Pharmacokinetic parameters of amikacin were determined in 12 healthy volunteers after a 1-hr continuous intravenous infusion of 7.5 mg of the drug/kg. The serum concentration rose rapidly to a peak of 37.5 +/- 4.9 mug/ml at the termination of the infusion and declined to 1.3 +/- 0.5 mug/ml 8 hr later. The mean half-life was 114 +/- 16.7 min, and the apparent volume of distribution was 18.1% +/- 1.8% of body weight. During a 4-hr constant intravenous infusion in three subjects, amikacin was cleared from the kidney at a mean rate of 84.3 ml/min per 1.73 m2, and from the serum at a mean rate of 129.7 ml/min per 1.73 m2. Of the administered dose, 93.5% was recovered from the urine in 24 hr (81.7% during the first 6 hr). After single intramuscular injections of 5 mg/kg in 30 patients, serum levels peaked at 1 hr (21.4 +/- 5.4 mug/ml) and declined to 2.4 +/- 0.9 mug/ml by 8 hr. Of 33 patients with serious urinary or bronchopulmonary infections (usually superimposed on chronic organic pathology) treated with amikacin (10 or 15 mg/kg per day for eight to 17 days), 27 had a clinical remission, and in 15 of these patients the pathogen was eradicated.

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Lysozyme production is a frequent property of potentially pathogenic staphylococci. In the present study, 1,186 strains of human origin, 85 strains of animal origin, and 156 strains of Staphylococcus albus (epidermidis) were tested. Of 1,114 coagulasepositive strains of human and animal origin, 1,098 were lysozyme-positive (98.5%). On the other hand, of 157 coagulase-negative strains which, based on further investigations, belong to the potentially pathogenic staphylococci, all were lysozymepositive. All of the 156 strains (100%) belonging to the species S. albus (epidermidis) were lysozyme-negative. We conclude that lysozyme production is a better index of potentially pathogenic staphylococci than the measurement of free coagulase, especially in cases of strains of animal origin. It is possible that lysozyme production allows a differentiation between pathogenic and nonpathogenic coagulase-negative staphylococci. In recent years, various reports have been

The incidence of nosocomial infections and antimicrobial resistance rates of nosocomial pathogens vary considerably among countries and even among intensive care units (ICUs) within one hospital. Such differences might be partly due to the selection pressure exerted by certain antibiotics, since intensive care patients are given more antimicrobials than any other group of patients. We therefore compared resistance rates of four important nosocomial pathogens (Staphylococcus aureus, E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) isolated from patients in general wards and ICUs. There were few trends toward higher resistance of ICU isolates, and most differences were found with Klebsiella pneumoniae.We also tried to relate antibiotic use in ICUs and frequency of antibiotic resistance of five selected nosocomial pathogens. The ampicillin and cephalosporin resistance of E. coli and Klebsiella pneumoniae arose along with an increase in usage of both drugs. Decreasing prescription of cotrimoxazole was not reflected by decrease in resistance of Staphylococcus aureus and Staphylococcus epidermidis. Increasing prescriptions of tetracyclines were followed by an increasing resistance of E. coli, but not of Staphylococci. The oxacillin resistance of Staphylococcus epidermidis almost paralleled the consumption, the opposite was true for Staphylococcus aureus. There seemed to be a rather close relationship between the incidence of resistant Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa strains and the quantities of gentamicin, tobramycin and azlocillin prescribed.The increase or decrease of prescriptions of certain antimicrobials increased or decreased their resistance rate to the respective drugs of only certain bacterial strains in one ICU, but not in the other. The findings in our hospital cannot necessarily be applied to other hospitals. Restriction of antimicrobial usage however decreased resistance rates in most situations.

The subspecies intestinalis and fetus of Campylobacter fetus are opportunistic pathogens in humans. So far, some 200 types of disease due to these pathogens have been reported from all over the world, and six new diseases are briefly described in this paper. The most frequent disease is sepsis, followed by meningitis. While ticarcillin, erythromycin, clindamycin and tetracycline are the antibiotics which show activity against these species, a large degree of resistance is seen against cephalothin, cefazolin, cefuroxime, cefoxitin and cefotaxime. There is a moderate degree of sensitivity to gentamicin. The epidemiology of the disease is not clear, and about twice as many men are affected as women. Subspecies intestinalis was isolated in 95% of all diseases. Antibodies to Campylobacter fetus were detected in 3.9% of the population.