In-vitro susceptibilities of Pseudomonas aeruginosa and Pseudomonas spp. to the new fluoroquinolones clinafloxacin and PD 131628 and nine other antimicrobial agents.

The in-vitro activities of two new fluoroquinolones, clinafloxacin (CI-960, PD 127391, AM-1091) and PD 131628 (the active component of the pro-drug CI-990, PD 131112) and nine other antibiotics were tested against 107 clinical isolates of Pseudomonas aeruginosa, 12 isolates of Xanthomonas maltophilia, and 19 isolates of other Pseudomonas spp. Of the 107 P. aeruginosa isolates, 33 were resistant to gentamicin, tobramycin and amikacin, 17 were resistant to only one or two of these aminoglycosides and 24 were aminoglycoside sensitive. Thirty-three were isolates from cystic fibrosis patients. Susceptibility studies were performed using the agar dilution technique and kinetic time kill curves. With the exception of aminoglycoside-sensitive P. aeruginosa isolates where ciprofloxacin had similar activity to clinafloxacin and PD 131628, the two new fluoroquinolones were the most active agents against all isolates tested (MIC90 0.25-2.0 mg/L). Cross-resistance was identified with ciprofloxacin and ofloxacin-resistant strains, but the superior activity of clinafloxacin and PD 131628 resulted in 90% of the isolates having MICs < 2 mg/L. Kinetic kill curves with aminoglycoside-sensitive P. aeruginosa revealed ciprofloxacin to have the most rapid and sustained killing. However, with amino-glycoside-resistant P. aeruginosa isolates, clinafloxacin and PD 131628 were more rapidly bactericidal than ciprofloxacin.

Health Education and the primary care physician: the practitioner's perspective.

Considering the attention given to health education and promotion, it is surprising that little research assesses the opinions and behavioral inclinations of physicians. Survey data collected in Florida address this issue. Responses of primary care private practitioners reveal that whereas MDs endorse health promotion and acknowledge a link between positive lifestyle and health, their outlook regarding the potential of community-based health education remains skeptical. A majority blame ineffective health education on public apathy. Nonetheless, a sizeable minority are willing to either begin or increase their involvement in health education programs. Multivariate analyses suggest that active or receptive MDs view the public's lifestyle knowledge as inadequate and select the MD as the health professional most suited to assume primary responsibility for health education. Clues for identifying practitioners who might engage in further health education are provided by examining age, specialty, patient load and community size. For example, GPs/FPs might more readily endorse an educational program if it allows for one-to-one physician-patient interaction; emphasizing this instructional mode appears less important in securing the cooperation of their more specialized primary care counterparts. Further, MDs with the larger caseloads are more likely to view health education as the physician's responsibility.

The need for cooperative health education: some survey findings.

PIP: This paper briefly reviews the literature on health education, presents findings from 2 surveys conducted by the authors in northwest Florida in 1978, and discusses implications of the data. The 2 surveys were a population-based multistage area probability sample of households which attempted to determine the current status of health knowledge, attitudes and practice of the study population, and a mail survey of the area's primary care physicians which sought to assess the extent and type of health education provided by physicians. Usable data was collected from 321 households (53.5%) and 103 physicians (45%). 49% of physicians believed that the average patient has an adequate level of knowledge about healthy lifestyles, but the health knowledge of the 321 household respondents as measured by identification of factors reducing risks for heart attack and recognition of early warning signs of cancer was found to be uneven. 57% of physicians believed that patients were not interested in expanding their knowledge of health, but a majority of respondents reported having been influenced to change their health habits. Discrepancy was found between the amount of time physicians report spending on health education and the amount of such education household respondents claim to receive. 80% of physicians felt that their patients had comparatively low regard for their health, whereas 69% of respondents from households placed health 1st, 2nd or 3rd in a field of 9 life values. The correspondence between health care knowledge and practice was found to be poor in many instances, as measured by the proportion of respondents who smoked, were overweight, failed to exercise or use seat belts, among other areas.^ieng