- Email: [email protected]
Comments on Current Literature: Advances in Antibiotic Therapy
THE JOURNAL OF PEDIATRICS VOLUME
VOHRA ETAL
134, NUMBER 5 17. Knauth A, Gordin M, McNelis W, Baumgart S. Semipermeable polyurethane membrane as an artificial skin for the premature neonate. Pediatrics 1989;83:945-50. 18. LeBlanc MH. Thermoregulation: Incubators, radiant warmers, artificial skins, and body hoods. Clin Perinatol 1991;18:403-22. 19. Ryser G, Jequier E. Study by direct calorimetry of thermal balance on the first day of life. Eur J Clin Invest 1972;2:176-87. 20. Yashiro K, Adams FH, Emmanouilides GC, Mickey MR. Preliminary studies on the thermal environment of low-birthweight infants. J Pediatr 1973;82:991-4. 21. Sauer PJJ, Dane HJ, Visser HKA. New standards for neutral thermal environment of healthy very low birthweight infants in week one of life. Arch Dis Child 1984;59:18-22. 22. Bruck K, Parmelee AH, Bruck M. Neutral temperature range and range of thermal comfort in premature infants. BioI Neonate 1962;4:32-51.
11. Dahm LS, James LS. Newborn temperature and calculated heat loss in the delivery room. Pediatrics 1972;49:504-13. 12. Baum JD, Scopes JW The silver swaddler. Lancet 1968; 1:672-3. 13. Baumgart S, Engle WD, Fox ww, Polin RA. Effect of heat shielding on convective and evaporative heat losses and on radiant heat transfer in the premature infant. J Pediatr 1981;99:948-56. 14. Bell EF, Weinstein MR, Oh WHeat balance in premature infants: Comparative effects of convectively heated incubator and radiant warmer, with and without plastic heat shield. J Pediatr 1980;96:460-5. 15. Baumgart S. Reduction of oxygen consumption, insensible water loss, and radiant heat demand with use of a plastic blanket for low-birth-weight infants under radiant warmers. Pediatrics 1984;74:1022-8. 16. Besch NJ, Perlstein PH, Edwards NK, Keenan WJ, SutheriandJM. The transparent baby bag. N Engl J Med 1971;284:121-4.
50 Year.lAgo
in~Tbe
23. Hey EN, Katz G. The optimum thermal environment for naked babies. Arch Dis Child 1970;45:328-34. 24. Bloom RS, Cropley C, the AHNAAP Neonatal Resuscitation Steering Committee, editors. Textbook of neonatal resuscitation. 3rd ed. Dallas (TX): American Heart Association; 1994. p. 2-9. 25. Whyte RK, Vohra S. Are we there yet? A cumulative method for determining when to stop a clinical trial. (abstract) Pediatr Res 1997;41:187A. 26. Lyon AJ, Pikaar ME, Badger p, McIntosh N. Temperature control in very low birth weight infants during the first five days of life. Arch Dis Child 1997;76:F47-F50. 27. Kleinbaum DG, Kupper LL, Muller KE. Analysis of covariance and other methods for adjusting continuous data. In: Applied regression analysis and other multivariate methods. 2nd ed. Boston: PWS-Kent; 1988.
Journal of PeuiatricJ
COMMENTS ON CURRENT LITERATURE: ADVANCES IN ANTIBIOTIC THERAPY
Blattner RJ. J Pediatr 1949;34:656-7 R. J. Blattner brings to readers' attention 2 remarkable discoveries: the isolation of neomycin from StreptomyceJ grMew and chloramphenicol from Streptomyc&f venezue!ae and a pharmaceutical feat, the chemical synthesis of chloramphenicol. The last opened a door for pharmaceutical research and development that still stands wide. It had been only 5 years since the discovery of streptomycin and its observed miraculous effect on tuberculosis, yet development of bacterial resistance and drug-related neurotoxicily already was evident. Interestingly, the new wonder drug, neomycin, would have less staying power because of cochlear toxicily than streptomycin, which remained the cornerstone of therapy for Haemophi1IM infl=nzae Iype b meningitis until the 1970s and continues to be part of combination drug therapy in some cases of tuberculosis. Chloramphenicol has been the Mr Hyde and Dr Jekyll of the antibiotic genre-saving lives of countless individuals with epidemic, murine, and scrub Iyphus, spotted fevers and rickettsial pox, psittacosis, Iyphoid fever, and bacterial meningitis while costing lives with drug-related aplastic anemia. And the beat goes on. Wonder drug ... drug resistance ... drug toxicily ... abandoned drug-in 4-part harmony. In the modern research theme, however, h~mdreds of thousands of "wannabe" antibiotics are isolated or created and laboratory-tested for toxicity and emergence of resistance, as well as antimicrobial activity, but only a few are brought to animal experimentation and fewer to human trials. Even after package inserts are written and final approval given, we have learned to be more guarded than Dr Blattner about "advances" in antibiotic therapy. We are reminded continuously that microbes have been around a lot longer than we have.
