Acetarsol

Abstract: In 1960 metronidazole was shown to be the ® rst effective systemic treatment for Trichomonas vaginalis1. As most previous treatments were topical and largely ineffective, its introduction was a signi® cant development2. Since then metronidazole has remained the standard antimicrobial agent for the treatment of trichomonal infections. The ® rst published reports of metronidazole resistant organisms emerged in the late 1970s and early 1980s and, although well established now, the existence of resistance was at ® rst controversial3,4. Although T. vaginalis remains one of the most prevalent sexually transmitted diseases (STDs) worldwide the documentation of resistant organisms is relatively infrequent5,6. However, individual cases of metronidazole resistance are often dif® cult to treat, a problem compounded by the lack of evidence to support the use of alternative therapies. Although unlicensed, acetarsol pessaries have been available for the treatment of T. vaginalis for several decades and were the standard treatment for trichomonal infections prior to the advent of metronidazole7. Recently there has been interest in the use of acetarsol pessaries where metronidazole has been shown to be ineffective8,9. We report 4 cases of trichomonal infections seen at the Department of Genitourinary Medicine, Guy’s and St Thomas’ Hospitals, where repeated treatments with metronidazole have failed, and describe our experience in the use of acetarsol pessaries.

Abstract: Since the introduction of emetine into 'Medical practice by Sir Leonard Rogers (1912).?following the lead given by Bardsley (1829) of Manchester, who had used the generally in dysentery, Tull Walsh v 1891), who used it in the treatment of dysentery in Calcutta, but reported that it did I'l't give better results than other drugs, and edder (1911), who tested its action on 1 ee-living amoebae, and suggested its therapeutic use?the treatment of acute and subacute amcebic dysentery has become a relalvely simple matter. The patient is put to

Abstract: America; and of foxes in Denmark, Finland, Norway, Holland, and the far west of the United States of America (for references to the literature, see Wilson and Miles, 1946). The apparent absence of this particular salmonella from the extensive eastern and mid-western parts of the United States is quite remarkable (Edwards et al., 1948). Raw milk from an infected cow is the usual vehicle for human Salm. dublin infections, and large outbreaks of foodpoisoning from this source have often been reported. Symptoms of the infection vary from a mild gastro-enteritis to a fulminating septicaemia, with a special predilection for fatal meningeal involvement in young children. In Britain Saim. dublin has been found more invasive for'humans than the other food-poisoning salmonellae (Report of Ministry of Health, 1950). The present carrier had no access to cow's milky but at the time when he had his bout of fever he was part owner of a water buffalo and customarily drank its milk raw. Since Salm. enteritidis (Gaertner) infection of water buffaloes had been described (Wolff, 1930) before this closely related organism was generally differentiated from Salm. dublin, they may well be natural'hosts, as cattle are, and the patient's febrile episode was perhaps a Salm. dublin infection resembling enteric fever, conveyed by buffalo milk, followed by the chronic carrier state. This man's unhygienic family environment emphasizes the possibility that his infant's death at weaning age was due to a Salm. dublin infection conveyed from the father. Chronic human carriers of salmonellae other than typhoid and paratyphoid are relatively uncommon, and those that have been reported were almost invariably faecal. I have failed to find any other chronic human carrier of Salm. dublin described in the literature. Ledingham and Arkwright (1912), however, mention two cases of chronic urinary infection with B. enteritidis Gaertner, which at that time was indistinguishable from Saim. dublin.