Patients with uncomplicated UTI caused by trimethoprim-resistant organisms had significantly worse clinical outcomes than those with trimethoprim-susceptible organisms. Nevertheless, trimethoprim resistance was rarer than predicted from routine laboratory submissions and we calculate that 23 women require microbiological investigation to prevent one reconsultation arising from resistance-based treatment failure. We therefore suggest empirical antibiotic treatment in acute, uncomplicated UTIs. If patients reconsult in the first week, we suggest a change of antibiotic treatment with urine culture and susceptibility testing then done. More generally, laboratory resources should concentrate on resistance surveillance to inform empirical antibiotic choice.

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Osseous coagulum is regarded by some clinicians as a useful material for grafting in procedures aimed at bone replacement. Its value in this regard has been assessed experimentally. Holes ∼ 2 mm in diameter were made in the right and left parietal bones of 15 middle‐aged Wistar‐strain albino rats weighing ∼ 500 g. Osseous coagulum was obtained from the interparietal bone, and was placed into the left hole, while the right served as a control. Three of the animals were injected with tetracycline; these animals were sacrificed at 4, 8 and 12 weeks postoperatively, and undemineralized sections of their calvaria were viewed in ultraviolet light to assess accretion of new bone. The remaining 12 animals were sacrificed at postoperative intervals of 1, 2, 3, 4, 8 and 12 weeks, and serial sections of their calvaria were examined by routine histological methods. The observations indicate that, in this system in which repair is normally poor, osseous coagulum consistently did not appear to have induced the formation of new bony callus. These findings bring into question the value of using osseous coagulum as an autograft in clinical periodontal procedures aimed at restoring the attachment apparatus.

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