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Thoracic actinomycosis is a rare infection but sensitive to penicillin G which is the antibiotic of choice. We report a case of thoracic actinomycosis which was characterised by a relapse, probably linked to antibiotic resistance following treatment with Tetracycline. This relapse presented as diffuse nodular dissemination, of miliary type, of which there are only a few examples in the literature.
Sodium fusidin prepared at the All-Union Research Institute of Antibiotics was studied experimentally and clinically. High antibacterial activity of fusidin especially against methicillin-resistant staphylococci was found. The clinical trials showed high efficacy of fusidin in treatment of perichondritis, osteomyelitis, pyodermia, pseudofurunculosis, multiple abscesses of the skin because of its satisfactory penetration into the skin and cartilage tissues, skin and subcutaneous cellular tissue. The tolerance of the drug by most of the patients was satisfactory.
The effectiveness of sodium fusidate and ofloxacin to eliminate nasal and catheter exit-site Staphylococcus aureus colonization and to prevent infections was compared in 31 patients on continuous ambulatory peritoneal dialysis (CAPD). In a prospective randomized study, 9 patients were treated with topical 2% sodium fusidate ointment applied in the anterior nares and in the pericatheter skin twice daily for 5 days; 9 subjects received oral ofloxacin 200 mg taken every 48 hours for 5 days and 13 subjects were in the control group. Treatment courses were repeated at one-month intervals. Mean duration of follow-up was 7.8 months (242 patients-month). Follow-up samples from the nares and the catheter exit-site were obtained every month from all participants to determine the presence of S. aureus. Development of S. aureus exit-site infection and peritonitis were assessed. During the study, S. aureus was recovered from 45%, 59% and 52% of the samples from the nares and/or exit-site in the sodium fusidate, ofloxacin and control groups, respectively (p = 0.13). S. aureus grew less frequently (p < 0.01) in samples from the exit-site in the sodium fusidate than in the other two groups. Eradication of nasal colonization (two negative cultures within one month) was observed in 43%, 40% and 33% of the cases in the sodium fusidate, ofloxacin and control groups, respectively (p > 0.50). The corresponding figures for exit-site eradication were 43%, 33% and 11%, respectively (p = 0.34). Twenty-four S. aureus-associated infection episodes (12 of exit-site and 12 of peritonitis) were diagnosed in 16 of the 31 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
The effect on canine otitis externa of a topical preparation composed of Fucidin, Framycetin, Nystatin, and Prednisolone was evaluated in a clinical trial comprising 235 dog ears. Cases caused by parasites or foreign bodies and cases requiring systemic therapy were excluded. Swabs from these and an additional 434 affected ears were examined bacteriologically and the sensitivity to antibiotics of the bacteria isolated determined. The infection most frequently diagnosed was staphylococci plus yeasts (29 % of total material) followed by pure yeast-infections (19 %) and pure staphylococcus infections (16 %). Pseudomonas aeruginosa and/or Proteus mirabilis were found in 7 % of the ears, while no organisms could be isolated from 22 %. Sensitivity tests showed a satisfactory in vitro effect of Neomycin (Framycetin) on most of the bacteria commonly isolated, and a very good effect of Fucidin on the staphylococci. Approximately 91 % of the ears treated were clinically cured or improved very considerably; the relation between clinical response and type of infection is shown diagrammatically in Fig. 1. It was confirmed that infections with Ps. aeruginosa represent a special problem; the results of post-treatment sensitivity tests seem to suggest, however, that a longer or more intense course of treatment than the one used in the trial (two weeks) would provide the answer to this.
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The aim of this experimental study was to examine two new wound healing adjuvants. Four experimental wounds were created on the back of rabbits to compare the kinetics of wound healing after applying the standard treatment, Silastic gel, and elastomer with and without compounds known to act on wound healing. We observed a tendency towards more rapid healing in the gel groups (13.7 days), the elastomer group (17.3 days) and the elastomer with active compound group (15.3 days) compared with the control group (17.3 days) and the standard treatment group (17.8 days). The differences were not however statistically different. Elastomer is the better carrier for active wound healing compounds because it has better stability over time. Silicon dressings are interesting for wound healing because they give satisfactory results in terms of healing time and in terms of redressing and patient comfort.
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Two cases are reported of patients who developed a dramatic pustulo-nodular rash on the chin. The onset was explosively sudden and cosmetically disabling. Ultimately, resolution occurred with minimal scarring.
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A reversed phase liquid chromatographic (HPLC) method is proposed for the determination of sodium fusidate, a steroid antibiotic, in a commercial ointment using three different detectors: a) fluorescence detector, after a preliminary derivatization with 2-bromoacetyl-6-methoxynaphthalene (Br-AMN), b) UV detection and c) evaporative light scattering detector (ELSD). Fluorescent derivatization was applied directly to the diluted sample, without any purification, whilst UV and ELSD detectors involved a preliminary liquid-liquid extraction procedure to obtain accurate analysis data.
The biosynthesis of fusidin, an antibiotic of steroid structure, was used as a model of steroid synthesis. Screening of compounds modifying the fusidin synthesis included 80 strains of mycelial fungi. A high frequency of such fungal cultures was observed. 9 cultures forming compounds which inhibited the synthesis of cholesterol in the cell culture of human hepatocytes were screened. A method for biological estimation of the activity of cholesterol synthesis inhibitors was developed on rabbits with high blood levels of cholesterol. It was shown that the cholesterol synthesis inhibitors, isolated as a result of the specific screening were not toxic and markedly lowered the cholesterol blood levels.
Eight cases of septic arthritis occurring in patients with rheumatoid arthritis are reviewed. The difficulty in diagnosis of this condition is due in part to a failure of these patients to respond normally to infection. Consequently patients often present late in the course of their septic episode and treatment is often delayed. The importance of early diagnosis and treatment of the infection is stressed by the high mortality rate in this group of patients. Many factors operate to encourage infection in rheumatoid arthritis and the current concepts of the problem are reviewed.
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Tetracycline-resistant strains of Staphylococcus aureus isolated from cattle in Brazil, were used as prospective donors for the transfer of resistance to laboratory strains, using mixed-culture and filter-mating protocols. Three lysogenic donors transferred tetracycline resistance in both mixed culture and during filter mating. In contrast, when a non-lysogenic strain was used as prospective donor, transfer was not detected using either mating protocol. In order to evaluate the involvement of phage, successful transfer experiments were repeated with the addition of sodium citrate, which sequestered calcium ions. Mixed-culture and filter-mating protocols did not result in the transfer of resistance. These results support the notion that transfer of the resistance determinant under both sets of conditions described here involve the same bacteriophage-mediated mechanism. Although transfer of tetracycline resistance was detected, without any attempt to create specialized transduction agents or to extract phages, the co-transfer of additional resistance markers indicated that it could not be conventional transduction.
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