Efficacy Of Topical Application Research Articles

Quantification of Cannabis in Infused Consumer Products and Their Residues on Skin.

Cannabis consumer products are a $4.6 billion industry in the U.S. that is projected to exceed $14 billion by 2025. Despite an absence of U.S. Food and Drug Administration (FDA) regulation or clinical data, thousands of nutraceuticals, topical consumer products, and beauty products claim benefits of hemp or cannabidiol. However, a lack of required quality control measures prevents consumers from knowing the true concentration or purities of cannabis-labeled products. Thirteen over-the-counter consumer products were examined for the presence of cannabidiol (CBD), cannabinol (CBN), Δ9-tetrahydrocannabinol (THC), cannabidiolic acid (CBDA), and Δ9-tetrahydrocannabinolic acid A (THCA). Additionally, the efficacy of topical applications was investigated using a porcine skin model, in which particle size and zeta potential relate to skin permeability. Skin permeation was correlated to particle size and relative stability in skin-like conditions but not directly related to the CBD content, suggesting that topical products can be designed to enhance overall skin permeation. Of the products analyzed, all products have some traceable amount of cannabinoids, while seven products had multiple cannabinoids with quantifiable amounts. Overall, the need for further regulation is clear, as most products have apparent distinctions between their true and labeled contents.

Naltrexone blockade of OGFr enhances cutaneous wound closure in diabetic rats

AimsNon-healing wounds are a major complication for the 27 million individuals in the United States with diagnosed diabetes. This study investigated the efficacy of a novel formulation to treat diabetic foot ulcers by targeting an underlying pathophysiology of diabetes. Main methodsThe proprietary GMP formulations utilized increasing dosages of naltrexone (NTX) to block the inhibitory peptide Opioid Growth Factor (OGF) from binding to the OGF receptor (OGFr). Efficacy of topical application was studied using male Sprague-Dawley rats with uncontrolled (T1D) or insulin-controlled (T1D-INS) diabetes. Wound closure time, tensile strength of healed skin, and angiogenesis were endpoints. Serum drug dispersion was assessed. Key findingsResidual wound areas were significantly reduced within 2 days of surgery in T1D rats receiving either 0.5% or 1% NTX. By day 10, NTX-treated wounds were 5-fold smaller than those measured on T1D rats receiving vehicle. Tensile strength measurements and morphology studies revealed that NTX treatment of cutaneous wounds on T1D or T1D-INS rats accelerated epithelialization, accelerated angiogenesis, and increased the integrity of healed skin. Topical application of NTX resulted in no visible toxicity, and the NTX was not detected in serum. SignificanceProprietary GMP formulations up to 1% NTX were found to be effective and safe for topical treatment of full-thickness cutaneous wounds in diabetic rats. The mechanism of action involves blockade of the OGF-OGFr axis, a pathway known to become dysregulated with diabetes. These data warrant proof-of-concept human clinical trials for treatment of diabetic foot ulcers.

Topical Use of Plant Extract-Based Oil Blend in Relieving the Symptoms of Primary Dysmenorrhea

A high occurrence of primary dysmenorrhea denotes a considerable female health concern. The objective of this study has been to evaluate the efficacy of topical application of a synergistic blend of plant-extracts oil in relieving the symptoms of primary dysmenorrhea (menstrual pain, pain duration, and menstrual flow). The study design was randomized, double-blind, multi-phasic and was a placebo-controlled cross-over study. Participants were females, 18-20 years old with regular cycles and suffering from symptoms of primary dysmenorrhea. Sixty-four participants were randomly allocated to apply either the test oil or the placebo for first phase of the study. For the second phase, the interventions were switched. It was assessed that topical application of the oil significantly and efficiently reduced 1) menstrual pain within 30 minutes during the first three days of menstruation, 2) duration of menstrual pain during the first three days of menstruation, and 3) amount of menstrual flow as compared to the placebo.

