The Health bulletin [serial] - University of North Carolina at Chapel Hill

May, 1951 The Health Bulletin 11Baltimore, writing in the Journal ofthe American Medical Association, recommendthat penicillin ointment beused in the eyes of newborn infants inpreference to silver nitrate because, intheir opinion, it is "the most eflacacious,the safest and least irritative agent"for this purpose.Dr, Davidson is on the staff of JohnsHopkins University and Hospital andis also senior assistant surgeon. UnitedStates Public Health Service. JustinaHill is also with the United States PublicHealth Service.Laws requiring the use of silver nitrateare a precautionary measure toprotect newborn babies from gonococcuseye infection. Such an infection—whichcan easily be transmitted at birth toan infant by a gonorrhea-infected mother—couldresult in serious eye damageor blindness.The doctors expressed the opinionthat, where necessary, regulations governingthe us» of silver nitrate shouldbe changed "to permit the use of penicillinoinment in hospital practice whenthe physician prefers it to silver nitrate."These recommendations come as aresult of their study of three differentmethods of eye care at Johns HopkinsHospital—penicillin ointment, penicillinintramuscular Injections, and silver nitrate.Each method was used in rotationfor a week at a time. During a twoyear period, 4,163 infants were treatedwith one of the three methods.All three methods proved equally effectivein preventing gonococcal infection,they reported, but the incidenceof eye irritation varied greatly.Only 10.6 per cent of the penicillinointment treated babies showed anysigns of inflammation such as redness,swelling or discharge. The Incidence ofirritation in silver nitrate treated babieswas 48.7 per cent. Irritation fromthe intramuscular treatment of penicillinwas recorded as 13.8 per cent."This observation," they said, "is inkeeping with the general experiencethat silver nitrate produces chemicalconjunctivitis (eye inflammation) In ahigh proportion of cases. (This inflammationdoes not cause serious or permanentinjury to the eye.)"Two other points in favor of thechange to penicillin ointment, accordingto the article, were that the costis approximately the same as that ofsilver nitrate and it Is easier to use.USE STREPTOMYCIN TO TREATTUBERCULOSIS IN CHILDRENStreptomycin has proved valuable intreating tuberculosis in children vmder12, according to an article in the Journalof the American Medical Association.Drs. William Berenberg, Charles D.Cook and Claire W. Twinam of Boston,authors of the article, tested the drugon 27 children between the ages of 7weeks and 17 years.They reported the following results:the disease was arrested in five, 18were improved, three were unimprovedand one was worse. The patient whobecame worse was a 7 weeks old Infantwho developed tuberculous meningitis.All three of the patients who did notimprove were over 12 years of age.Eight patients over 12 received the drugbut only two appeared to derive anylasting benefit from it, the doctors said.They explained that tuberculosis inchildren under 12 is somewhat differentfrom the type encountered in adultsand children over 12. Most children,they continued, between the ages of 3and 12 do well without specific treatment.The 27 children who received the drugwere selected because they failed toimprove with the usual treatment.Streptomycin may be expected to"supplement but not replace" the timetestedmeasures of prevention of reinfection,hygienic regulation, dietarysupervision, adequate rest and nursingcare in the treatment of tuberculosisin children, they said.