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Despite the fact that group A streptococci (GAS) remain susceptible to penicillin V (pen V), an increasing rate of bacteriological treatment failures has occurred. A recent study has suggested that the major variables associated with pen V treatment failures were the number of days ill prior to initiation of treatment (<2 days) and age <6 years. In order to study the link between pen V treatment failures and individual variables, we reviewed the files of all children enrolled in four randomised multicentre trials of oral antibiotic therapy, carried out from 1993 to 1999. A standard protocol and follow-up examination were used in these four studies: cultures were obtained 4 days and 1 month after completion of treatment. Total DNA restriction fragment length polymorphism was used to compare pre- and post-treatment GAS isolates. We enrolled 1560 children aged 3 to 12 years, 685 received a 10 day pen V regimen (45 mg/kg per day divided into three doses/day), among them 536 were assessable for bacteriological efficacy at the first and second follow-up visit. We found the only variable associated with penicillin treatment failure was the age of the child when infected. The rate of failure was statistically more important for children younger than 6 years (35.5%, 95% CI 29.9--41.1) than for older children (21.9%, 95% CI 16.9-26.9). CONCLUSION: in this study only young age (<6 years) increases penicillin V treatment failures for group A streptococcal tonsillopharyngitis. This may lead to different antibiotic regimens and follow-up modalities for these targeted patients.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12111186&dopt=Abstract




J Gen Microbiol. 1975 Dec;91(2):338-44.
The induction of mutants of Acinetobacter calcoaceticus NCIB8250 and their selection by vancomycin.

Ahlquist EF, Fewson CA, Ritchie DA.

The mutagenic and lethal effects of N-methyl-N'-nitro-N-nitrosoguanidine (NTG), ethyl methanesulphonate (EMS), ultraviolet light irradiation and near-ultraviolet light irradiation with 8-methoxypsoralen on the bacterium Acinetobacter calcoaceticus NCIB8250 were examined. The production of auxotrophic mutants was used as a measure of mutagenic efficiency. Under appropriate conditions all four agents were mutagenic. EMS and NTG although more effective than irradiation, did not cause such a high frequency of mutation as has been observed with other bacteria. A combination of vancomycin and penicillin V gave enrichment of non-metabolizing bacteria and optimum conditions were found for the use of these compounds in a selection technique.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=812942&dopt=Abstract




Klin Padiatr. 1976 Jan;188(1):88-91.
[A "new cause of erythema nodosum worth knowing: yersinia-infections (author's transl)]

[Article in German]

Toeller W, Pandel C, Wiedemann HR.

In the German literature little has so far been published on the appearance of erythema nodosum (e.n.), particularly in childhood, following Yersinia infections. We have seen a boy aged 10 years and 8 months with marked e.n. on the legs and mildly on the left fore-arm. This had been preceeded by typical enteritic symptoms; contact with numerous animals was noteworthy. When we treated him with penicillin V, septic fever and a rise in the ESR occurred. Serologic examination showed high titres against Yersinia pseudotuberculosis. The titre of type I fell, that of type II rose which indicated a mixed infection. In view of the increasingly common reports on e.n. following Yersinia infections in adults we have to assume that in childhood, too, Yersinia infections will be found increasingly as a cause of e.n.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=815715&dopt=Abstract













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