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A method for studying antibiotic concentrations in inflammatory exudate.

A new technique is described for studying antibiotic concentrations in an experimental inflammatory exudate in vivo. In most exudates concentrations of four antistaphylococcal drugs which were of potential therapeutic significance could be assayed, and fucidin appeared to diffuse best. Higher concentrations of all antibiotics gained access to the lesion in the first two hours of inflammation, suggesting that their mobility did not depend on binding to cells during the inflammatory response. The technique may ultimately help to elucidate the relationship between antibiotics and host defences at the primary sites of infection.

Adult↗

Anti-gamma haemolysin as a diagnostic test in staphylococcal osteomyelitis.

The anti-alpha-haemolysin test is widely used in the diagnosis of staphylococcal osteomyelitis. An additional test would be welcomed because raised antibodies to this antigen are not seen in all proven cases. This communication reports that anti-gamma-lysin was present in the serum of most of the 19 patients with proven staphylococcal osteomyelitis studied here. In two cases followed up after chemotherapy was initiated both tests indicated the satisfactory progress of the patient.

Adolescent↗

Progress towards agreement in reports of antibiotic sensitivity.

Results of three quality control trials of antibiotic sensitivity testing carried out on staphylococci by the Birmingham Regional Bacteriologists Group are presented. An overall reduction in the number of discrepant results from 5.2 to 1.2% when retesting the same organisms was thought to be due largely to the alteration in methods of testing for resistance to neomycin- and penicillinase-resistant antibiotics. Improvements were noted in the performance of all laboratories, which were felt to be due partly to participation in the trials.

Cephalosporins↗

Comparison of susceptibility of Neisseria meningitidis to sodium sulphadiazine and sodium fusidate in vitro.

Out of 100 strains of meningococci examined 62 were resistant to 1 mg/l or more of sodium sulphadiazine, including 82% of group W135 strains and 69% of group B strains. All strains were sensitive in vitro to 0.5 mg/l of sodium fusidate. Sodium fusidate should be considered as a chemoprophylactic agent for those who may be at risk of meningococcal disease.

Drug Resistance, Microbial↗

Sodium fusidate in Gillain-Barré syndrome: a case report.

A patient with Guillain-Barré syndrome is reported on who responded favourably to a short course treatment with the novel immunosuppressant sodium fusidate (Fucidin), given at a daily dose of 1.5 g for one week. Along with prompt and clear cut clinical improvement, treatment with Fucidin was associated with a rapid decline in the blood concentrations of inflammatory cytokines presumably implicated in the pathogenesis of Guillain-Barré syndrome such as interleukin-2, interferon-gamma, and tumor necrosis factor-alpha. The ex vivo production of these cytokines was also markedly diminished compared with pretreatment values. Fucidin was well tolerated and no clinical or biochemical side effects were seen.

Dose-Response Relationship, Drug↗

Efficacy of non-acaricidal containing otic preparations in the treatment of otoacariasis in dogs and cats.

Eighty-nine cats and 38 dogs naturally infested with the ear mite Otodectes cynotis were randomly allocated into two treatment groups. One group was treated with a product containing miconazole nitrate, polymyxin B sulphate and prednisolone acetate, the other with a combination of diethanolamine fusidate, framycetin sulphate, nystatin and prednisolone. The treatment (five drops in each ear) was applied twice daily for 14 days, and its efficacy was evaluated on days 7, 14 and 21 on the basis of an otoscopic examination of the external ear canal, a microscopical examination of scrapings for the presence of ear mites and clinical signs of pruritus, pain, erythema and/or exudate. Both treatments were highly effective, and there were no significant differences between the two products, either in efficacy or in the clinical improvements observed. Apart from an allergic reaction in one cat treated with the second product, no adverse effects were observed.

Animals↗

Methicillin-resistant Staphylococcus aureus neck infections resulting in a delayed abscess and a tracheo-oesophageal fistula.

We describe 2 cases of methicillin-resistant Staphylococcus aureus neck infections resulting in a deep neck abscess in one and formation of a tracheo-oesophageal fistula in the other. Predisposing factors, preventive measures and the principles of management are discussed. The role of carrier detection and rational use of antibiotics are highlighted.

Abscess↗

Cetuximab-induced acne.

BACKGROUND: Cetuximab is a member of a new family of antineoplastic agents that inhibit epidermal growth factor receptor (EGFR). These molecules may induce acneiform eruptions. In this study, we aimed at evaluating (a) the characteristics of acne and (b) whether these acneiform eruptions could be improved by classical anti-acne treatments. METHODS: All patients treated with cetuximab in a single institution from October 2003 to May 2004 were prospectively evaluated. The presence of acne, its severity, need for a treatment and response to this treatment were recorded. RESULTS: 13 patients were included: 11 (85%) developed acneiform eruptions after a mean interval of 10 days. It was severe in 4/13 (31%). Comedones were never found and acne involved nonclassical sites in 3/11. Antibiotic treatment was given to 4 and local treatment to 2 patients: it was always efficient. CONCLUSION: Cetuximab-induced acne is frequent, differs from classical acne and may be treated effectively with classical modalities.

Acne Vulgaris↗

The problems, diagnosis and treatment of infection by Staphylococcus aureus.

Present-day problems of infection by Staphylococcus aureus are described against a brief historical account of the evolution of the multiple antibiotic resistant 'hospital staph'. which caused such immense problems of hospital cross-infection in the 1950's and 1960's. These problems have lessened considerably since that time, but staphylococcal infection still remains as a cause of morbidity and mortality. Diagnosis and treatment are not always straight-forward. Apart from applying general supportive measures, and appropriate surgical intervention when necessary, the attending doctor is faced with making a choice from a multiplicity of antibiotic agents. A brief account of the main antibiotic agents currently available is given with comments on some of the disadvantages and complications attendant on their use. The potential dangers of staphylococcal sepsis and the need for rapid diagnosis and prompt vigorous treatment are stressed.

Aminoglycosides↗