Background The management of complex orthopedic infections usually includes a prolonged course of intravenous antibiotic agents. We investigated whether oral antibiotic therapy is noninferior to intravenous antibiotic therapy for this indication. Methods We enrolled adults who were being treated for bone or joint infection at 26 U.K. centers. Within 7 days after surgery (or, if the infection was being managed without surgery, within 7 days after the start of antibiotic treatment), participants were randomly assigned to receive either intravenous or oral antibiotics to complete the first 6 weeks of therapy. Follow-on oral antibiotics were permitted in both groups. The primary end point was definitive treatment failure within 1 year after randomization. In the analysis of the risk of the primary end point, the noninferiority margin was 7.5 percentage points. Results Among the 1054 participants (527 in each group), end-point data were available for 1015 (96.3%). Treatment failure occurred in 74 of 506 participants (14.6%) in the intravenous group and 67 of 509 participants (13.2%) in the oral group. Missing end-point data (39 participants, 3.7%) were imputed. The intention-to-treat analysis showed a difference in the risk of definitive treatment failure (oral group vs. intravenous group) of −1.4 percentage points (90% confidence interval [CI], −4.9 to 2.2; 95% CI, −5.6 to 2.9), indicating noninferiority. Complete-case, per-protocol, and sensitivity analyses supported this result. The between-group difference in the incidence of serious adverse events was not significant (146 of 527 participants [27.7%] in the intravenous group and 138 of 527 [26.2%] in the oral group; P = 0.58). Catheter complications, analyzed as a secondary end point, were more common in the intravenous group (9.4% vs. 1.0%). Conclusions Oral antibiotic therapy was noninferior to intravenous antibiotic therapy when used during the first 6 weeks for complex orthopedic infection, as assessed by treatment failure at 1 year. (Funded by the National Institute for Health Research; OVIVA Current Controlled Trials number, ISRCTN91566927.)

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Wild‐caught mutton snapper Lutjanus analis, a high‐value marine food fish species, matured in flow‐through seawater (36 g/L) tanks after 3 yr in captivity. On 31 May 1995, a female with a mean oocyte diameter of 382 μm was injected with human chorionic gonadotropin (HCG) (500 IU/kg body wt.) followed 24 h later by a second injection (1,000 IU/kg body wt.). At the time of the second injection, three males were injected with HCG (500 IU/ kg body wt.). Voluntary spawning occurred 33 h after the first injection, with a total of 534, 781 eggs released. Fertilization rate was 75.7%, while average diameter of fertilized eggs was 783 μm. Embryos were stocked in a 30‐m3 outdoor tank at a density of 10.5/L. On day 2 post‐hatching (d2ph), larval density was 8.61 larvae/L, and average notochord length was 2.6 mm. Larvae were fed ss‐type rotifers from dl‐d28ph, Artemia nauplii from 0–08ph, and artificial diets (52–48% protein) from d24‐d38ph. On d38ph, fish averaged 0.308 g and 22.2 mm standard length. Survival (from d2ph) was 14.3%, with a total of 36,900 post‐metamorphic juveniles produced. On d97ph, 1,390 hatchery‐reared juveniles (avg. wt. = 10.5 g) were stocked into two 14.5‐m3 recirculating seawater tanks (695 fish/tank; 48 fish/m3) and fed a 56% protein pellet. After 168 d, fish averaged 140.8 g, with a survival rate of 97.8% and a feed conversion ratio (dry wt./wet wt.) of 1.2. These preliminary results reveal the mutton snapper to be a prime, new candidate species for commercial cultivation.

Growth and feed utilization of juvenile, hatchery‐reared mutton snapper Lutjanus analis (mean weight = 12.2 g) were compared for 40 d in laboratory aquaria on four isonitrogenous diets (45% crude protein) of varying lipid content (6, 9, 12 and 15%) with energy:protein ratios (E: P; kJ/g protein) of 33.9, 36.3, 38.8, and 41.2, respectively. Growth on these diets was compared under temperatures of 25 and 30 C. Final weights (Wtr) and specific growth rates (SGR) were higher (P < 0.05) at lower dietary E: P ratios of 33.9 and 36.3 (Wtr= 20.3–22.0 g; SGR = 1.25–1.35%/d) than at E:P ratios of 38.8 and 41.2 (Wtr= 17.2‐17.7 g; SGR = 0.84–0.85%/d). Growth at 30 C (Wtr= 21.5 g, SGR = 1.35%/d) was higher (P < 0.05) than at 25 C (Wtr= 17.3 g; SGR = 0.82%/d). Feed consumption (FC) was higher (P < 0.05) at a dietary E: P ratio of 33.9 (1.57%/d) than at 36.3 (1.27%/d) or 38.8–41.2 (0.89–0.98%/d). Growth was highly correlated (P < 0.01) to E: P ratio and to feed consumption. Feed conversion ratio (FCR = 2.17–3.98), protein efficiency ratio (PER = 0.58–1.03) and apparent net protein retention (ANPR = 15.8–20.0%) were not significantly (P > 0.05) affected by dietary E: P ratio. Apparent net energy retention (ANER) was higher (P < 0.05) at E: P ratios of 33.9 and 36.3 (9.50–9.98%) than at E: P ratios of 38.8 and 41.2 (7.15–7.10%). Feed utilization parameters were significantly (P < 0.05) better at 30 C (FC = 1.36%/d; FCR = 2.6; PER = 0.88; ANER = 10.2%) than at 25 C (FC = 1.03%/d; FCR = 3.38; PER = 0.69; ANER = 6.72%), with the exception of ANPR (17.0–17.8%). Maximum growth and energy retention in juvenile mutton snapper using a diet containing 45% crude protein was obtained at dietary lipid levels of 6–9% and E: P ratios of 33.9–36.3 kJ/g protein. Studies which determine optimum protein levels and the effects of reducing E: P ratios below 33.9 kJ/g are needed to improve feed conversion and growth.