained with the bacteriological and pharmacological data normally evaluated, the author demonstrates the value of the present study . The analysis of the results collected during the tests shows that comparison between antibiotics are of greater value when they are of the same family . Nevertheless, the experimental pattern, when applied to antibiotics as different as kanamycine and cephalosporins, give a very good correlation particularly when the overstepping coefficient, as proposed by Canetti, is calculated on the results expressed as free products.

J Pharm Sci, 1976 Oct, 65(10), 1505 - 10
Synthesis and properties of mesoionic pyrimido{1,2-b-a1pyridazine-2,4-diones and mesoionic pyridazino{2,3-a-a1-s-trizine-2,4-diones: mesoionic analogs structurally related to fervenulin; Coburn RA et al.; Derivatives of two new and unusual classes of heterocycles, possessing structural similarities to the broad spectrum antibiotic fervenulin, were synthesized and examined for in vitro antimicrobial activity . Only three of 17 mesoionic pyrimido{1,2-b}pyridazine-2,4-diones exhibited evidence of antimicrobial activity while seven of eight mesoionic pyridazino{2,3-a}-s-triazine-2,4-diones were active against one or more microorganisms . Susceptibility toward attack by nucleophiles of both mesoionic pyridazino{2,3-a}-s-triazine-2,4-diones and fervenulin was observed.

Surg Gynecol Obstet, 1976 Oct, 143(4), 561 - 4
A rationale for intraperitoneally administered antibiotic therapy; Smith EB; A satisfactory clinical response occurred in 96.7 per cent of 210 patients with proved bacterial peritonitis following appropriate surgical intervention and an antimicrobial regimen of 1 per cent cephalothin administered intraperitoneally, with supplementary antibiotics as indicated . Instillation of cephalothin achieves the therapeutic benefits of high intraperitoneal levels with an antibiotic of broad activity and minimum toxicity and permits flexibility in the choice of additional antimicrobial therapy . Adjuvant therapy with cephalothin did not result in peritoneal adhesions or significant abdominal pain . Clinical experience suggests that it may promote healing of anastomotic leaks . The results of this study indicate that intraperitoneally administered cephalothin is a significant factor in lowering the death rate in peritonitis.

Immun Infekt, 1976 Oct, 4(5), 203 - 10
{Atypical pneumonia, etiology and possibilities for the diagnosis (author's transl)}; Brunner H; Beginning with the antimicrobial chemotherapy a decrease in the incidence of bacterial pneumonias is accompanied by a relative increase in the incidence of the so-called atypical pneumonia . This disease syndrome is predominantly caused by Mycoplasma pneumoniae, Chlamydia psittaci, Coxiella burneti and various viruses . In addition, bacteria which are usually involved in lobar pneumonia may occasionally cause atypical pneumonias . The present publication is concerned with the most frequently occurring causative agents of atypical pneumonia, the epidemiology of the disease and the possibilities for the diagnosis.

Postgrad Med, 1976 Oct, 60(4), 75 - 80
Newer antibiotics: guidelines for use; Weinstein AJ; The number of antimicrobial agents available for use has increased significantly since the introduction of penicillin in the mid 1940s . Consequently, choosing among them has become an increasingly complex problem . In selecting an antibiotic, careful consideration must be given to the status of the patient and to the organism isolated . In addition, the physician must have detailed knowledge about the specific characteristics of each agent and must apply basic guidelines of antimicrobial therapy in order to make a rational choice.

Scand J Dent Res, 1976 Sep, 84(5), 304 - 7
Intraoral spread of the antimicrobial effect of a chlorhexidine gel; Saxen L et al.; The aim of the study was to determine the range of the antimicrobial effect of Hibitane Dental Gel (ICI, Macclesfield, England), containing 1% chlorhexidine, when used as a dentifrice while brushing . A standard toothpaste with no claim for antibacterial activity (Pepsodent) was used as a control . Twenty-four dental students brushed their teeth during two 4-day periods using the closed mouth technique, i.e . they kept their teeth tightly clenched and brushed only the facial tooth surfaces twice daily . Before and after each test period the lingual and linguomesial surfaces of the mandibular teeth were scored for clearly visible plaque . The facially applied chlorhexidine gel had no more effect on plaque growth lingually than the standard toothpaste which was used as control . The lack of effect of the gel was suggested to be due to an insufficient spread and penetration capacity of its antimicrobial component.

J Periodontol, 1976 Sep, 47(9), 535 - 7
Clinical reduction of gingivitis through the use of a mouthwash containing two quaternary ammonium compounds; Rosa M et al.; A commercially available antimicrobial mouthrinse was evaluated among students in Mexican boarding schools . The application was made daily for 3 months under the direct supervision of the project personnel . The observations indicated that the use of this mouthrinse decreased gingivitis substantially in comparison to the use of a control rinse which consisted of flavored water . It is concluded that this mouthwash, containing the known antimicrobial agents cetylpyridinium chloride and domiphen bromide, can be of clinical benefit if conscientiously applied as an adjunct in an oral hygiene regimen of regular toothbrushing with a dentifrice.

