Demonstration of non-inferiority of a novel combination intramammary antimicrobial in the treatment of clinical mastitis.

AIM: To test the non-inferiority of a novel combination intramammary product containing penicillin and cloxacillin to a reference intramammary product containing oxytetracycline, oleandomycin, neomycin and prednisolone with regard to bacteriological cure and clinical cure. METHODS: Clinical cases of mastitis were sourced from 30 spring-calving dairy farms in the Southland region of New Zealand. Affected quarters were infused three times at 24 hourly intervals with either the novel combination product containing 1 g penicillin and 200 mg cloxacillin, or a reference product containing 200 mg oxytetracycline, 100 mg oleandomycin, 100 mg neomycin and 5 mg prednisolone. Cows were enrolled when a farmer detected a case of clinical mastitis. Milk samples were collected for microbiological culture immediately before treatment (Day 0) and on Days 9, 16 and 23. Bacteriological cure was compared for 187 and 178 quarters treated with the reference and novel product, respectively, and clinical cure was compared for 235 and 223 quarters, respectively. Non-inferiority was assessed by calculating the difference in cure rates between the two products and constructing a 95% CI around the difference, using the variance inflation factor to account for herd level clustering. The non-inferiority margin was 20% for both bacteriological and clinical cure. Generalising estimating equation models were used to determine predictor variables. RESULTS: The bacteriological cure percentage, adjusted to account for herd-level clustering, was 8.5 (95% CI=-1.7-21.8)% higher for quarters treated with the novel than the reference product. The adjusted clinical cure percentage was 0.3 (95% CI=-11.2-12.0)% higher for clinical quarters treated with the novel than the reference product. Bacterial species was the only covariate for bacteriological cure (p=0.003), and quarter score at enrolment (indicating udder inflammation) was the only covariate for clinical cure (p=0.032) in the multivariable models. CONCLUSION: The novel combination product was demonstrated to be non-inferior to the reference product with regards to both bacteriological cure and clinical cure. CLINICAL RELEVANCE: Clinicians treating mastitis now have access to this novel combination intramammary product, and demonstration of its non-inferiority compared to the existing reference product will provide options for treatment approaches. The novel product contains fewer antimicrobials; which are of a narrower spectrum of activity.

[Experience in the management of osteomyelitis of the fibula]. / Tapasztalataink a fibula osteomyelitis kezelésével.

Authors report on experiences gained with the treatment of 22 cases of osteomyelitis of the fibula in the 17 years material of their Department. It is stated that the fibula osteomyelitis has to be treated first of all with operation and the end results of the treatment are good. In this, the anatomical situation which enables the resection and removal of the proximal part of this bone without more ado has a role. The more frequent occurrence of the disease on the right fibula in their material is an accidental finding.

Prevalence et antosensibilite des gonoccoques isoles a Niamey : analyse de 6.608 prelevements genitaux

Un bilan de la recherche de neisseria gonorrhoeae dans 6.608 prelevements genitaux effectues de 1985 a 1992; a Niamey est presente. Ce germe a ete isole 624 fois; soit une prevalence globale de 9;44 pour cent. Quant aux antibiogrammes; pour les 17 antibiotiques retenus; l'on constate de grandes variations dans la frequence de leur utilisation. Cela n'a pas permis de tirer des conclusions generalisables sur les taux d'efficacite de chacun de ces produits sur le gonocoque. Celui-ci semble cependant plus frequemment sensible au chloramphenicol; aux cyclines et a l'oleandomycine

[Microcalorimetric Investigations, regarding the antibacterial efficiency of chemotherapeutics (author's transl)]. / Mikrokalorimetrische Untersuchungen zur Charakterisierung der antibakteriellen Wirksamkeit von Chemotherapeutika.

An investigation method is described by which microcalorimetry and continuous density measurement are used to show the antibacterial efficiency of chemotherapeutics. Oleandomycin, erythromycin, both macrolide antibiotics, and doxycycline, a tetracycline, blockers of the protein synthesis, have the same effect on the microcalorimetric curve of a staphylococcus strain. Among the aminoglycosides tobramycin and gentamicin influenced the microcalorimetric activity of a growing E. coli strain in the same way, spectinomycin produced different curves. Penicillins interfere with the synthesis of the cell membrane by blocking the enzyme transpeptidase. Epicillin, penicillin, ampicillin, oxacillin, carbenicillin, and azlocillin influence the microcalorimetric activity of staphylococci in a typical way which is different from that of the blockers of the protein synthesis.