Topical application of mupirocin to exit sites in patients on peritoneal dialysis: a systematic review and meta-analysis of randomized controlled trials

BackgroundThe International Society for Peritoneal Dialysis guidelines recommends the topical application of antibiotics on the exit site for the prevention of peritoneal dialysis (PD)-related infections. However, the recommendation is based on meta-analyses on applying nasal mupirocin ointment or observational or retrospective studies. Here, we evaluated the efficacy of topical application of mupirocin on the exit site for the prevention of PD-related infections.MethodsWe searched the databases, MEDLINE and CENTRAL, documenting the topical application of antibiotics on the exit site in PD patients in April 2017. We included only randomized controlled trials (RCTs) with adult patients wherein the effects of mupirocin were examined. Exit site infection (ESI), peritonitis, and technical failure were assessed as the main outcomes.ResultsOverall, six RCTs were included in this study. It was uncertain whether the application of mupirocin ointment prevents ESI (rate ratio (RR), 0.36; 95% CI, 0.13–1.05), peritonitis (RR 0.78, 95% CI 0.50–1.21), and technical failure (RR, 1.35; 95% CI, 0.25–7.21). Moreover, a comparison between mupirocin and gentamicin showed no difference in the incidence of ESI (RR, 1.14; 95% CI, 0.27–4.81), peritonitis (RR, 0.85; 95% CI, 0.32–2.26), and technical failure (RR, 0.58; 95% CI, 0.28–1.20).ConclusionsIt remains unclear whether topical application of mupirocin on the exit site has any significant effects on PD-related infection or technical failure. Large-scale RCTs with high methodological quality are required to confirm the efficacy of topical application of antibiotics on the exit site.Trial registrationUMINR000039267

Efficacy of Topical Applications on Reducing Uremic Pruritus: A Systematic Review

Introduction: Uremic pruritus is an unpleasant sensation that has been recognized as a frequent complication in patients with chronic kidney disease. This study was undertaken to determine the effect of topical applications for reducing pruritus.Methods: A systematic review was conducted by searching Science Direct, Scopus and Google Scholar to create an integrative 12 articles review focusing on a 10 year period from 2009 to 2018. The language used was English and the studies focused on pruritus, itching, hydration, chronic kidney disease and where the patient did not undergo a kidney transplant. The articles in this systematic review were experimental studies (pre-experimental, true experimental and quasi-experimental).Results: Most of the findings of the studies showed that a topical application for reducing uremic pruritus (clove oil, almond oil, cromolyn sodium 4%, baby oil, sweet almond oil, vinegar and avenasativa, glycerol and paraffin, sericin cream and chia seed oil) can be used as an adjuvant moisturizing agents for pruritis.Conclusion: Topical applications have a positive effect on itching and decreased pruritus. Topical applications are simple, safe, inexpensive and easily applied, so it can be used on many people.

Физиологическое обоснование немедикаментозной методики реабилитации пациентов с хроническим катаральным гингивитом

Treatment of inflammatory periodontal diseases is one of the most urgent problems in dental practice. If we take into account the increase in the level of population allergization, tolerance of microorganisms and their associations to drugs, the approach to treatment with drug-free methods remains very relevant. In this study we deals with the etiological factors of chronic catarrhal gingivitis, we analyze the main means of rehabilitation in this disease, which are used in modern times, justified drug-free approach in the rehabilitation method. As the purpose of the study, we identify the theoretical justification and development of drug-free rehabilitation techniques for chronic catarrhal gingivitis, based on the local application of therapeutic concentrations of medical ozone. In this study we investigate the clinical efficacy of topical application of ozonized olive oil in the complex treatment of patients with chronic catarrhal gingivitis. During the experiment, the high clinical efficacy of the ozonated olive oil method in patients with chronic catarrhal gingivitis was observed, which was used to optimize the pro/antioxidant body system, improve the state of the autonomous system of local immunity of the oral cavity, significantly reduce the values of hygienic indices characterizing the state of the periodontium, significantly reduce the content of microorganisms and their associations, improve clinical indicators. The application method of ozonated olive oil in patients with chronic catarrhal gingivitis, has a therapeutic and healing effect, and also meets the requirements for technologies of periodontal rehabilitation.

Optimization of postoperative management of patients undergoing functional endoscopic sinus surgery