J Antibiot (Tokyo), 1976 Sep, 29(9), 923 - 7
New pleuromutilin derivatives with enhanced antimicrobial activity.II.Structure-activity correlations; Egger H et al.; Structural modification of the antibiotic pleuromutilin has afforded several derivatives with considerably enhanced activity against bacteria and mycoplasmas, and has permitted conclusions to be reached about structure-activity relationships . The carbonyl group in the five-membered ring and the hydroxyl group at C11 seem to be essential for activity . The vinyl group can be hydrogenated without loss of activity . Chemical modification at C14 offers the most possibilities for achieving the best activity and solubility properties . Mutilin, and other compounds with a free OH at C14, are inactive . It was shown that mutilin esters of substituted thioglycolic acids had distinctly superior MIC values, especially in combination with a tertiary amino group in the side chain, the latter group of derivatives having MIC values better than pleuromutilin by a factor of more than 10 . Further variation within this group led to the development of 14-deoxy-14-{(2-diethylaminoethyl) thioacetoxy}-mutilin hydrogen fumarate (81.723 hfu, tiamulin) for extensive investigation of its chemotherapeutic potential.

J Antibiot (Tokyo), 1976 Sep, 29(9), 915 - 22
New pleuromutilin derivatives with enhanced antimicrobial activity . I . Synthesis; Egger H et al.; A series of new derivatives of the antibiotic pleuromutilin, produced by some Basidiomycetes, was synthesized by chemical modification of natural pleuromutilin . Most of them contain basic functional groups in the side chain at C14 of the mutilin skeleton . The monotosylate of pleuromutilin was used as a versatile intermediate for displacement by N-, O- and S-nucleophiles.

J Antibiot (Tokyo), 1976 Sep, 29(9), 890 - 901
Nocardicin A, a new monocyclic beta-lactam antibiotic II . Structure determination of nocardicins A and B; Hashimoto M et al.; The structures of nocardicins A and B, novel monocyclic beta-lactam antibiotics produced by a strain of Nocardia, have been established as 1 and 2, respectively, on the basis of spectroscopic and chemical evidence . They are the first examples of monocyclic beta-lactam antibiotics possessing relatively high antimicrobial activity, and are stereochemically and biologically related to penicillins and cephalosporins.

J Pharm Sci, 1976 Sep, 65(9), 1301 - 5
Substitued 5-nitro-1, 3-dioxanes: correlation of chemical structure and antimicrobial activity; Lappas LC et al.; Various derivatives of 5-nitro-1, 3-dioxane were synthesized to determine the relative effect of chemical substitution in the 2-and 5-positions on broad spectrum antimicrobial activity . Each compound was evaluated quantitatively by calculation of a microbiocidal index, which measured the time to kill several different microorganisms . This test system indicated that 5-bromo-5-nitro substitution was essential for significant activity . Optimal activity was effected by 2-methyl substitution in the alkyl series and 2-hydroxy-phenyl substitution in the aryl series . The antimicrobial activity of the substituted dioxanes was not related directly to water solubility or hydrolysis to microbiocidal diols or aldehydes.

J Pediatr, 1976 Sep, 89(3), 406 - 11
Course of cystic fibrosis in 95 patients; Stern RC et al.; The course of 95 patients with cystic fibrosis is presented . Survivors have a mean follow-up period of over 14 years (minimum: 13 years) . Of 45 patients diagnosed prior to extensive irreversible pulmonary involvement, only one has died and none is disabled . In contrast, of the other 50 patients diagnosed after substantial irreversible pulmonary disease was present, 26 have died . Mortality and morbidity has been greater in females . Possible factors contributing to the improving prognosis include early diagnosis, aggressive management with comprehensive care, easy access to specialized care, and improved antimicrobial therapy.

Clin Exp Immunol, 1976 Sep, 25(3), 442 - 8
Antimicrobial factors in the exudates of skin windows in human subjects; McClelland DB et al.; The "skin window" technique in which the horny layer of the skin is abraded with a high speed grinder has been used to study the appearance of proteins with antimicrobial activity in the fluid accumulating in damaged human skin . The fluid was absorbed into paper discs and protein levels measured by radial diffusion . The skin exudates contained about 45% as much IgG and IgM as the subjects' serum, but the amount of IgA (68% of the serum level) in the exudate was significantly greater, suggesting selective transport into the lesion . The fluid also contains complement proteins, lysozyme and lactoferrin . The methods used in this study may provide useful information about clinical situations in which susceptibility to cutaneous infection is increased.

Gastroenterology, 1976 Sep, 71(3), 479 - 83
Fata eosinophilic enteritis; Tytgat GN et al.; A patient is reported with eosinophilic enteritis of the jejunum with fatal evolution . Surgical resection was considered impossible and medical treatment with corticosteroids, elemental diet, parenteral nutrition, and antimicrobials to combat the intestinal bacterial overgrowth failed to control the disease . The destructive and fatal nature of the reported eosinophilic enteritis raises the problem of classification of such disease entity, refractory to corticosteroid therapy.

