Pros and cons of the use of antibiotic combinations.
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Serums from 119 swine exposed to swine dysentery inoculum, and medicated with various drugs, were tested for antibodies to the large spirochete, using the indirect fluorescent antibody test, and were compared in tests with known positive serums from 18 nonmedicated swine which had recovered naturally. An inverse relationship existed between the efficacy of the drug and the serum antibody titer (highest dilution of the serum producing immunofluorescence of large spirochetes). The more efficacious drugs or doses resulted in lesser development of serum antibody. Diarrhea usually seemed necessary for the development of serum antibody. With the less efficacious drugs, there were more days of diarrhea. Some swine had diarrhea but did not develop an antibody titer, and a few swine had a titer but did not develop diarrhea. Swine which developed a titer were more immune against reexposure with infective inoculum. The medicaments, especially those given at higher concentrations, seemed to resolve the diarrhea or prevent the development of diarrhea, occurrences which were necessary for the development of immunity.
Strains of Staphylococcus aureus isolated from poultry, pigs and cases of bovine mastitis and strains of S. hyicus isolated from pigs were examined for their susceptibility of the macrolides and other related antibiotics. The susceptibility of these strains to erythromycin, oleandomycin, tylosin, spiramycin, lincomycin, clindamycin, virginiamycin, and its components virginiamycin S and M, was tested by the quantitative plate dilution method. With S. aureus, 3 p. 100 of the bovine, 12 p. 100 of the avian and 53 p. 100 of porcine isolated were found to be resistant. With S. hyicus strains 76 p. 100 were found to be resistant. Most resistant strains showed the generalized constitutive macrolide-resistance type. Twelve p. 100 of the porcine S. aureus strains were resistant to the virginiamycin component M.
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Three different antibiotic regimens (trospectomycin plus azteonam, clindamycin plus azteonam, and triple antibiotics-ampicillin plus clindamycin plus gentamicin) were all effective in treating patients with postcesarean endometritis. Patients are frequently cured clinically despite the fact that the offending organisms may be isolated in post-treatment cultures. Treatment of postcesarean endometritis without obtaining endometrial cultures is acceptable gynecologic practice. Obtaining post-treatment cultures is clearly not cost effective nor clinically beneficial. Drug treatment efficacy should be evaluated by clinical response. This communication is the first to report the new antibiotic, trospectomycin, in the treatment of postcesarean endometritis. Further clinical trials are currently underway.
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The statistics relating to the incidence of sexually transmitted diseases in many developing countries are not available and where there are, they are unreliable. Nevertheless, the impression of many physicians is that they constitute serious public health problems as they are endemic in some developing countries. The facilities for diagnosis and treatment of the diseases have been briefly discussed. The merits and the demerits of various antimicrobial agents have been outlined with the causes of failure of treatment in the developing countries. The economic importance of the "traitment minute" in the tropical environment has been stressed because of its economic advantage in terms of time spent in overcrowded hospitals. The resultant effect of the widescale misuse of antibiotics in developing countries has been suggested as a cause of the increasing resistant strains encountered. A plea is made for stricter control of the antimicrobial agents in developing countries.
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