Oral ciprofloxacin versus intravenous therapy with other non-quinolone agents: a study of 291 infections.

A retrospective comparison of oral ciprofloxacin in mono- or combination therapy versus standard intravenous (i.v.) therapy with non-quinolone agents was undertaken to evaluate efficacy and cost in actual clinical practice. The choice, dose and duration of antibiotic therapy was determined solely by the patients' physicians. The patients were treated for infections of the lower respiratory tract; urinary tract and skin (totalling 291 infections). The most frequent species isolated were Escherichia coli (21.6%), Staphylococcus aureus (12%), and Pseudomonas aeruginosa (11.7%). No significant differences (p > 0.10) in the cure rates and duration of infection were observed when comparing oral ciprofloxacin only, versus standard i.v. therapy. The administration of simultaneous combination therapy resulted in a lower cure rate and longer infection, regardless of the site of infection. The duration of therapy required to show a cure or improvement was significantly shorter (p < 0.0001) for oral ciprofloxacin alone, than for i.v. therapy and ciprofloxacin combination therapies.

Comparison of the Oxi/Ferm and N/F systems for identification of infrequently encountered nonfermentative and oxidase-positive fermentative bacilli.

The N/F system (Flow Laboratories, Inc. Rockville, Md) and the Oxi/Ferm Tube, (Roche Diagnostics, Div. Hoffman-La Roche, Inc. Nutley, N.J.) were evaluated in parallel for identification of infrequently encountered nonfermentative gram-negative bacilli and oxidase-positive, fermentative gram-negative bacilli selected from fresh clinical isolates and stock cultures. When compared with conventional media, the Flow N/F system correctly identified 97.7% (86 or 88) of all strains tested. No organisms were misidentified, but this system failed to identify two strains. Six supplemental tests were needed for the complete identification of 16 strains (18%); however, correct results were obtained within 48 h for 85% of the isolates. The Oxi/Ferm method correctly identified 87.5% of the isolates; 7% were incorrectly identified, and the method failed to identify five strains. Seventeen supplemental tests were required to identify 64 strains (73%). Complete identification within 48 h was obtained for 60% of the organisms tested.

Entamoeba histolytica: efficacy of microscopic, cultural, and serological techniques for laboratory diagnosis.

Of 110 subjects with clinical evidence of amebiasis, 15 (14%) were shown to be infected with Entamoeba histolytica. Microscopic examination of stool specimens rendered a diagnosis in all eight cases of localized intestinal infection, but in only one of seven patients with invasive amebiasis. Culture was concomitantly diagnostic in six patients intestinal amebiasis and in one patient with extraintestinal infection. Assay for antibody to E. histolytica by counterimmunoelectrophoresis and indirect hemagglutination were each 100% effective in all cases of invasive amebiasis and in diagnosing two of eight patients with intestinal infection. Stool specimens of 15 patients revealing intestinal parasites other than E. histolytica failed to demonstrate cultural or serological evidence of amebiasis. Low levels of antibody were observed in the indirect hemagglutination assay in four patients with disease other than amebiasis and in three control sera positive for rheumatoid factor. By counterimmunoelectrophoresis, reactive sera were only encountered among those derived from patients with amebiasis. Six of seven patients with hepatic amebiasis may have gone undiagnosed if not for serology.