INFECTIONS Recurrent furunculosis often affects several members of the same family. Even if all are treated with appropriate antistaphylococcal an- tibiotics, recurrences are frequent. Steele 1 first treated a number of families with oral oxacillin or dicloxacillin, twice-daily showers with hexachlo- rophene-containing soap, and bacitracin cream intranasally for 2 weeks. Then, in randomly se- lected families, all members were inoculated in- tranasally with nonpathogenic Staphylococcus au- reus 502A or with a placebo. No recurrences of furunculosis occurred if colonization of the nares was successful. With a placebo inoculation recur- rences were frequent. Since cultures of S. aureus 502A can apparently be kept frozen indefinitely and still retain viability, this approach lends itself to office use. Gonococcal septicemia often presents with a few necrotic pustules on acral areas. The usual practice is to hospitalize patients with this disease, although they are not particularly ill, and treat them intensively with antibiotics. According to Thompson et al, z this may be unnecessary. They found that penicillin G, one million units intrave- nously every 3 hours for 3 days, was no more effective than oral erythromycin, 500 mg every 6 hours for 5 days. Thus, it seems that gonococcal septicemia can be readily and safely treated on an outpatient basis. Ketoconazole, a new, oral antifungal agent, has been shown to be effective in most cases of tinea versicolor. 3 The 4 weeks of therapy was associ- ated with minimal systemic side effects in a few patients. Even more effective, less costly, and safer is the topical application of 50% propylene glycol in water. Faergemann and Fredriksson '~ re- ported complete clearing in twenty patients after 2 weeks of twice daily use. Perhaps even a lower concentration of propylene glycol would be effec- tive and would reduce the risk of excessive drying and irritation. In a well-conducted, double-blind study, unde- cylenic acid powder was shown to be more effec- tive than a placebo in the treatment of tinea pedis. Chretien et al '~ reported that after only 2 weeks of therapy negative cultures were obtained in 88% of those treated with the active preparation and in only 14% of the control group. In striking con- trast, a negative potassium hydroxide (KOH) preparation was present in about 60% of patients treated with either the active or the placebo prep- aration. This disparity between the results of fun- gal cultures and KOH preparations shows up fairly
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