[Penetration of oleandomycin into the subarachnoid space of neurosurgical patients]. / Proniknovenie oleandomitsina v subarakhoidal'nye prostranstva neirokhirurgicheskikh bol'nykh.

Penetration of oleandomycin into the subarachnoid space in neurosurgical patients treated with the drug administered orally and intramuscularly in doses of 375 and 500 mg respectively was studied. The oleandomycin levels in the blood and cerobrospinal fluid were determined after a single administration of the antibiotic at an interval of 30 minutes to 7 hours. A total of 52 observations were recorded. Relation between oleandomycin penetration into the cerebrospinal fluid from the blood and the administration route was shown. The index of penetration through the blood-liquor barrier for the antibiotic intramuscular or oral administration was 9--70 and 3--40 per cent respectively. The maximum concentrations of the drug in the liquor were found in the patients with the clinical picture of meningitis.

[The clinical effect of antibiotics in the macrolide family on bronchial asthma. Non-antimicrobial actions of oleandomycin [author's transl)].

Non-antimicrobial actions of oleandomycin (triacetyloleandomycin and oleandomycin phosphate) were studied in patients with bronchial asthma. Twenty-one cases of the disease without associating infections entered the study, and they were given 750mg of oleandomycin or triacetryloleandomycin in three divided doses daily for two weeks. Clinical manifestations and laboratory findings were compared to assess the effectiveness of the antibiotic therapy between the three 2-week periods before, during and after the therapy. Improvements in clinical manifestations were attained in 11 of 21 cases (52.3%), and last after discontinuance of the therapy in 8(38.1%). The blood level of 11-OHCS as determined by the Demoorr's fluorescence method increased by greater than 20% at the end of thearpy in 7 of 18 cases (38.9%). In 5 of the 7 cases favorable responses were seen clinically to the oleandomycin therapy. The serum IgE level determined by the radioimmunosorbent test was compared before and after the therapy to reveal that oleandomycin caused decrease of IgE in 10 and increase in 9 of 20 cases examined. The oleandomycin therapy resulted increases by greater than 20% of the vital capacity and FEV 1.0 in 2 and 3, respectively, of 15 cases. Jaundice in association with elevations of the GOT, GPT and alkaline phosphatase developed in one patient, and generalized skin eruption in another. Both of these cases were given triacetyloleandomycin.

[Olemorphocycline treatment of calculous and noncalculous pyelonephritis]. / Lechenie olemorfotsiklinom bol'nykh kal'kuleznym i nekal'kuleznym pielonefritom

40 patients suffering from calculous and non-calculous pyelonephrits were treated with olemorphocycline administered intravenously in a dose of 250 00 Units 2 times a day for 5--7 days. The clinical effect was observed in 62.5 per cent of the cases. In 54.7 per cent of the cases the isolates were resistant to oleandomycin and morphocycline. The kidney tissue and urine from the kidney pelvis taken during surgical operations of 20 patients were plated out. Staphylocci were most often detected in the platings of the kidney tissue. The microflora of the urinary bladder before the treatment and that of the urine from the kidney pelvis and the kidney tissue taken during the surgical operation was mainly ident

Quantitative and qualitative determinations of the combined effect of tetracycline and oleandomycin. II. In vivo effect.

The combination effect of tetracycline (TC) and oleandomycin (OM) on acute infection of mice with four strains of Staphylococcus aureus including TC or OM resistant ones was examined by the quantitative determination of protective potencies of single and combined drugs. The grade of synergism was expressed by the synergistic ratio (SR), a ratio of experimentally determined potency of the combined drug over a hypothetical potency in which additive effect of the both drugs is assumed. With 3 out of the 4 strains of S. aureus synergism between TC and OM or triacetyloleandomycin (TAO) was demonstrated by the determination of the 50% effective dose and by statistical examination of the SR. The grade of synergistic protection by these drugs varied with the strains infected and it did not depend upon the sensitivity to antibiotics or grade of synergism in vitro. There was no synergistic enhancement of acute toxic action in the combined administration of TC and OM to mice.