Topicality: The result of surgical treatment depends largely on the chosen method of management of the postoperative period, the main purpose of which is to reduce the effects of surgical trauma. Despite the wide variety of drugs for local and systemic use, the question of pharmacotherapy of the operated sinus remains open to this day. The main properties that a modern drug should possess are safety and high clinical efficacy. Aim: to study the clinical efficacy of topical application of a complex preparation based on a saline solution containing sodium hyaluronate and dexpanthenol in patients with chronic sinusitis after functional endoscopic sinus surgery (FESS). Materials and Methods: Clinical and laboratory studies were conducted on 47 patients with chronic rhinosinusitis who underwent surgery using the FESS technique. Patients were divided into 2 groups according to the principle of the postoperative period. Patients of research group (n=21), except for traditional therapy, was used locally NASOMER (a preparation based on a water-salt solution containing sodium hyaluronate and dexpanthenol); to the control group (n=26) patients entered, in the postoperative period received traditional therapy. Traditional therapy included a toilet of the nasal cavity, the use of short-course topical decongestants, irrigation of the nasal cavity with water-salt solutions. Criteria of clinical effectiveness: data of endoscopy of the nasal cavity, rhinomanometry, activity of the mucociliary transport system. The effectiveness of functional research methods in the postoperative period was determined on the 7th and 14th day of treatment. Results: On the 3rd day of the study, an increase in the swelling of the nasal cavity was observed in patients of both clinical groups, correlated with difficulty in nasal breathing. On the 7th day, a decrease in edema was observed in patients of both groups, but in the experimental group, the index of nasal breathing, according to rhinomanometry, was significantly (p<0.05) different from the control group, and was respectively 1.54±0.14 and 2.04±0.19 kPa/l*s. On the 14th day of the study, no significant difference was observed between these indicators. When studying the activity of the ciliated epithelium of the mucous membrane of the nasal cavity, it was proved that patients of the experimental group on day 7 after surgery showed a statistically significant difference in this indicator compared to the control group (17.8±1.0 and 22.7±2.1 min. respectively). Conclusions: The use of NASOMER after surgical intervention in patients with chronic rhinosinusitis contributes to more effective treatment compared with traditional therapy, as evidenced by the rapid recovery of the main functional parameters according to active posterior rhinomanometry and mucociliary clearance. Based on the results of the studies performed, the use of NASOMER for pharmacotherapy in the postoperative period is recommended for patients who have undergone rhinosurgical interventions with the aim of reducing the period of postoperative rehabilitation as an effective anti-inflammatory and wound-healing agent.

Experimental Evaluation of the Efficacy of Sodium Selenite as a Remedy for Wounds

Relevance. Emergencies, both of natural and anthropogenic origin, are accompanied by a large number of injuries and wounds, the treatment of which is associated with great difficulties due to frequent infectious complications and lethargic repair of damaged tissues. Promising approach to this problem is the use of antioxidants to reduce the severity of inflammation and stimulate repair. Intention. To evaluate the efficacy of topical application of the antioxidant composition based on selenium for acceleration of reparative processes in woundу. Methods. Experimental studies were carried out on 45 male Wistar rats. Wounds in rats were modeled under ether anesthesia by up to 4 cm excision of a pre-depilated area of the skin of the back to the underlying fascia. Wounds were treated by daily dressings with 0.5 % sodium selenite vs dimethyl sulfoxide solvent as a comparator. The presence and nature of the inflammatory reaction, the condition of edges and bottom of wounds, time to cleaning out necrotic tissues and the appearance of granulation, the nature of granulation tissue, time to the onset of epithelialization of wounds and the general condition of animals, the cytogram of wound prints, and the activity of antioxidant protection enzymes were evaluated in rats. Results and Discussion. It has been established that local use of sodium selenite has a stimulating effect on reparative processes in the wound due to increased activity of antioxidant enzymes. Thus, after 6-day treatment. sodium selenite increased catalase activity by 18.1 %, glutathione peroxidase by 63.2 %, glutathione reductase by 46.1 % compared to ointment with dimethyl sulfoxide. It was revealed that enhanced antioxidant protection of wound tissues accelerates maturation of granulations and wounds heal 1.6 times faster than in the control group. Conclusion. Medicinal compositions with sodium selenite are promising for local treatment of wounds.

Efficacy of Topical Application, Leaf Residue or Soil Drench of Blastospores of Isaria fumosorosea for Citrus Root Weevil Management: Laboratory and Greenhouse Investigations.