J Antibiot (Tokyo), 1976 Sep, 29(9), 937 - 43
Structure-activity relationships among negamycin analogs; Uehara Y et al.; Various negamycin analogs were examined for (1) miscoding activity and (2) inhibition of the termination of protein synthesis . Since properties (1) and (2) do not correlate for the investigated compounds they may depend on different structural features of negamycin analogs . The results of biochemical and antimicrobial studies indicate that (a) the natural configuration of the carbon atom carrying the beta-amino group is essential, (b) the delta-hydroxyl group is unnecessary, and (c) the acylation of the epsilon-amino group causes loss of activity.

Br J Dermatol, 1976 Sep, 95(3), 311 - 6
The effect of long term tetracycline treatment for acne vulgaris on the occurrence of R factors in the intestinal flora of man; Valtonen MV et al.; R factors are known to be the most important mechanism of antimicrobial resistance of intestinal flora . Short courses with therapeutic doses (1000 mg/day) of tetracycline select for strains containing transferable resistance factors to more than one antimicrobial agent . In this report we show that long term treatment with very low doses (100 mg/day) of tetracycline for acne vulgaris has an equally strong effect favouring establishment of resistent strains and R factors in the intestinal flora of patients.

Res Vet Sci, 1976 Sep, 21(2), 132 - 40
In vitro studies on the antimicrobial effects of colostrum and milk from vaccinated and unvaccinated pigs on Escherichia coli; Nagy LK et al.; Unsupplemented porcine colostrum and milk exhibited a powerful bactericidal effect for porcine strains of E coli incubated in vitro at 37 degrees C . This activity was independent of complement but was susceptible to acid pH, to the presence of soluble iron and to the selective immunoprecipitation of IgG, IgA and IgM . Manifestation of bactericidal activity required bacteria in an active state of metabolism and the length of incubation was an important factor in demonstrating the quality of the anticoli activity, ie, proliferation-inhibitory, bacteriostatic or bactericidal . Whey obtained by acid precipitation or by the application of rennin was devoid of bactericidal activity but was capable of slowing down proliferation of E coli . There was no correlation between lysozyme and anticoli activity although the complete removal of lysozyme by adsorption on to bentonite reduced bactericidal titres . With very few exceptions the highest bactericidal titres were recorded for colostrum, but even 28 days post partum about one half of 22 undiluted milk samples exhibired bactericidal activity.

J Antibiot (Tokyo), 1976 Aug, 29(8), 824 - 8
Microbial transformation of antibiotics II . Additional transformation products of maridomycin III; Shibata M et al.; Streptomyces sp . strain No . K-245 was found to transform maridomycin III into four derivatives (A1, A2, A3 and A4) in addition to the transformation products reported previously . Isolation of the main product A1 was carried out by column chromatography on silica gel developed with CHCl3-MeOH (19:1) . From the partial investigation of the structure of A1, it proved to have a C-18-aldehyde group and C 4''-propionyl group but no antimicrobial activity . The relationships between A group's derivatives and known derivatives of maridomycin III are also discussed.

Arch Microbiol, 1976 Aug, 109(1-2), 65 - 74
Metabiolic products of microorganisms . Tirandamycin B(author's transl)}; Hagenmaier H et al.; Streptomyces flaveolus, strain Tu 1240 produces besides Tirandamycin A, a hitherto unknown antibiotic, which is closely related to Tirandamycin A . The new antibiotic Tirandamycin B contains one additional hydroxylgroup . Both antibiotics exhibit a similar antimicrobial spectrum and they seem to have the same mechanism of action . According to the data obtained from mass spectrometry, 13C-and 1H-NMR spectra formula II could be deduced for Tirandamycin B.

Stomatol DDR, 1976 Aug, 26(8), 510 - 6
{Comparative clinical and experimental studies of various denture cleansers . 2 . Testing of antimicrobial efficiency}; Ehmer D et al.; Agar diffusion plate tests were performed on five strains of micro-organisms to characterize the disinfecting properties of nine denture cleaners . Furthermore, the liberation of oxygen was determined as a function of time, and the course of pH variation of the various cleaning solutions was studied . The highest oxygen concentrations and the best antimicrobic activities were achieved by the preparations Eladent G and T.

J Med Chem, 1976 Aug, 19(8), 1020 - 6
Synthesis and antiviral and antimicrobial activity of certain 1-beta-D-ribofuranosyl-4,5-disubstituted imidazoles; Srivastava PC et al.; Starting with AICA ribonucleoside the following nucleosides were prepared . Methyl 5-amino-1-(2,3,5-tri-O-acetyl-beta-D-ribofuranosyl)imidazole-4-carboxylate (5) was converted into methyl 5-chloro-1-(2,3,5-tri-O-acetyl-beta-D-ribofuranosyl)imidazole-4-carboxylate (6) via diazotization in the presence of cuprous chloride . Similarly, 5-amino-1-(2,3,5-tri-O-acetyl-beta-D-ribofuanosyl)imidazole-4-carbonitrile (9) was converted into 5-chloro-, 5-bromo-, and 5-iodo-1-(2,3,5-tri-O-acetyl-beta-D-ribofuranosyl)imidazole-4-carbonitrile derivatives . These 5-halogenated imidazole nucleosides were treated with several nucleophiles such as ammonia, hydroxylamine, and hydrogen sulfide to provide, respectively, 5-haloimidazole-4-carboxamide, 5-haloimidazole-4-carboxamidoxime, and 5-haloimidazole-4-thiocarboxamide ribonucleosides . 5-Chloro- or 5-bromo-1-(2,3,5-tri-O-acetyl-beta-D-ribofuranosyl)imidazole-4-carbonitrile was treated with potassium hydrosulfide to yield 5-mercapto-1-beta-D-ribofuranosylimidazole-4-thiocarboxamide (16) . The catalytic reduction of 5-chloro- or 5-bromo-1-beta-D-ribofuranosylimidazole-4-carboxamidoxime provided 1-beta-D-ribofuranosylimidazole-4-carboxamidines as their hydrochloride and hydrobromide salts, respectively . These nucleosides were tested for in vitro antiviral, antifungal, and antibacterial activity . The 5-halo analogues of 1-beta-D-ribofuranosylimidazole-4-carboxamide showed significant antiviral activity whereas compound 16 was found inhibitory to fungi.

