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Proper care of the umbilical cord of newborn infants may prevent later infections. When St Joseph's Hospital in Hamilton, Ontario, started using alcohol instead of triple dye for umbilical cord care, there was a dramatic increase in the incidence of bacterial colonization in newborns in the nursery and, later, in the number of cases of staphylococcus-related skin infections in infants born at the hospital. Follow-up on 1,545 infants revealed that triple dye was significantly more effective than alcohol in reducing the growth of gram-positive organisms, especially Staphylococcus aureus and group B streptococcus, and several gram-negative organisms. Because hospital medical staff had carefully collected data on bacterial colonization, they were quickly aware of the problem and could justify resuming the use of triple dye.

The antibacterial activity of trimethoprim-sulfamethoxazole against 99 strains of Staphylococcus epidermidis was tested on media known to be low in thymidine content, as determined by screening with Streptococcus faecalis. Eighty-one percent of the isolates were susceptible by agar dilution. Trimethoprim-sulfamethoxazole was bactericidal against two strains of S. epidermidis when thymidine phosphorylase was added to the medium, indicating utilization of minimal amounts of thymidine that were undetected by screening. Because bacteria vary in their utilization of thymidine and body tissues vary in thymidine content, in vitro susceptibility tests may not correlate with in vivo bactericidal activity.