Oxytetracycline. Reports of therapy with oxytetracycline in 27 collected cases of bacterial endocarditis75, 113, 134, 136, 154, 164, 169–172, 174 175 176 177 178 indicate that the results were qual...

Treatment of Bacterial Endocarditis

From 1974 to 1994, 2,033 specimens from children were submitted for cultures for anaerobic bacteria. Eighty-three Veillonella spp. were recovered from 83 children (4%). Most Veillonella species were recovered from abscesses, aspiration pneumonias, burns, bites, and sinuses. The infections were polymicrobial in 79 (95%) patients, but in 4 (5%) patients, Veillonella species were recovered in pure culture. The predisposing conditions associated with the recovery of these organisms were previous surgery, malignancy, steroid therapy, foreign body, and immunodeficiency. These data illustrate that Veillonella spp. are found infrequently in children, mostly in association with mixed infections, and are recovered mixed with mouth and bowel flora.

Veillonella infections in children.

Infective endocarditis caused by anaerobic bacteria.

The Genus Veillonella

A diet consisting largely of coarse-ground corn meal will usually cause a high incidence of carious-like lesions in molar teeth of the white rat (1). Either fluoride or iodoacetate in the diet and drinking water, however, will markedly inhibit this induced form of rat caries (2). Preliminary results now indicate an inhibition of such rat caries and a striking reduction in counts of oral L. acidophilus by adding penicillin to rats' food and drinking water. In vitro, L. acidophilus is susceptible to penicillin (3). Other studies (4) have demonstrated a rapid fall in the total bacteria of the oral cavity after application of penicillin pastilles. In this study experimental rats, matched with litter-mate controls, received a corn meal caries-inducing diet containing 75 units of penicillin4 per gram and drank water containing 75 units per ml. Control rats of the pairs received no penicillin. The penicillin diet and penicillin drinking water were renewed daily, numerous assays (5, 6) having revealed practically no deterioration of penicillin in the diet and water after standing 24 hours in food cups and in drinking fountains which were cleaned and sterilized daily. After 125 days on experiment the rats were sacrificed and their teeth diagnosed microscopically for caries and scored according to a standard procedure (7). As shown in Table I no caries appeared in the test (penicillin) rats whereas 50.0% of the control rats had carious teeth. Although severity and incidence of caries in the control animals was less than usual, the outcome in the control animals contrasts strikingly with the negative caries results for rats given penicillin. To obtain the plate counts for oral L. acidophilus (Table II)' tooth surfaces were thoroughly scrubbed with a small cotton swab, and the swab placed immediately in a measured quantity (5 ml. or 2 ml.) of 1% dextrose meat infusion broth (pH 5.0). An aliquot portion (0.2 ml.) of this broth was cultured on a tomato juice agar media (pH 5.0) and the L. acidophilus colonies counted after 96 hours incubation (8). In 7 instances as shown in Table II, plate counts for penicillin rats were mostly negative or yielded less than 50 colonies of L. acidophilus organisms. The great majority of control rats on the other hand, developed upwards df 50 colonies per plate.

The Relation of Penicillin to Induced Rat Dental Caries and Oral L. Acidophilus

The rational employment of penicillin for the successful treatment of disease involves the evaluation of dosage schedules. It is well known that there are marked in vitro differences in the susceptibility of various organisms to the action of penicillin. This variability is apparent even among different strains of the same organism. Dosage schedules at the present time, however, do not always take these differences in susceptibility into account, and the treatment of infections is still largely empirical. Probably the most important reason for this is the fact that methods of penicillin assay are principally adapted to commercial production and are difficult to adjust in the average hospital laboratory. Various modifications of the cup method (Fleming, 1942; Foster and Woodruff, 1943) or of turbidimetric methods (Foster, 1942; Joslyn, 1944) have been developed, but the-serial dilution method devised by Rammelkamp (1942) for the quantitative determination of penicillin in body fluids and exudates offered the greatest promise. The percentage of error inherent in this technique is so high and the number of pipetting operations required is so large that for routine purposes it is rather cumbersome. Nevertheless the amount of fluid required for testing is small, and consequently the method is readily adaptable to clinical studies. In establishing suitable dosage schedules of penicillin by various routes of administration, a simple, easily readable method of penicillin assay related to the turbidimetric and hemolytic systems was developed and found practical for routine use. The materials required in this method are a'standard solution of penicillin of known potency, a standard organism (Streptococcus pyogenes, strain C-203, group A, is used), and the patient's blood or, preferably, serum. All tests-are performed in brain heart infusion broth (Difco) under sterile precautions. Sensitivity tests may also be estimated in this broth and correlated with serum penicillin levels. Although at the present time determinations have been performed only on whole blood, serum, and urine, there does not seem to be any valid reason why other body fluids, such as sputum, cerebrospinal fluid, etc., cannot also be utilized. The amount of fluid required is small; 5 ml of whole blood yields sufficient serum for one or more assays. S. pyogenes C-203 is passed frequently through mice, transferred weekly on

A Method for the Determination of Penicillin Levels in Body Fluids.

The Effect of Incompletely Inhibitory Concentrations of Penicillin on Escherichia Coli

The clinical manifestations of subacute bacterial endocarditis caused by Streptococcus s.b.e.

Conclusions1. When the plasma para-aminohippuric acid concentration was maintained at or above 10 mg/100 ml a 3 to 6 fold elevation in penicillin plasma concentration was obtained except in two instances. 2. When the para-aminohippuric acid plasma levels were allowed to fall below 10 mg/100 ml there was no effect of that compound on the plasma concentration of penicillin. 3. The para-aminohippuric acid was non-toxic in the dosage given even when administered over a period of 8 days.

The Prolonging Action of Penicillin by Para-Aminohippuric Acid.

Science, a weekly journal, is published each Friday by the American Association for the Advancement of Science at Mt. Royal & Guilford Avenues, Baltimore 2, Maryland. Founded in 1880, it has been since 1900 the official publication of the AAAS. Editorial, Advertising, and Circulation Offices, 1515 Massachusetts Avenue, N.W., Washington 5, D. C. Telephone, EXecutive 6060 or 6061. Cable address SCIMAG, Washington, D. C. Entered as second class matter January 17, 1947, at the postoffice at Baltimore, Maryland, under the act of March 3, 1879. Articles offered for publication should be sent to the Editor, 1515 Massachusetts Avenue, N.W., Washington 5, D. C. Membership correspondence for the AAAS should be sent to the Administrative Secretary, 1516 Massachusetts Avenue, N.W., Washington 5, D. C. Annual subscription, $7.50; single copies, $25; foreign postage (outside the Pan-American Union), $1.00 extra; Canadian postage, $.50 extra. Remittances and orders for subscriptions and single copies, and notices of changes of address should be sent to the Circulation Department. Claims for missing numbers will not be allowed if received more than 60 days from date of issue. No claims allowed from subscribers in Central Europe, Asia, or the Pacific Islands other than Hawaii or because of failure to notify the Circulation Department of a change of address or because copy is miming from the files.

http://science.sciencemag.org/content/sci/106/2760/494.full.pdf

Enhancement of Penicillin Blood Levels Following Oral Administration of Caronamide.

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