1333hospital is £5 2s. 8d., which is a little more than a 14-day course of ampicillin in the dosage used in this trial.It would seem, then, that in ampicillin the physician has a useful addition to his armamentarium for the treatment of pneumonia. SummaryA controlled trial was carried out to compare the use of ampicillin with a combination of penicillin and streptomycin in the treatment of pneumonia. Seventy-eight patients were allocated to the ampicillin group, in which the regime was oral ampicillin 250 mg. six-hourly for 7 or 14 days. Sixtyseven were allocated to the penicillin/streptomycin group, in which the regime required injections of penicillin 1 mega unit b.d. for 7 or 14 days with streptomycin 1 g. b.d. for the first seven days. The treatment groups were comparable, and the results of treatment were similar in the two groups. The only difference of statistical significance was that a larger proportion of cases infected with pneumococci alone became afebrile within one week when treated with ampicillin than when treated with penicillin and streptomycin. Ampicillin appears to be at least as effective as penicillin and streptomycin even in the comparatively small doses used in this trial. There would appear to be an advantage in domiciliary practice in using a drug that can be given by mouth, and if an allowance is made for the cost of giving injections there is little difference in the expense.Our thanks are due to the following doctors who played a major part in the day-to-day conduct of the trial: Drs.

Mackintosh, T. F., and Walker, C. H. M. (1973). Archives of Disease in Childhood, 48,547. Blood viscosity in the newborn. The blood of the newborn has been shown to possess viscoelastic properties similar to adult blood, with a straight line relation between blood viscosity and PCV (packed cell volume) at normal PCV levels, and progressively disproportionate increases in viscosity at PCV levels above 65. The viscosity/ shear rate curve indicates an increase in viscosity as shear rate declines. The mean values for viscosity of the blood from 110 normal term infants increased from 5 -5 cps (centipoise) at 232 sec-1 to 33 -7 cps at 1 v 16 sec1, whereas the corresponding values for adults are considerably lower, 4 -3 to 14 -5 cps. This tends to make the blood flow in infants more susceptible to changes in haematocrit. Corresponding values for 21 normal preterm infants (5 0 to 30-6 cps) did not differ significantly from those of normal infants. Those for 13 small-for-dates infants were higher (6 6 to 44*6 cps). There was no clear relation between viscosity and the respiratory distress syndrome, the values in 20 distressed infants being 4*8 to 28 -1 cps. However, 13 of 24 babies with 'cerebral' signs had values above the normal 2 SD limit, the range for these babies being 6 9 to 47 0 cps. Among the 188 infants studied, 19 were regarded as hyperviscous with values above 2 SD from the mean. Of these, 4 were symptom free, 4 showed plethora and cyanosis only, and 11 had 'cerebral' signs, 2 having additional RDS and 1 prolonged physiological jaundice. 7 of the symptomatic infants were preterm and 4 were small-for-dates. 6 infants received haemodilution therapy by partial plasma exchange, with clinical improvement in 5. It is concluded that haemodilution should be considered in any infant with cardiopulmonary or cerebral symptoms and in whom the haematocrit is above 65 to 70%.In recent years the viscosity of blood, the occurrence of hyperviscous states, and the effects of hyperviscosity on blood flow have been studied

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Plasma calcium was significantly lower and inorganic phosphorus higher in the umbilical vein plasma of the LBW infants. Magnesium values were comparable throughout. Concentrations of copper were higher in the plasma of the toxaemic mothers but fetal concentrations were normal.The relevance of these findings in relation to placental function and the subsequent development of the infants was discussed.