The efficacy of topical, leaf residue, and soil drench applications with Isaria fumosorosea blastospores (Ifr strain 3581) was assessed for the management of the citrus root weevil, Diaprepes abbreviatus (L.). Blastospores of Ifr were applied topically at a rate of 107 blastospores mL−1 on both the larvae and adults, and each insect stage was incubated in rearing cups with artificial diet at 25 °C, either in the dark or in a growth chamber under a 16 h photophase for 2 weeks, respectively. Percent larval and adult mortality due to the infection of Ifr was assessed after 14 days as compared to untreated controls. Leaf residue assays were assessed by feeding the adults detached citrus leaves previously sprayed with Ifr (107 blastospores mL−1) in Petri dish chambers and then incubating them at 25 °C for 2–3 weeks. Efficacy of the soil drench applications was assessed on five larvae feeding on the roots of a Carrizo hybrid citrus seedling ~8.5–10.5 cm below the sterile sand surface in a single 16 cm × 15.5 cm pot inside a second pot lined with plastic mesh to prevent escapees. Drench treatments per pot consisted of 100 mL of Ifr suspension (107 blastospores mL−1), flushed with 400, 900, or 1400 mL of water compared to 500, 1000, and 1500 mL of water only for controls. The mean concentration of Ifr propagules as colony forming units per gram (CFUs g−1) that leached to different depths in the sand profile per treatment drench rate was also determined. Two weeks post-drenching of Ifr treatments, larvae were assessed for percent mortality, size differences, and effect of treatments in reducing feeding damage to the plant root biomass compared to the controls. Topical spray applications caused 13 and 19% mortality in larvae and adults after 7 days compared to none in the control after 14 days, respectively. Adults feeding on a single Ifr treated leaf for 24 h consumed less than the control, and resulted in 100% mortality 35 days post-treatment compared to 33% in the untreated control. Although offered fresh, untreated leaves after 24 h, only adults in the control group consumed them. Ifr CFUs g−1 were isolated 8.5–10.5 cm below the sand surface for the 1000 and 1500 mL drench rates only, resulting in 2%–4% larval mortality. For all the Ifr drench treatments, no differences were observed in percent larval mortality and size or the effect of treatments in reducing feeding damage to the plant root biomass compared to the controls. These results suggest that the foliar application of Ifr may be an efficient biocontrol strategy for managing adult populations of D. abbreviatus; potential alternative larval management strategies are discussed.

The topical application of ag nanoparticles-based medications after the nasal cavity and paranasal sinuses surgery

Most of the standard methods of treatment of patients with inflammatory nose and paranasal sinuses diseases are not effective enough. Argogel is a topical nanotechnology-based preparation which could be a conservative therapeutic alternative for such patients. The objective of this study was to evaluate the efficacy of topical application of the preparation containing silver nanoparticles in the early post-surgery period of the nasal cavity and paranasal sinuses. The study covered 40 patients with chronic rhinosinusitis aged from 25 to 70 after the ambilateral endoscopic maxillary ethmoidotomy. In the course of treatment on most of the patients, Argogel preparation application was accompanied with rapid improvement of objective state, normalization of rhinoscopic pattern and rhinocytogram results in comparison with application of the ointment Levomekol. This tendency has been observed over the whole treatment period.

Suitable Use of Nanostructures in the Treatment of Tumors by the Radiofrequency Ablation Method

Radiofrequency ablation (RFA) is a minimally invasive method, suitable for treatment of irresectable primary and secondary tumors. The principle of this method is to supply electric current to the target’s centre where it causes coagulative necrosis. Electric current, generated by a radiofrequency (rf.) generator, is used for ablation. Electrodes of different shape and dimensions (according to the type of tumor tissue and lesion shape and size) are then used to optimize 3D distribution of electric current in the area to be treated. If tumor centers are of approximately spherical shape, that could be generated by the use of electrodes, then the treatment will be effective. More irregular the tumor shape is, faster the treatment effect decreases. High doses of energy are concentrated  in the immediate vicinity of the applicator resulting in heat production. Considerable heat loss occurs as the transfer of thermal energy decreases rapidly with distance. Moreover, the thermal energy transfer is significantly influenced by the thermal conductivity, therefore, it depends on the conductivity parameters (including perfusion) of tissues. Thus, the resultant thermal effect may be insufficient to completely treat the predicted tumor area. Other treatment limitations are the total treatment volume and therapeutic time both limited by the maximal temperature near the end of the applicator; temperature above 105°C leads to tissue carbonization and the loss of current conduction in the treated tissue. To improve the effects of treatment methods, there are different solutions: by reducing or increasing the power source of radiofrequency energy, by influencing the spread of current or by influencing the tissue response. Application of suitable combination of nano-particles (because of their dimensions and unique physical and chemical properties) represents a new approach to improve the effects of treatment methods; the applied nano-particles induce selective thermal energy spreading beyond the effective applicator range. It represents an application of nano-biotechnology in this type of medical treatment. The aim of this study is to demonstrate the efficacy of topical application of suitable nanoparticles directly into the tumor before using the applicator for local heating of tissue. This paper will demonstrate that the use of nano-particles (iron oxide) in the method of radiofrequency ablation will influence the size and progress of the final ablation lesion. Experiments were performed on samples of the liver and kidney of pigs and ex vivo on prepared agar phantoms of special materials simulating homogeneous tissue with the application of nanoparticles directly into the tissue (phantom) in the established RF applicator. The source of radiofrequency energy was RITA generator with an operating frequency of 460 kHz, power of 90W. The present work demonstrates that the prepared and applied nanomaterials iron oxide (prepared by the method of Tada et al and Qu et al) can lead to an increase in the resulting ablation spheres up to 50% and shortening the time required to achieve the resulting sphere. It will be proved by the experiment presented in this article.

