ADJUNCTS TO ANTIBACTERIAL THERAPY

Antibiotic and prednisolone therapy of erysipelas: a randomized, double blind, placebo-controlled study

112 patients admitted to hospital with a diagnosis of erysipelas, were randomized to 8 days treatment with prednisolone or placebo in addition to antibiotics. 108 patients received the study drugs and were evaluated for time to cure, which was the primary end-point. The median healing time was significantly shorter in the prednisolone group, 5 days, vs 6 days in the placebo group (p < 0.01). The 90th percentile healing time was 10.0 days in the prednisolone group vs 14.6 days in the control group. The prednisolone-treated patients had a median length of hospital stay (secondary end-point) of 5 days vs 6 for the placebo-treated (p < 0.01). The median treatment time with intravenous antibiotics (secondary end-point) was 4 days in the placebo group, which was 1 day longer than in the prednisolone group (p < 0.05). 13 patients, 7 of whom received placebo, relapsed during the observation period of 3 weeks. The frequency of side effects attributable to the study drug was not higher in the prednisolone group.

Role of gamma interferon in the pathogenesis of bacteremic pneumococcal pneumonia

Gamma interferon (IFN-gamma) concentrations in blood, but not in lungs, rose significantly at 24 to 48 h after murine pulmonary infection with virulent pneumococci. In contrast, infection with avirulent pneumococcal strains produced minimal rises in serum IFN-gamma concentrations. Compared with that of immunocompetent mice, mortality was appreciably increased after pulmonary infection of IFN-gamma gene knockout mice, suggesting a protective role for IFN-gamma in host response to pneumococcal disease.