The cutaneous application of antiviral agents was studied by iontophoresis, a process that increases penetration of most drugs 20- to 60-fold. Twenty-seven subjects with vesicular orolabial herpes were treated one time in a double-blind, placebo-controlled clinical study: nine received vidarabine monophosphate (ara-AMP), nine received acyclovir (ACV), and nine received NaCl. Ara-AMP-treated lesions yielded lower titers of virus after 24 hr compared with lesions treated with NaCl or ACV (P less than .05). Ara-AMP significantly decreased the duration of shedding of virus (P less than .05) and time to dry crust (P less than .05) compared with the other two agents. There was a trend toward decreased healing time after ara-AMP treatment.
Osteomyelitic rat tibiae were examined by scanning electron microscopy for the extracellular glycocalyx of Staphylococcus aureus. S. aureus and fractured tibiae from normal rats were incubated together in vitro and examined similarly. Low magnification of endosteal Haversian portals from tibiae studied in vivo and in vitro disclosed adherent S. aureus exuding glycocalyx that buried the organism in dense, coccoid-studded biofilms. The biofilm became progressively more dense over time in vitro and was exuberant at day 70 in vivo. S. aureus incubated in vitro without tibiae disclosed no glycocalyx. Bone chips studied in vitro disclosed staphylococci more commonly near the endosteal Haversian portals than on the intervening endosteal surfaces (mean +/- SE, 280 +/- 75 vs. 12 +/- 3 per 2,500-micron 2 field; P less than .002 by Student's t test). Organisms within ostia were not counted, although they occluded 10%-40% of the ostium. Staphylococci were adherent to exposed woven material, perhaps collagen.
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