Ann Intern Med, 1976 Aug, 85(2), 237 - 45
5-Azacytidine . A new anticancer drug with effectiveness in acute myelogenous leukemia; Von Hoff DD et al.; Clinical studies involving 5-azacytidine, a ring analogue of cytidine, began in Europe in 1967 and the United States in 1970, and we review available preclinical and clinical studies here . The drug possesses cytotoxic, antimicrobial, antineoplastic, abortive, and mutagenic activity in various biological systems . 5-Azacytidine is thought to exert its antineoplastic effect through interference with nucleic acid metabolism . The dose-limiting toxicities are nausea, vomiting, and leukopenia, while the incidence of thrombocytopenia is low . Hepatic toxicity ranges from abnormal findings in liver function tests to hepatic coma . Clinical results in solid tumors are not encouraging, but 5-azacytidine shows consistent antitumor activity in patients with acute myelogenous leukemia resistant to previous treatment . An overall response rate of 36%, with 20% complete remissions, was achieved in 200 previously treated patients with acute myelogenous leukemia . Further studies must define the role of 5-azacytidine alone and in combination for the first-line treatment of acute myelogenous leukemia.

Schweiz Med Wochenschr, 1976 Jul 17, 106(29), 994 - 7
{Pneumomediastinum and mediastinitis, rare complications of a lung abscess . 1 case}; Weber W et al.; A case is reported with pneumomediastinum and mediastinitis complicating lung abscess in the lingula of a 77-year-old man . Causative factors were the association of virulent organisms having necrotizing properties in a host with diminished resistance and location of the cavity adjacent to the mediastinal pleura . A review of 1119 documented patients with lung abscess revealed that this complication has been reported only twice previously . Early surgical drainage combined with systemic administration of antimicrobial agents are the most effective therapeutic measures for mediastinal infection . Therefore, close observation is required of patients with lung abscess adjacent to mediastinal structures.

Indian Pediatr, 1976 Jul, 13(7), 517 - 20
Treatment of small bowel diarrhea with electrolyte glucose drink; Chakrabarti GC et al.; PIP: The results of 102 cases treated with an oral electrolyte-glucose solution for rehydration caused by mild cases of small bowel diarrhea without using an antimicrobial agent in conjunction are presented . Clinical features, such as frequency of loose bowel movement, age distributions, and other relevant symptomatology are provided tabularly . The solution used consisted of: sodium chloride, .85 gm; potassium bicarbonate, 1 gm.; glucose, 17.5 gm.; boiled and cooled water, 500 ml . 97 of 102 were treated only with the oral electrolyte-glucose solution, and the remainder received intravenous fluid before initiation of oral rehydration . Due to follow-up problems, 13 cases were omitted from the statistical analysis; of the remaining 89, 84 were controlled within 72 hours (as judged by cessation of loose bowel movements) . During therapy, breastfeeding or cow's milk was expressly forbidden, but 4 of the 5 failures were later discovered to have recieved breastfeedings, and 1 was marasmic . The treatment of small diarrhea, not having persistent vomiting or shock, with some suitable oral electrolyte-glucose solution only is highly successful, safe, and inexpensive . Success rate was 94.38% .

Ann Clin Lab Sci, 1976 Jul-Aug, 6(4), 306 - 11
Chronic toxic nephropathies--diagnosis and management; Balter P et al.; As a result of industrial and medical progress, man is exposed to an ever changing array of chemicals, drugs and biological products . The kidneys are extremely vulnerable to chronic toxic effects of these substances . Although acute renal failure, nephrotic syndrome and renal tubular disorders result from acute nephrotoxicity, chronic renal failure with renal failure and hypertension result from chronic nephrotoxicity . Heavy metals, analgesic agents and antimicrobials are the common nephrotoxic substance producing chronic renal disease . Medical management consists of preventive exposure measures and early detection of nephrotoxicity by modern industrial medicine . In addition, early clinical diagnosis with appropriate management may prevent the need for chronic hemodialysis and renal transplantation.

