Hematopoietic stem cells are generally transfused through a central venous catheter (CVC), which also facilitates administration of medications and intravenous fluids. We had observed a high rate of CVC infections at our Bone Marrow Transplantation (BMT) unit. Accordingly, we evaluated the impact of administration of doxycycline as a prophylactic strategy to reduce CVC infection rates. Data was collected retrospectively on 54 consecutive patients, 26 who received doxycycline (doxycycline group), and we compared their outcomes to a previous cohort of 28 subjects who did not receive doxycycline (comparison group). The groups were comparable in regards to age, gender, transplant type, and CD34 cell dose. No (0%) CVC infection was observed in the doxycycline group, while 5 infection episodes (18%) occurred in 4 patients in the comparison group (p<0.001). Isolated organisms included: Escherichia-coli (EC)=1, coagulase-negative Staphylococcus-spp (CNSS)=2, both EC & CNSS=1. Notwithstanding the non-randomized comparative nature of our study, results suggest that CVC infection rate was reduced significantly after adding doxycycline for prophylaxis. A randomized controlled study is warranted to confirm these findings.

Acute pharyngitis is one commonest reasons for patients to visit the family physician, 80-90% of cases are caused by viruses particularly adenovirus. The most important bacterial cause is group A streptococcus, which is responsible for about 15% of all cases. Because of the time required to confirm the presence of group A streptococci using throat cultures many commercial antigen detection tests for the rapid identification of group A streptococci directly from throat swabs have been developed utilizing the latex agglutination principle and a result is available within 5 minutes. Objective: The purpose of this study was to determine the value of using rapid detection procedure (Reveal color strep A test, Murex) for group A streptococci directly from throat swabs. Material and Method: Data from 200 patients with sore throat attending one of the Public Medical Centers in Amman over 6 month period May 1998-January 1999. Both throat swabs and cultures were taken and throat swabs were subjected using (Reveal color strep A test) for rapid detection. The culture results were interpreted and reported by microbiologist. Data were analyzed by calculating the number of positives and negatives for both swabs and cultures, the specificity, sensitivity and predictive value were determined. Results: The usefulness of latex test was as follows: Sensitivity 87%, Specificity 98.2%, Predictive value positive 90%, and Predictive value negative 97.6%. Conclusion: Using tests for the rapid identification may help in establishing a policy for sore throat management in general practice by avoiding unnecessary cultures and antibiotic prescription