Twenty-seven patients with peritonitis to whom a drain was applied were given sulbenicillin (SBPC), a broad-spectrum antibiotic, which has to so little hepatic and renal toxicity that massive doses may be feasible, and examination was made as to its therapeutic effects and concentrations of the antibiotic in the ascites.
Daily dosage of SBPC was 10g in two divided doses in most cases given by the intravenous infusion. Medication was continued for 3-15 days. The highest daily dosage was 20g and the largest total dosage reached 190 g, but there was no adverse reaction except for one case of a slight anemia.
Peritonitis complicated appendicitis, adnexitis, duodenal ulcer perforation, intestinal obstruction or trauma as its primary disease. No difference in the therapeutic effect existed among the primary diseases. The response to SBPC treatment was excellent in 8 of the 27 patients and good in 17. Two patients failed to respond to the therapy.
When SBPC was givep. just before operation, the SBPC concentration in ascites obtained at operation was 112μg/ml in 2 cases. The SBPC concentrations in ascites were examined following intravenous infusion of 5g over an hour, and a peak concentration of 94.7μg/ml was obtained at the completion of infusion (an hour after the start of infusion), which gradually decreased thereafter. In the ascites excreted from the drain after operation, a high concentration of 12.7-90.2μg/mi (mean: 51.7±7.7g/ml) was obtained on the day after the operation day, but the concentration was lower thμEreafter.
The SBPC concentrations in ascites were compared as regards the sites of drainage (WnisLow's foramen, ileocecum and DOUGLAS' fold), but no particular difference was observed.
The SBPC concentrations in ascites after operation were in inverse proportion to the alleviation of peritonitis. They were higher when the inflammation was severer.

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A patient with epilepsy, 45 years of age, developed a lung abscess due to Fusobacterium nucleatum which was successfully treated with intravenous lincomycin. Quantitative anaerobic cultures of washed sputum proved to be useful in detecting the causative organism.

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A radioimmunoassay for an aminoglycoside antibiotic, sagamicin, was developed using antisera from rabbits injected with a sagamicin-bovine serum albumin conjugate. Sagamicin was iodinated by a modified BOLTON & HUNTER method. The standard curve was linear on a logit-log plot yielding an sensitivity of 0.5 ng/tube. A correlation coefficient of 0.95 was obtained between the radioimmunoassay and a microbioassay for sagamicin in human sera. Cross-reaction occurred with gentamicin components and some of sagamicin subunits, but there was no cross-reactivity to neomycin, kanamycin and amikacin. Antibody was purified by affinity chromatography on sagamicin bound agarose.

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Combinations of tobramycin (TOB) with cephalothin (CET) or carbenicillin (CBPC) were evaluated by in vitro test against 161 clinical isolates of Klebsiella pneumoniae, Escherichia coli, indole-positive Proteus, Enterobacter and Serratia marcescens which were not inhibited by 6.25 ug/ml of CET.
The combinations were considered to show synergy when there was a 4-fold or greater reduction in MIC values (FIC index<0.5) of both antibiotics when combined. Synergy of TOB with CET could be demonstrated against 83% of Klebsiella pneumoniae, 78% of E. coli, 44% of Proteus reugeri and 39% of Proteus inconstans. Synergy of TOB with CBPC could be demonstrated against 78% of Proteus vulgalis, 45% of Serratia marcescens and 28% of Proteus inconstans.
Bactericidal effect showing synergy of TOB with CET could also be demonstrated against each 2 strains of Klebsiella pneumoniae and E. coli.
Frequency of synergy of TOB with CET under the condition of large inoculum size was significantly higher than that of synergy of TOB with CET under the condition of small inoculum size.
Synergy of bactericidal effect of TOB combined with CET against Klebsiella pneumoniae and E. coli was more active when they were combined at the same time, than those of when TOB was combined after 2 hours exposure by CET or when CET was combined after 2 hours exposure by TOB.
No antagonistic action was observed in these.studies.

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The antibacterial activities, absorption and excretion of talampicillin hydrochloride were compared with those of amoxicillin and ampicillin.
Talampicillin hydrochloride showed a broad-spectrum antibacterial activity against Gram-positive and Gram-negative bacteria as seen in amoxicillin and ampicillin. The antibacterial activities of talampicillin hydrochloride, amoxicillin and ampicillin were quite similar.
In experimental murine infection with Staphylococcus aireus, protective effect of talampicillin hydrochloride was superior to ampicillin. For Escherichia coli infection, protective effect of talampicillin hydrochloride was similar to that of amoxicillin, while ampicillin was less active than both talampicillin hydrochloride and amoxicillin.
The absorption and excretion of 250 mg equivalent doses of talampicillin hydrochloride, amoxicillin and ampicillin were compared in nine fasting healthy volunteers after oral administration of these antibiotics in randomized triple crossover study. In order to calculate the pharmacokinetic parameters, plasma levels were analyzed using an one-compartment open model, as well as area under the plasma concentration curve (AUC) and urinary excretion. Maximum plasma levels calculated were 2.8 times higher for talampicillin hydrochloride and 1.45 times higher for amoxicillin than for ampicillin. AUC was greater for talampicillin hydrochloride than for amoxicillin and lowest for ampicillin. Urinary excretion of talampicillin hydrochloride as penicillin determined in biological assay was comparable to that of amoxicillin and 1.55 times higher than that of ampicillin. Penicillins can be metabolized to penicilloic acids in the body. After taking into account the penicilloic acid contents in urine, total excretion in urine was 61% for talampicillin hydrochloride, 67% for amoxicillin and 42% for ampicillin during 6 hours after dosing.
The absorption of the drugs was evaluated according to the plasma levels, the area under plasma concentration curve and the percentage of excretion in urine. The results obtained showed that talampicillin hydrochloride was well absorbed from the gastro-intestinal tract.

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