Mutat Res, 1976 Jul, 40(3), 261 - 8
Effect of tetracycline on cultured mouse cells; Tsutsui T et al.; By use of an assay system in vitro with cultured FM3A cells from a C3H mouse mammary carcinoma, tetracycline hydrochloride was found to have the ability to induce an 8-azaguanine-resistant mutation . It is suggested that an assay system using mammalian cells for the detection of mutagenicity of certain substances having antimicrobial action is more practical than a system using bacteria . As other effects of tetracycline hydrochloride on FM3A cells, the damage on chromosomes and the inhibition of syntheses of protein and nucleic acids were demonstrated.

Lloydia, 1976 Jul-Aug, 39(4), 204 - 12
Alkaloids of Thalictrum . XV . Isolation and identification of the hypotensive alkaloids of the root of Thalictrum lucidum; Wu WN et al.; Sixteen alkaloids, namely homoaromoline, obaberine, O-methyl-thalicberine, oxyberberine, thalidasine, thaliglucinone, thalrugosine, obamegine, oxyacanthine, berberine, columbamine, jatrorrhizine, magnoflorine, palmatine, thalifendine and base A chloride, plus the artifact, 8-trichloromethyldihydroberberine, were isolated from the alkaloid fraction of the roots of Thalictrum lucidum L . Of these, obamegine, thalrugosine, O-methylthalicberine, thaliglucinone, obaberine and homoaromoline were found to possess hypotensive activity in normotensive dogs . Thalidasine, homoaromoline, thalrugosine, thaliglucinone, obamegine, jatrorrhizine, and columbamine were found to possess antimicrobial activity against Mycobacterium smegmatis at a concentration of 100 mug/ml or less.

J Pharm Sci, 1976 Jul, 65(7), 1074 - 8
Antimicrobial agents: synthesis and antimicrobial activity of new aryloxyalkyl esters of p-hydroxybenzoic acid; Shridhar DR et al.; Several new aryloxyalkyl esters of p-hydroxybenzoic acid were synthesized and screened for in vitro antimicrobial activity . Although a few compounds showed low antifungal activity, many possessed appreciable in vitro antibacterial activity . However, none of these compounds was active against Mycobacterium tuberculosis (H37Rv).

Acta Paediatr Scand, 1976 Jul, 65(4), 519 - 20
Pseudomonas cepacia pneumonia in a child with chronic granulomatous disease and selective IgA deficiency; Sieber OF Jr et al.; A 6 1/2 year-old boy with chronic granulomatous disease (CGD) and selective IgA deficiency developed a chronic progressive pneumonia which failed to respond to several conventional combinations of antimicrobial therapy . On lung biopsy, Pseudomonas cepacia was obtained in pure culture, sensitive to chloramphenicol, tetracycline, kanamycin and nalidixic acid . With specific therapy, he slowly recovered . P . cepacia has not been previously described as a cause of persistent pneumonia in immunodeficient children . The occurrence of CGD and selective IgA deficiency together is a very rare combination of immunodeficiencies.

J Am Geriatr Soc, 1976 Jul, 24(7), 323 - 8
The problem of pressure sores in a nursing home population: statistical data; Michocki RJ et al.; This study on 93 patients was conducted at a skilled nursing facility . Twenty-two of the 93 patients had pressure sores; 34 of the 54 sores were present when the patients were admitted and 20 developed after admission . Only 5 of the 54 sores healed . Healing times ranged from 15 to 55 days after the beginning of treatment . Thirteen deaths occurred among the 71 patients without sores, and 17 deaths among the 22 patients with sores . Specific treatment regimens varied (cleaning solutions, antimicrobial drugs, heat, enzymatic debridement) but always included frequent changes in the position of the patient . Ten of the 22 patients with sores were anemic vs . 19 of the 71 patients without sores . Half of the patients with sores were maintained with tube feedings whereas more than half of the patients without sores received regular house diets . Pressure sores are a serious problem among geriatric patients in nursing homes . All those who care for the aged should be fully aware of the procedures involved in the prevention and management of these sores.

Can J Comp Med, 1976 Jul, 40(3), 247 - 51
Characterization of enterotoxigenic bovine Escherichia coli; Sivaswamy G et al.; Among 300 isolates of bovine Escherichia coli, 56 which had been found enterotoxigenic in calf gut loops were characterized on the basis of O and K antigens, colonial morphology and resistance to seven antimicrobial drugs . The 56 isolates enterotoxigenic in the calf were compared with the nonenterotoxigenic ones . Of the 56 enterotoxigenic E . coli the majority possessed the A type of K antigen and had OK groups, O9:K(PS274) or O101:K(RVC118) . Fourteen of these isolates had the K99 antigen . None of 27 isolates found enterotoxigenic in the piglet but not in the calf possessed the K99 antigen or belonged to OK groups O9:K(PS274) or O101:K(RVC118) . Comparison of the patterns of resistance to seven antimicrobial drugs showed that all enterotoxigenic and nonenterotoxigenic isolates were susceptible to nitrofurantoin and sulphachlorphyridiazine and that there was no significant difference in the patterns between the two groups . The majority of enterotoxigenic isolates were mucoid, whereas most of the nonenterotoxigenic isolates were nonmucoid.

