A patient-initiated system for hospital review over 2 yr offers some clinical benefit compared with the traditional system, using fewer resources and attracting greater patient confidence. Longer-term assessment of the system would be appropriate.
Unpublished data made available to us suggested that a new antibiotic, aureomycin,3 was of low toxicity, was highly effective against a variety of experimental infections in animals, and, therefore, warranted a clinical trial. The bacteriological studies which were conducted as part of the clinical evaluation of this agent are presented in this paper. SENSITIVITY OF VARIOUS BACTERIA Aureomycin hydrochloride was found to have considerable antibacterial action in vitro against a wide range of gram-positive and gram-negative bacteria. The sensitivities to aureomycin of 186 strains of organisms recently isolated from patients in the Boston City Hospital are presented in table 1. Among the strains of the various organisms tested, only those of Proteus vulgaris and of Pseudomonas aeruginosa were regularly found to be relatively resistant to aureomycin. COMPARATIVE SENSITIVITY TO THREE ANTIBIOTICS The sensitivity to aureomycin, penicillin, and streptomycin of a selected group of microorganisms is presented in table 2. Weight for weight, aureomycin was found to be less effective than penicillin, but more effective than streptomycin, in the case of most coccal organisms. Aureomycin was about as effective as streptomycin against most gram-negative bacilli. Aureomycin possesses equal antibacterial activity against penicillin-sensitive and penicillin-resistant staphylococci as well as against streptomycin-sensitive and streptomycin-resistant bacteria. It is also effective against streptomycin-dependent organisms. FACTORS INFLUENCING ANTIBACTERIAL ACTIVITY OF AUREOMYCIN The concentration of antibiotic which is necessary to inhibit any bacterium depends upon many factors, some of which are concerned chiefly with the antibiotic and others of which have largely to do with the microorganisms. Those
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