Topical application of tranexamic acid reduces postoperative bleeding in open-heart surgery: myth or fact?

To determine the efficacy of topical application of Tranexamic acid in controlling postoperative bleeding in open-heart surgery. Double blind randomized control trial. Departments of Cardiac Surgery and Intensive Care of Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC-NIHD), Rawalpindi, Pakistan, from May to October 2011. A total of 100 consecutive adult patients fulfilling the inclusion criteria undergoing elective on-pump cardiac surgeries were randomly divided in groups 'A' and 'B'. A study solution that contained 2.5 g of Tranexamic acid in 250 ml normal saline in group-A and equal amount of normal saline (placebo) in group-B was poured in the pericardial cavity over the mediastinal tissues before sternal closure. Postoperative bleeding was measured in both groups for 24 hours in the cardiac surgical ICU. Efficacy of Topical Tranexamic Acid / Placebo was measured in terms of mean postoperative bleeding in ml. Kindly again include these lines which seem to have been omitted in the final proof. There was significant difference in the mean postoperative bleeding within 24 hours among the two groups 340.1 ± 112.4 ml in Tranexamic acid group vs. 665 ± 187.28 ml in placebo group (p < 0.001). Patients who did not have topical Tranexamic acid before chest closure had a significantly higher postoperative bleeding. Topical Tranexamic acid application is an effective and economical way for controlling non-surgical bleeding in patients undergoing cardiac surgery with cardiopulmonary bypass.

Efficacy of topical application of PTD-SOD on wound healing in mice with mechanical injury

Objective To study the role of the oxidative stress in the development of wound healing and observe the effect of the antioxidant PTD-SOD on damage and inflammation reaction after mechanical wound. Methods In this experiment,acute wound healing model by removal the whole layer dorsal skin of the mice was prepared,SOD(3 000 U and 6 000 U)and the fusion protein PTD-SOD with different concentrations(1 000 U,3 000 U,6 000 U and 10 000 U)were used to deal with the wounds continuously for 13 days.The mice were divided into different concentration SOD treatment group and PTD-SOD treatment group,model control group,physiological saline treatment group and compound iodine solution control group.The wound healing situation and healing percentage of the fight and left skin wounds of each mouse in every group was recorded every day.At day 14 after wound,the wound healing skin of each group was removed and some were used to make 10%tissues homogenate for detecting the activities of superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px)and contents of malondialdehyde(MDA)and hydroxyproline(Hyp);in the meantime,the other removed skin were fixed in 10% formalin for observing the histopathological changes of the tissues. Results Compared with the model control group,the physiological saline treatment group and the compound iodine solution control group,the skin wound healing percentage was significantly(P<0.05 or P<0.01)improved,with increase of the activities of SOD,CAT,GSH-Px and contents of Hyp (P<0.05 or P<0.01)and decrease of MDA(P<0.05 or P<0.01) in the SOD groups or PTD-SOD groups (except for 10 000 U PTD-SOD group).When compared with the physiological saline treatment group or the compound iodine solution treatment group,the effect was similar to the model control group.In comparison to the SOD groups,under the same dosage and environment condition,the PTD-SOD groups were much better than SOD groups with regard to promoting skin wound healing percentage,increasing activities of antioxidases and contents of Hyp,decreasing contents of MDA.Among the PTD-SOD groups,the effect of high dosage 10 000 U on promoting skin wound healing was declined. Conclusions The oxidative stress may playan important role in the development of wound healing.Proper application of treatment with antioxidants is a alternative strategy in the early stage of wound.PTD-SOD is able to prevent the oxidative stress damage,inhibit inflammatory infiltration and promote skin wound healing efficiently. Key words: Wound healing;  Antioxidants;  Oxidative stress;  Reactive oxygen species