Gut, 1976 Jul, 17(7), 495 - 500
Antibiotics in biliary disease: the relative importance of antibiotic concentrations in the bile and serum; Keighley MR et al.; A randomised controlled trial has been performed in 150 patients undergoing biliary operations to determine whether an antibiotic which is excreted almost entirely in bile (rifamide) is to be preferred to one having satisfactory serum levels only (gentamicin) . Patients were allocated to one of three groups: 50 received gentamicin, 50 received rifamide, and there were 50 controls who received no antibiotic cover . In the absence of duct obstruction, rifamide achieved extremely high bile levels but low serum concentrations . However, in jaundiced patients, both the bile and the serum concentrations of rifamide were too low to be of therapeutic value . The incidence of postoperative sepsis was not reduced by rifamide compared with controls . In contrast, gentamicin achieved adequate serum concentrations in 88% of patients . Despire poor bile levels, gentamicin was associated with a significant reduction of wound infection from 22% to 6% and septicaemia from 14% to 2% compared with controls . To reduce the septic complications of biliary operations, adequate serum levels of an effective antimicrobial are more important than an antibiotic, which is excreted almost entirely into the bile.

J Pediatr, 1976 Jul, 89(1), 66 - 72
A controlled study of intrathecal antibiotic therapy in gram-negative enteric meningitis of infancy . Report of the neonatal meningitis cooperative study group; McCracken GH Jr et al.; Eighteen institutions collaborated in evaluating the comparative efficacy of combined ampicillin and gentamicin therapy with and without intrathecal administration of gentamicin on the clinical and bacteriologic responses of 117 infants with meningitis caused by gram-negative enteric bacteria . There was a random distribution of patients within the two study groups with regard to age on enrollment, birth weight, sex, race, number of infants greater than 30 days of age, the etiologic agent, and their antimicrobial susceptibilities . There were no statistically significant differences (P greater than 0.05) in mortality, morbidity, or days that cerebrospinal fluid cultures remained positive among the infants in the two treatment groups . The case fatality rate for all patients was 32%; that for full-term infants (18%) was significantly lower (P less than 0.01) than that for low-birth-weight infants (45%) or for the patients greater than 30 days of age (48%) . Fifty-one of the 80 (64%) survivors were assessed as normal on follow-up examinations performed up to four years after illness.

Zentralbl Bakteriol {Orig B}, 1976 Jul, 162(1-2), 106 - 13
{On the effect of particulate airborne substances on various micro-organisms (author's transl)}; Ruden H et al.; Experimental studies on the reaction of micro-organisms on fine-dust filters (type C) and high-efficiency particulate air filters (type R and S) have shown no evidence of a growth of microorganisms . Therefore efforts were aimed at detecting antimicrobial factors which were supposed to exist in the precipitated acidic continental aerosol . With this in mind, air filters from different locations and with service times were extracted in water and the extract was tested for its antimicrobial effects . Die-off rates are used to demonstrate the influence of such extracts with varying concentrations of substances and pH values on bacteria.

J Antibiot (Tokyo), 1976 Jun, 29(6), 618 - 22
Samarosporin, a new peptide antibiotic . I . Fermentation, isolation ahd characterization; Inoue N et al.; A new antibiotic, samarosporin, was isolated in a crystalline state from a mycelial extract of a strain of Samarospora species (an ascomycete) . Samarosporin is a neutral cyclopeptide and has a molecular formula of C72H111N15O19 . Samarosporin shows a broad antimicrobial activity against various test microorganisms.

J Trauma, 1976 Jun, 16(6), 488 - 95
The influence of route of administration on wound fluid concentration of prophylactic antibiotics; Alexander JW et al.; The effectiveness of prophylactic antibiotics is dependent upon both the antimicrobial potency of the drug and the time at which it is first administered . Effectiveness is progressively lost when therapy is delayed, and it is generally recognized that drugs administered only 3-4 hours after contamination of a wound are largely without benefit . Another factor potentially influencing effectiveness in the traumatized patient is the considerable variation in the rate in which various antibiotics penetrate into the interstitial fluid compartment of surgical or traumatic wounds . The present study investigated the effect of route and method of administration of ampicillin, gentamicin, clindamycin, tetracycline, and cephalothin on subsequent wound fluid concentrations . Equivalent doses of each antibiotic were administered by either intermittent intravenous bolus (IV Push), continuous IV infusion (IV Cont) or intermittent intramuscular injection (IM) . Peripheral blood and wound tissue fluid from previously implanted stainless steel cylinders were sampled sequentially during an 18 to 24 hour period and assayed for concentration of the antibiotic . Each antibiotic had a different pattern of distribution between serum and wound tissue compartments, but in general, the IV Push method showed comparable levels in wound fluid 4-12 times faster than the IV Cont method . After 12 hours, the highest sustained antibiotic concentrations in wound fluid was usually achieved with the IM route . These data suggest that the earliest and most sustained levels of antibiotic in wound tissue fluid can be achieved by a simultaneous IV Push and IM injection of the drug followed by intermittent IM injections in the normotensive patient or by an IV Push followed by IV Cont administration for patients in shock . These techniques are recommended when it is not possible to administer prophylactic antibiotics before bacterial contamination has occurred, such as regularly occurs in the traumatized patient, especially when treatment is delayed.

