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Blindness Induced by Double-blindedness

Blindness Induced by Double-blindedness Abstract To the Editor. —I am sympathetic to the apology by Conn for his "ert" placebo that was published in the June 1981 Archives (141:846-847). Unfortunately, the pH-lowering effect of sorbitol complicates interpretation of his encephalopathy trials even more than acknowledged in the editorial. The antimicrobial activity of the aminoglycoside antibiotics is notably diminished by increased acidity.1 Thus, the fact that "lactulose was found to be more effective than neomycin [sulfate] plus sorbitol" may not be as happy an observation as Conn sanguinely asserts. The decreased stool pH induced by sorbitol would have diminished the antibacterial effect of the neomycin, thus likely making it seem less effective than it would if used alone while, reciprocally, increasing the apparent effectiveness of lactulose together with neomycin. References 1. Young LS, Hewitt WL: Activity of five aminoglycoside antibiotics in vitro against gram-negative bacilli and Staphylococcus aureus. Antimicrob Agents Chemother 1973;4:617-625.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Blindness Induced by Double-blindedness

Archives of Internal Medicine , Volume 142 (7) – Jul 1, 1982

Blindness Induced by Double-blindedness

Abstract

Abstract To the Editor. —I am sympathetic to the apology by Conn for his "ert" placebo that was published in the June 1981 Archives (141:846-847). Unfortunately, the pH-lowering effect of sorbitol complicates interpretation of his encephalopathy trials even more than acknowledged in the editorial. The antimicrobial activity of the aminoglycoside antibiotics is notably diminished by increased acidity.1 Thus, the fact that "lactulose was found to be more effective than...
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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340200176037
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —I am sympathetic to the apology by Conn for his "ert" placebo that was published in the June 1981 Archives (141:846-847). Unfortunately, the pH-lowering effect of sorbitol complicates interpretation of his encephalopathy trials even more than acknowledged in the editorial. The antimicrobial activity of the aminoglycoside antibiotics is notably diminished by increased acidity.1 Thus, the fact that "lactulose was found to be more effective than neomycin [sulfate] plus sorbitol" may not be as happy an observation as Conn sanguinely asserts. The decreased stool pH induced by sorbitol would have diminished the antibacterial effect of the neomycin, thus likely making it seem less effective than it would if used alone while, reciprocally, increasing the apparent effectiveness of lactulose together with neomycin. References 1. Young LS, Hewitt WL: Activity of five aminoglycoside antibiotics in vitro against gram-negative bacilli and Staphylococcus aureus. Antimicrob Agents Chemother 1973;4:617-625.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1982

References