Section oj Infectiow DMetU&f St. ChrMtopher;' HfMpilaljor ChiIJren Philadelphia, PA 19134-1095
551
VOHRA ETAL
134, NUMBER 5 17. Knauth A, Gordin M, McNelis W, Baumgart S. Semipermeable polyurethane membrane as an artificial skin for the premature neonate. Pediatrics 1989;83:945-50. 18. LeBlanc MH. Thermoregulation: Incubators, radiant warmers, artificial skins, and body hoods. Clin Perinatol 1991;18:403-22. 19. Ryser G, Jequier E. Study by direct calorimetry of thermal balance on the first day of life. Eur J Clin Invest 1972;2:176-87. 20. Yashiro K, Adams FH, Emmanouilides GC, Mickey MR. Preliminary studies on the thermal environment of low-birthweight infants. J Pediatr 1973;82:991-4. 21. Sauer PJJ, Dane HJ, Visser HKA. New standards for neutral thermal environment of healthy very low birthweight infants in week one of life. Arch Dis Child 1984;59:18-22. 22. Bruck K, Parmelee AH, Bruck M. Neutral temperature range and range of thermal comfort in premature infants. BioI Neonate 1962;4:32-51.
11. Dahm LS, James LS. Newborn temperature and calculated heat loss in the delivery room. Pediatrics 1972;49:504-13. 12. Baum JD, Scopes JW The silver swaddler. Lancet 1968; 1:672-3. 13. Baumgart S, Engle WD, Fox ww, Polin RA. Effect of heat shielding on convective and evaporative heat losses and on radiant heat transfer in the premature infant. J Pediatr 1981;99:948-56. 14. Bell EF, Weinstein MR, Oh WHeat balance in premature infants: Comparative effects of convectively heated incubator and radiant warmer, with and without plastic heat shield. J Pediatr 1980;96:460-5. 15. Baumgart S. Reduction of oxygen consumption, insensible water loss, and radiant heat demand with use of a plastic blanket for low-birth-weight infants under radiant warmers. Pediatrics 1984;74:1022-8. 16. Besch NJ, Perlstein PH, Edwards NK, Keenan WJ, SutheriandJM. The transparent baby bag. N Engl J Med 1971;284:121-4.
50 Year.lAgo
in~Tbe
23. Hey EN, Katz G. The optimum thermal environment for naked babies. Arch Dis Child 1970;45:328-34. 24. Bloom RS, Cropley C, the AHNAAP Neonatal Resuscitation Steering Committee, editors. Textbook of neonatal resuscitation. 3rd ed. Dallas (TX): American Heart Association; 1994. p. 2-9. 25. Whyte RK, Vohra S. Are we there yet? A cumulative method for determining when to stop a clinical trial. (abstract) Pediatr Res 1997;41:187A. 26. Lyon AJ, Pikaar ME, Badger p, McIntosh N. Temperature control in very low birth weight infants during the first five days of life. Arch Dis Child 1997;76:F47-F50. 27. Kleinbaum DG, Kupper LL, Muller KE. Analysis of covariance and other methods for adjusting continuous data. In: Applied regression analysis and other multivariate methods. 2nd ed. Boston: PWS-Kent; 1988.
Journal of PeuiatricJ
COMMENTS ON CURRENT LITERATURE: ADVANCES IN ANTIBIOTIC THERAPY
Blattner RJ. J Pediatr 1949;34:656-7 R. J. Blattner brings to readers' attention 2 remarkable discoveries: the isolation of neomycin from StreptomyceJ grMew and chloramphenicol from Streptomyc&f venezue!ae and a pharmaceutical feat, the chemical synthesis of chloramphenicol. The last opened a door for pharmaceutical research and development that still stands wide. It had been only 5 years since the discovery of streptomycin and its observed miraculous effect on tuberculosis, yet development of bacterial resistance and drug-related neurotoxicily already was evident. Interestingly, the new wonder drug, neomycin, would have less staying power because of cochlear toxicily than streptomycin, which remained the cornerstone of therapy for Haemophi1IM infl=nzae Iype b meningitis until the 1970s and continues to be part of combination drug therapy in some cases of tuberculosis. Chloramphenicol has been the Mr Hyde and Dr Jekyll of the antibiotic genre-saving lives of countless individuals with epidemic, murine, and scrub Iyphus, spotted fevers and rickettsial pox, psittacosis, Iyphoid fever, and bacterial meningitis while costing lives with drug-related aplastic anemia. And the beat goes on. Wonder drug ... drug resistance ... drug toxicily ... abandoned drug-in 4-part harmony. In the modern research theme, however, h~mdreds of thousands of "wannabe" antibiotics are isolated or created and laboratory-tested for toxicity and emergence of resistance, as well as antimicrobial activity, but only a few are brought to animal experimentation and fewer to human trials. Even after package inserts are written and final approval given, we have learned to be more guarded than Dr Blattner about "advances" in antibiotic therapy. We are reminded continuously that microbes have been around a lot longer than we have.
Section oj Infectiow DMetU&f St. ChrMtopher;' HfMpilaljor ChiIJren Philadelphia, PA 19134-1095
551