J Med Chem, 1976 Jun, 19(6), 814 - 6
Imidazo(1,2-c)pyrimidine nucleosides . Synthesis and biological evaluation of certain 1-(beta-D-arabinofuranosyl)imidazo(1,2-c)pyrimidines; Bartholomew DG et al.; The first chemical syntheses of the arabinosylhypoxanthine and arabinosylguanine analogues of the imidazo-{1,2-c}pyrimsdine series are described . Condensation of trimethylsilyl-7-chloroimidazo{1,2-c}pyrimidin-5-one (1) with 2,3,5-tri-O-benzyl-alpha-D-arabinofuranosyl chloride (2) gave 7-chloro-1-(2,3,5-tri-O-benzyl-beta-arabinofuranosyl)imidazo{1,2-c}pyrimidin-5-one (3) which on catalytic dehalogenation furnished 1-(2,3,5-tri-O-benzyl-beta-D-arabinofuranosyl)imidazo{1,2-c}pyrimidin-5-one (4) . Amination of 3 gave 7-amino-1-(2,3,5-tri-O-benzyl-beta-D-arabinofuranosyl)imidazo{1,2-c}pyrimidin-5-one (5) . Reductive hydrogenolysis of 4 and 5 gave 1-(betaD-arabinofuranosyl)imidazo{1,2-c}pyrimidin-5-one (6), the arabinosylhypoxantine analogue, and the corresponding 7-amino isomer 7, the arabinoosylguanine analogue, respectively . The unequivocal assignment of the site of glycosylation and the anomeric configuration have been established . None of the compounds exhibited significant antiviral or antimicrobial activity in vitro.

Mutat Res, 1976 Jun, 38(3), 215 - 24
Genetic activity of the antimicrobial food additives AF-2 and H-193 in Saccharomyces cerevisiae; Shahin MM et al.; The genetic activity of the antimicrobial food additives AF-2 and H-193 has been investigated in Saccharomyces cerevisiae . The strains chosen for the present studies were D5 for the induction of mitotic recombinational events and XV185-14C for the induction of reversion of the mutants lys1-1, his1-7 and homs3-7 . When three concentrations (25, 50 and 100 mug/ml) of AF-2 were used in the reversion system of strain XV185-14C, there was an increase in the frequency of hom+ and his+ revertants as a function of incubation time, while the lysine mutant exhibited a very low frequency of induced reversion . When AF-2 and H-193 were compared at the same concentration and exposure time, AF-2 exhibited a higher genetic activity in both systems than H-193 . However, H-193 was genetically more active in inducing revertants than AF-2, when the comparison was made at the same survival level . Cells of both haploid and diploid strains were found to be more sensitive to inactivation by AF-2 than by H-193 It should be pointed out that the solubility of H-193 was lower (about 4 mug/ml saturation) than the solubility of AF-2 (120 mug/ml saturation) . The haploid strain was more sensitive to both compounds than the diploid strain.

West Afr J Pharmacol Drug Res, 1976 Jun, 3(1), 50P - 55P
Medical treatment of sexually transmitted disease in developing countries I: Gonorrhoea; Osoba AO; The statistics relating to the incidence of sexually transmitted diseases in many developing countries are not available and where there are, they are unreliable . Nevertheless, the impression of many physicians is that they constitute serious public health problems as they are endemic in some developing countries . The facilities for diagnosis and treatment of the diseases have been briefly discussed . The merits and the demerits of various antimicrobial agents have been outlined with the causes of failure of treatment in the developing countries . The economic importance of the "traitment minute" in the tropical environment has been stressed because of its economic advantage in terms of time spent in overcrowded hospitals . The resultant effect of the widescale misuse of antibiotics in developing countries has been suggested as a cause of the increasing resistant strains encountered . A plea is made for stricter control of the antimicrobial agents in developing countries.

Arch Surg, 1976 Jun, 111(6), 707 - 10
Surgical treatment of infective valvular endocarditis; Palafox BA et al.; Infective valvular endocarditis, whether occurring on a native or prosthetic heart valve, continues to carry a serious prognosis . Death is usually due to congestive heart failure, arrhythmia, or embolic complications, rather than infection per se . While antimicrobial therapy and medications to control congestive heart failure continue to be the treatment of choice in most cases, early valve replacement is indicated in certain situations . During the past four years, 12 patients underwent valve replacement for infective endocarditis . Six patients underwent elective valve replacement after antibiotic or antifugal therapy . All survived the operation and were improved . Six other patients underwent emergency valve replacement . Two patients died intraoperatively and their operations, in retrospect, were delayed unnecessarily . Four patients survived and are improved . Prosthetic valve replacement during the course of infective valvular endocarditis should be considered based on indications such as congestive heart failure, rhythm disturbances, etc, rather than the status of the infection.

Am J Obstet Gynecol, 1976 May 15, 125(2), 212 - 4
Studies on the antimicrobial activity of amniotic fluid; Miller J et al.; Sixty-one amniotic fluid samples from women in their second and third trimesters of pregnancy were examined for antimicrobial activity . Seventy per cent of the fluids were found to be active . The factor or factors responsible for this activity were present in low concentrations . The presence of spermine in the fluids accounted for some of the antimicrobial activity.

