The new 4-quinolones have excellent broad-spectrum antibacterial activity. Pharmacokinetic studies show that they are reliably absorbed when given orally and reach high tissue levels. They are effective in animal models of systemic infections, with activity comparable to that of current antimicrobial regimens. Their use to date in systemic infections in humans has not been extensive, but results in the treatment of severe infections, including bacteremia, osteomyelitis, and pneumonia have been encouraging. The few comparative studies that have been undertaken confirm the efficacy of these agents. The limited experience with these drugs in the treatment of infection in the immunosuppressed host is largely favorable. Emergence of resistance, although demonstrable in vitro, does not appear to pose a clinical problem, although addition of a second agent may be advantageous. These drugs appear to be well tolerated, with gastrointestinal disturbance being the most commonly reported adverse effect.

Acute Disease↗

PubMedDate not supplied

The treatment of intractable encopresis: a team intervention approach.

Childhood encopresis is discussed in terms of problems of definition, approaches to management in relation to symptoms and underlying mechanisms, and efficacy of treatment. Case histories of six intractable clinic cases are examined and an intensive team intervention programme described. Difficulties in carrying through a consistent plan are outlined: the key worker providing an essential motivational role towards participant staff, parents and child.

Adolescent↗

PubMedDate not supplied

Trimethoprim-polymyxin B sulfate cream versus fusidic acid cream in the treatment of pyodermas.

One hundred patients with a clinical diagnosis of a primary or secondary superficial pyoderma were entered into a double-blind study. They were allocated treatment with either trimethoprim-polymyxin B sulfate cream or fusidic acid cream according to a fully randomized treatment code. Data suitable for evaluation were obtained from 87 patients, and statistical analysis revealed trimethoprim-polymyxin B sulfate (TP) cream to be significantly better than fusidic acid cream in alleviation several of the individual signs and symptoms associated with pyogenic infection of the skin as well as in reducing the overall severity score at the end of the 2-week study period.

Administration, Topical↗

PubMedDate not supplied

Seizure frequency and major life events in epilepsy.

A group of 18 patients with chronic epilepsy were followed in an outpatient clinic for 1-6 years. Month-by-month seizure records were kept and the response to treatment was systematically explored. The present study was prompted when three patients became seizure-free, apparently in response to major life events (marriage, parenthood, and retirement) rather than to changes in treatment. All the subjects were interviewed in their own homes with a companion, friend, or relative present. The interview was based on a standard instrument (Life Experiences Survey, LES). The home environment was chosen to facilitate recall of events and to enable subjects to confirm dates. The seizure record was then compared with the parallel life events record. Two methods of analysis were adopted. In the first, each life event was assumed to have impact on seizure frequency only during the month in which it occurred; life event months were compared with non-life-event months. In the second, a life event was considered a watershed; seizure frequencies before and after the event were compared. Nonparametric statistical methods were used. These approaches revealed associations between life events and seizure frequency in three additional patients (total six). Most of the patients who showed an association experienced partial seizures.

Adult↗

PubMedDate not supplied