1e:T40c,AFTER thermal burns local and systemic infection, especially withPseudomonas aeruginosa, is a major cause of death. The use of soluble sodium sulfonamides in wounds and burns was investigated during World War II,¹and in studies of extensive burns,²topical antibacterial therapy was combined with treatment for the burn wound by using a neutralized mixture of tannic acid and sodium sulfadiazine. Although the results were good, emphasis shifted to the role of sodium salts in systemic therapy in an era of disbelief in the efficacy of local antibacterial therapy. As predicted in 1952 by Meleney,³there is now a renaissance of topical antibacterial therapy with the introduction of dilute silver nitrate solutions⁴and mafenide-containing ointments.⁵Both agents are effective in burn wound sepsis, especially that caused byP aeruginosa, but both also produce characteristic fluid and electrolyte alterations. The hypotonic (29.4 millimol/liter) silver nitrate solution1f:T44e,We assessed the efficacy of periodic instillations of hydrogen peroxide into urinary drainage systems in the prevention of catheter-associated bacteriuria in a prospective and randomized clinical study of 668 patients with indwelling urethral catheters. Bacteriuria was documented in 68 (10%) of the 668 patients after a mean duration of four days of catheterization. There was no difference between the hydrogen peroxide group and the control group in the mean duration of catheterization before the onset of bacteriuria, in the attack rate for bacteriuria, or in the spectrum of etiologic agents recovered. Bag contamination with the same organism responsible for bacteriuria preceded infection in only five (7%) of the 68 patients, three patients using hydrogen peroxide and two in the control group. We conclude that infections arising intraluminally from contamination of the drainage bag are uncommon among catheterized patients and that the periodic instillation of disinfectants into closed sterile drainage systems is not effective in reducing the incidence of catheter-associated bacteriuria.20:T66b,

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