Ticarcillin, a broad-spectrum penicillin [l], is susceptible in inactivation by a number of beta-lactamases. Clavulanic acid, a naturally occurring beta-lactamase inhibitor, has been shown to prevent the enzymatic degradation of beta-lactam antibiotics by a number of bacterial species [2]. In vitro studies have shown that in combination, ticarcillin and clavulanic acid may be synergistic in activity [3,4]. In the current study, we evaluated the clinical efficacy and safety of this combination in hospitalized patients with skin and skin structure infections. PATIENTS AND METHODS Patient Population. This research protocol was approved by the Human Studies Committee at both Hahnemann University Hospital and St. Michael’s Medical Center. The 79 patients in this study were adults hospitalized at either of the just mentioned medical centers, and informed consent was obtained by the investigators from each patient who entered the study. Each patient had either an acute or chronic skin or skin structure infection caused by an organism or organisms known or suspected to be susceptible to the combination of ticarcillin plus clavulanic acid. Patients excluded from the study included: pregnant or lactating women; recipients of an antimicrobial agent within the previous 72 hours to which the pathogen was susceptible; subjects with a known hypersensitivity to penicillin; and patients with known moderate to severe renal or hepatic dysfunction. Laboratory Studies. The following laboratory determinations were made before, during, and after treatment with ticarcillin plus clavulanic acid: complete hemogram, prothrombin time, quantitative platelet count, direct Coombs’ test, alkaline phosphatase, bilirubin, serum glutamic oxalacetic transaminase, serum glutamic pyruvic transaminase, lactic dehydrogenase, serum concentrations of sodium, potassium, chloride, carbon dioxide, blood urea nitrogen, serum creatinine, blood glucose, and urinalysis. Blood, purulent exudates from wounds, pus from abscesses, and excised tissue were obtained before, during, and after antibiotic therapy for aero

AbstractElectronic thermometers used in many hospitals require insertion into the mouth of a temperature-sensing probe covered by a pre-packaged probe cover. Handling procedures used by hospital personnel can lead to inadvertent manual contact with the probe cover. We attempted to determine the rate of non-sterility of these probe covers under normal hospital conditions and the extent to which pathogens could be detected on these and other components of the thermometer. Probe covers were removed before entry into the patient's mouth and aseptically inoculated into fluid thioglycollate medium. Subcultures were made to appropriate differential media. Over a 13-week period, 180 covers were cultured on two private hospital services. Forty-three percent were found to be non-sterile; control covers from central supply were only 6% non-sterile. Four percent of the probe covers harbored potential pathogens: coagulase positive Staphylococcus aureus, Streptococcus pyogenes, Enterobacter, and Bacteroides. No attempt was made to correlate these findings with infection. These results indicated a potential infection hazard for high-risk patient groups and a need by hospital personnel to consider this as a possible source of contamination [Infect Control 1981; 2(4):315-6.]