The effect of peroral penicillin-V (55 mg/kg/day in 7 days) on acute otitis media was studied in 149 children between the ages of 1 and 10 years in a double-blind, placebo-controlled investigation. The parameters of the disease employed were symptom scores for earache, fever and common cold, the use of analgetics, otoscopy, as well as tympanometry. The children were followed-up for 3 months. Penicillin had no effect on fever and common cold, but earache was significantly reduced on the 2nd day of treatment. The acute course of the disease was satisfactory in 69% of the children in the placebo group and in 86% in the penicillin group. In patients with pneumococci or haemolytic streptococci in the nasopharynx, the pain disappeared after 1-2 doses of penicillin, whereas the treatment had no effect in children with Haemophilus influenzae. There was no difference between the penicillin and the placebo groups with regard to the results of otoscopy and tympanometry after 1 week, 1 month and 3 months. No serious complications were observed. It is concluded that an attitude of "masterly inactivity" with regard to the treatment of acute otitis media is justifiable, provided sufficient analgesic treatment is given and also that the patient can be closely followed. As there are still many unanswered questions more controlled investigations are warranted.

An anaerobic adaptation of the lysis-filtration system for detection of anaerobic microorganisms in blood is described. The method was compared with a conventional broth bottle system in detection of anaerobic bacteremia after oral surgery. Of 43 blood samples obtained during and after surgery, 31 were positive with the lysis-filtration system and 17 were positive with the broth bottle system. Sixteen aerobic and 62 anaerobic strains were isolated with the lysis-filtration system versus 9 aerobic and 22 anaerobic strains with the broth bottles. The lysis-filtration technique was thus superior to the conventional broth bottle method in detecting anerobic bacteria.

The effect of antibiotic prophylaxis on bacteraemia was assessed in 60 oral surgery operations. Fifty-one patients were divided in three groups receiving a 2 g dose of phenoxymethylpenicillin, a 0.5 g dose of erythromycin or no prophylaxis. During operation, the total numbers of bacteria were lower in the antibiotic groups than in the non-treatment groups (P less than 0.05). The number of patients with anaerobic bacteraemias, however, were similar in all three groups. The incidences of bacteraemia 10 min after operation were significantly lower in the antibiotic groups (P less than 0.05). The minimum inhibitory concentrations (MICs) of phenoxymethylpenicillin were below 2 mg/l in 93% of the strains and the minimum bactericidal concentrations (MBCs) were below this value in 80% of the strains. The MICs of erythromycin were below 2 mg/l in 80% of the isolates, and the MBCs were between 4-32 mg/l in 62% of the isolates.

10 healthy volunteers received 200 mg norfloxacin orally every 12 h for 7 days. Saliva, throat and faecal specimens were collected days 0, 3, 5, 7, 14 and 21 to study the effect of norfloxacin on the normal microflora. The concentrations of norfloxacin in serum, urine, saliva and faeces were determined by a microbiological method and all samples except faeces were also assayed by high-pressure liquid chromatography (HPLC). The pharmacokinetics of norfloxacin were studied on day 3. The mean peak serum concentration (+/- SD) attained after 0.75-1.0 h was 0.75 +/- 0.15 mg/l measured by HPLC, and the mean terminal serum half-life was 4.2 +/- 0.6 h. The mean cumulative urinary elimination was 29% during 12 h after dosing. There was no significant difference between values obtained by microbiological assay and by HPLC. The saliva concentration was approximately 30% of the serum levels 1.0-1.5 h after administration. No accumulation in faeces was found during the administration period, and mean concentrations were 940 mg/kg. The changes in the oropharyngeal flora were minor and only branhamella were affected. In the colonic flora, the number of enterobacteria was strongly depressed while the anaerobic microflora was only slightly affected. Two weeks after the administration period, both the oropharyngeal and colonic microflora had returned to normal.

1 Erythromycin concentrations in serum and urine were determined in 24 healthy male, fasting subjects after oral administration of 250, 500, or 1000 mg of erythromycin base (250 mg capsules containing enteric‐ coated pellets). The subjects also received a film‐coated erythromycin stearate tablet (equivalent to 500 mg base). 2 The mean +/‐ s.d. maximal serum erythromycin concentrations were 1.9 +/‐ 0.8, 3.8 +/‐ 1.4, 6.5 +/‐ 2.9 and 2.9 +/‐ 1.7 mg/l for 250, 500, or 1000 mg base and 500 mg stearate, respectively. The serum peaks usually occurred after 2 h irrespective of dosage form given. 3 The mean +/‐ s.d. areas under the serum concentration v time curves (AUC0‐infinity) were 4.5 +/‐ 1.7, 11.2 +/‐ 4.3, 27.2 +/‐ 10.6 and 7.5 +/‐ 3.4 mg l −1 . h after 250, 500, or 1000 mg base, and 500 mg stearate, respectively. 4 The urinary recoveries were 5.0, 6.7, 8.6% of the base doses given and 4.4% of the stearate dose given. 5 Dose‐dependent excretion of erythromycin occurred. The increase in AUC was larger than multiples of the lowest base dose.