New novobiocin preparations in hospital practice
David, N.A.; Mccawley, E.L.; Debolt, W.L.
Antibiotics Annual 1956: 402-410
1956
ISSN/ISBN: 0570-3131 PMID: 13425412 Document Number: 9433
Novobiocin was used intramuscularly mainly to determine the proper amounts of diluent required for solution of the 250 or 500 mg. doses of the powder and to find out how well injections of various dilutions would be tolerated. It was possible to dissolve the 500 mg. dose of novobiocin in 2 ml. of diluent providing a period of from 10 to 20 minutes was allowed for complete solution; however, we usually used the larger amounts of 2.5 or 3 ml. for solution and injection, since this was more convenient and somewhat less painful on injection. Fifteen adult patients and 1 infant were given intramuscular injections before transfer to oral therapy. In only the patient who could not swallow was the intramuscular route of administration used exclusively. The sirup preparation of novobiocin, given to 12 infants, was found convenient, easily administered in various dosages, well tolerated, and quite acceptable. A clear-cut evaluation of the response to novobiocin was difficult to make, since 14 of the 34 adults and 11 of the 16 infants received other antibiotic therapy during novobiocin treatment. However, results were arbitrarily considered as excellent in 10 adults, good in 15, fair in 5, and inconclusive or poor in 4. The response to novobiocin in the pediatric group was excellent. Of possible interest relative to the future use of novobiocin was the finding that 19 of the 34 organisms obtained on culture from 20 of the adult patients were sensitive to novobiocin. Moreover, in 4 staphylococcal and 2 E. coli infections, these organisms were sensitive to only novobiocin. Mild toxic reactions occurred in 12 adults and 3 infants. Five adults had skin eruptions, 4 complained of transient nausea, 3 (including 2 infants) had mild diarrhea or loose stools, 1 ambulant nurse complained of vertigo, and 1 infant who had been given novobiocin intramuscularly apparently had a yeast infection appearing at several sites of injection. An eosinophilia of from 6 to 17 per cent appeared in 7 patients and in 2, on continuation of novobiocin, decreased or the count returned to normal. No other abnormalities of the hematopoietic system were noted nor was there any evidence of hepatic or kidney dysfunction.
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