[Clinical application of clindamycin-2-phosphate to otorhinolaryngological infections (author's transl)].
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Nonspore-forming anaerobic microorganisms were isolated in 83.3% of patients with suppurative-inflammatory diseases (SID) of ENT organs. It was found that so-called sterile inoculations of the pus from the inflammation focus were produced by obligate anaerobes and primarily by bacteroids and gram-positive anaerobic cocci present. The application of anaerobic bacteriological procedures for examining the pathological samples from these patients enlarged significantly the spectrum of isolated microorganisms at the expense of obligate anaerobes. They formed predominant microorganisms of the suppurative-inflammatory focus causing SID due to microbial synergism. It was demonstrated that gas-fluid chromatography can be successfully used to rapidly identify anaerobic infection. Effective drug therapy of SID of ENT organs should address anaerobic microflora and should include agents with antianaerobic action.
Concerning five observations of cervico-facial actinomycosis in the O.R.L. ward of Charles-Nicolle hospital, authors report sings, diagnosis and bacteriology. The cure consists in the extracting of the teeth concerned, the removal of the necrosed tissues and an antibiotherapic treatment based on ligh doses of penicillin relaying with cyclins.
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A report on experience with adenoidectomies, tonsillectomies, and adenotonsillectomies carried out at the Hospital for Sick Children, Toronto in the period 1968-75. Operations were performed on 25,443 patients during this period. Reasons for the reduction in T&A operations in recent years are considered, and views are expressed regarding when such operations are indicated, age of patient for surgery, the allergic child, cleft palate patient, the presence of quinsy, cardiopulmonary changes, subluxation of cervical spines, anesthesia, and postoperative care and complications.
Each stage of life is characterized by the prevalence of certain affections; among others, inflammatory diseases of the ear, nose and throat are frequent in old age. Therefore, specific problems of chemotherapy in old age are dealt with in general terms in the introduction, with special stress being placed on the functions of individual organs, mainly of the kidneys, and on questions of disturbed absorption. Inflammations caused by streptococci, requiring at least ten days of antibiotic treatment, always deserve particular attention, and so do staphyloccocal diseases, requiring the selective administration of semi-synthetic pencillines (sioxazol preparations). Penicillin is still the first choice among all antibiotics, penicillin substitutes, to be used in case of allergies, are listed according to their order of value. As anaerobic germs may also be present in the ENT area, the effective modern therapy by means of special antibiotics is also referred to. Finally, due consideration is given to local antibiotic therapy, with an emphasis on the ototoxicity of chemotherapeutical agents, such as amino-glycosides.
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The controversy over the efficacy of adenotonsillectomy is resolved in only very select clinical situations. An attempt is made to summarize and objectively criticize available data in this ongoing debate.
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