Appl Environ Microbiol, 1976 May, 31(5), 718 - 22
Resistance of a strain of Pseudomonas cepacia to esters of p-hydroxybenzoic acid; Close JA et al.; Cells of a strain of Pseudomonas cepacia were isolated from an oil-in-water emulsion containing methyl and propyl p-hydroxybenzoates (methylparaben and propylparaben) as preservative additives . This strain demonstrated the ability to destroy these additives, to utilize the propyl ester as sole carbon source, and to hydrolyze the methyl ester . When the isolate was grown on Eugon agar, exposure to the methyl ester killed 99.9% of the inoculum, but the surviving cells grew logarithmically . On the other hand, cells grown on media containing propylparaben were less susceptible when subsequently exposed to emulsions containing methylparaben . These observations demonstrate one mechanism by which microorganisms develop resistance to antimicrobial preservatives.

Urology, 1976 May, 7(5), 499 - 500
Bacterial prostatitis: treatment with trimethoprim-sulfamethoxazole; McGuire EJ et al.; Fifteen patients with chronic bacterial prostatitis were treated with trimethoprim-sulfamethoxazole for three months . In 60 per cent of the patients a recurrence of chronic bacterial prostatitis developed during a follow-up period of from one to two and one-half years . It appears that factors other than a diffusion barrier to effective antimicrobial agents into the prostatic gland are responsible for the persistence of chronic bacterial infections of the prostate.

Am Rev Respir Dis, 1976 May, 113(5), 637 - 41
Etiologic diagnosis of intrapleural empyema by counterimmunoelectrophoresis; Coonrod JD et al.; Cultural methods failed to identify the infecting organism in 4 patients with intrapleural empyema . Antimicrobial drugs had been administered to 3 of the patients before their admssion to the hospital . In each case, soluble polysaccharides believed to be those of pneumococcus or hemophilus were detected in the empyema fluid by counterimmunoelectrophoresis . These findings provided a rational basis for management of antimicrobial therapy for 3 of the patients and useful information on the origins of the empyema in the fourth patient . Counterimmunoelectrophoresis is a useful additional method for presumptively identifying the infecting organism in patients with intrapleural empyema.

Antibiotiki, 1976 May, 21(5), 441 - 4
{Lysozyme as a local defense factor in the gastrointestinal tract of patients with chronic diseases of the digestive organs}; Kudinova TI; No microbial growth in platings of the gastric juice of patients with gastric ulcer and chronic anacidic gastritis was observed . It means that the absence of hydrochloric acid in the gastric juice does not deprive it of any antimicrobial action . The possible role of lysozyme in providing sterility of the proximal part of the gastro-intestinal tract was studied . Eighty patients with chronic diseases of the digestive organs were observed . It was noted that the levels of lysozyme in the gastric juice was high and markedly exceeded the maximum concentrations required for lysis of organisms most resistant to it . The maximum concentration was determined at pH of the gastric juice equal to 7.0-7.5 (265 gamma/ml+/-28) . No lysozyme in the content of the duodenum and jejunal juice was found in most cases . Its presence in the above parts of the gastro-intestinal tract was mainly associated with microbial growth . The maximum concentration of lysozyme (40 gamma/ml) in the jejunal juice was observed in a female patient with chronic enterocolitis and significant microbial proliferation in the thin colon (more than 10(4) microbial bodies per 1 ml of the juice) . Such parallelism between the presence of lysozyme in the gastric juice and microbial proliferation in it may be considered as a protective-adoptive reaction of the host.

J Antibiot (Tokyo), 1976 May, 29(5), 554 - 8
A new semisynthetic 7alpha-methoxycephalosporin, CS-1170: 7beta-((cyanomethyl)thio)acetamido)-7alpha-methoxy-3-((1-methyl-1H-tetrazol-5-yl)thio)methyl)-3-cephem-4-carboxylic acid; Nakao H et al.; The synthesis and antimicrobial activity of a new semisynthetic 7alpha-methoxycephalosporin,7beta {{(cyanomethyl)thiol}acetamidol}-7alpha-methoxy-3-{{(1-methyl-1H-tetrazol-5-yl)thio}-methyl}-3-cephem-4-carboxylic acid (CS-1170), are described . This compound shows interesting antibacterial activity when compared to cefoxitin and cephalothin.

J Pharm Sci, 1976 May, 65(5), 660 - 4
Synthesis of 3-substituted thieno {2, 3-d} pyrimidin-4(3H)-one-2-mercaptoacetic acids and their ethyl esters for pharmacological screening; Devani MB et al.; 3-Substituted thieno {2, 3-d} pyrimidin-4(3H)-one-2-mercaptoacetic acids and their ethyl esters were synthesized from 2-mercaptothieno {2, 3-d} pyrimidin-4(3H}-ones, which were obtained by cyclization of thienylthioureas in acidic medium . Analgesic, anti-inflammatory, and anticonvulsant activities were found in some of these compounds . Significant antimicrobial activity was exhibited by thienylthioureas.

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