A Randomized Controlled Clinical Trial Comparing the Efficacy of Dead Sea Mineral-Enriched Body Lotion versus Two Types of Placebo in the Treatment of Cutaneous Dryness, Itching, Peeling and Tightness in Hemodialysis Patients (EDIT)

Background/Aims: The present study was designed to investigate the short-term safety and efficacy of topical application with body lotion enriched with minerals from the Dead Sea versus 2 different placebo treatments in reducing symptoms of uremic pruritus. Methods: In this single-center, randomized, double placebo-controlled clinical trial, 78 hemodialysis patients with self-reported uremic pruritus were randomized to twice-daily topical treatment with body lotion enriched with minerals from the Dead Sea (DS) or to each of 2 types of placebo: (1) lotion with no Dead Sea minerals but otherwise identical to DS (P1) or (2) lotion with no active ingredients (P2). Symptoms of uremic pruritus (itching, dryness, peeling, tightness) were evaluated at baseline and 2 weeks (14 days) after treatment intervention using a 5-point Likert scale. Results: Following treatment, significant differences in symptom severity scores between DS and P1 and, separately, between group DS and P2, were not detected. Additionally, when DS was compared to the combined placebo groups (P1 and P2 together), significant post-treatment differences in symptom severity scores were not observed. Symptoms were less severe post-treatment regardless of treatment assignment. Conclusions: DS was not superior to either of the placebo treatments in the symptomatic relief of uremic pruritus.

Genivir (DIP-253) 1% Cream versus Placebo Cream in the Treatment of Recurrent Genital Herpes: A Double-Blind Study

A total of 100 heterosexual adults of either sex with frequent episodes of recurrent genital herpes were allocated to treatment with either Genivir (DIP-253) 1% cream or placebo cream. All patients had genital herpes previously verified by a positive viral culture. The study was carried out as a double-blind parallel group trial. Fifty patients were allocated to each of the two treatment groups. The treatment was initiated within 24 hours after the first sign of a recurrence, and at the pretreatment examination all patients had developed typical lesions with blisters and/or sores. At baseline a sample for herpes virus culture and typing was obtained. The creams were applied four times daily for five days. Follow-up examinations were carried out on days 1, 2, 4 and if needed on days 7, 10 and 14. The major factor used for assessment of efficacy was the time to complete healing of all lesions. Duration of pruritus and pain were also recorded. In the group of patients treated with Genivir cream the time to complete healing was 3.3 days and in the placebo group 6.1 days. The difference was statistically significant (P less than 0.001). The mean duration of pain was 1.3 days in the Genivir group and 2.5 days in the placebo group: this difference also reached significance (P less than 0.01). The duration of pruritus was about the same in both groups. The active agent in Genivir, DIP-253, is a heterocyclic aromatic complex with confirmed anti-herpetic activity and with evidence of a local immunomodulatory effect. It was concluded that the efficacy of topical application of DIP-253 may be due to combined antiviral and immunomodulatory activities.

Antibiotic effects on bacterial counts in skin lesions of experimental staphylococcal skin infections in the hamster.

ABSTRACTWe studied the microbiological efficacy of antibiotics on skin infections using experimentally induced skin infection in hamsters.Topical gentamicin (GM), intramuscular injection of GM and oral administration of cephalexin (CEX) were used in hamsters against experimentally induced staphylococcal skin infections. Effects were studied as a function of the dose of cephaloridine (CER) injected intramuscularly at a fixed daily frequency. Effects were also studied as a function of the daily frequency of intramuscular injection of CER at a fixed dose. We found no marked differences in the efficacy of topical application, intramuscular injection, and oral administration. In the dosage study, there were no differences in the efficacy when CER was used at the dosage of 20 mg/kg or more. No differences were found in efficacy when CER was injected twice or more times a day.Topical antibiotic treatment has limitations in the management of skin infection. Skin has a moderate repair activity, so an antibiotic can produce a good clinical course even at a lower concentration than the MIC against a causative organism. The antibiotics studied could give constant efficacy when administered at appropriate doses at fixed frequency or in appropriate frequencies at a fixed dosage.