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Streptomycin in clinical practice. A review and case reports
SUPPORTIVE TREATMENT Streptimycin in Clinica! Practice. A Review and Case Reports. John S. Hunt, Vanderbilt University School of Xedieine, Pratt. 1: K-86, October, 1346.
Hugh J. Morgan Nashville, Term.
and Am.
-% review of the present-day knowledge of streptomycin and a report of 45 additional These cases represented examples of suseases treated with the antibiotic are presented. ceptible infections selected by the committee on chemotherapeutics and other agents of the National Research Council for more extensive clinical trial of streptomycin. The need for a simple method of estimating levels of streptomycin in body fluids is stressed. Estimation of such levels by methods of bioassay is difficult and subject to erfol The authors feel that only general rules for optimum dosage unless carefully controlled. of streptomycin in various infections can be laid down because of the wide variation in the susceptibility in vitro to streptomycin of different bacterial species and of different strains of the same species. They emphasize the importance of in vitro tests of the SUSceptihility of bacteria to streptomycin in order to insure the administration of adequate doses of the antibiotic and to minimize the risk of acquired resistance to it. They are in agreement with other investigators who recommend the institution of treatment of susceptible infections with large doses of streptomycin in order to bring about rapid control of the infection and to prevent the development of resistant bacterial strains. All parenterally administered streptomycin was given by repeated intramuscular injections, and the authors feel that multiple or continuous intravenous injections are They believe that intrathecal rarely necessary in the treatment of severe infections. administration of streptomycin is advisable in cases of meningitis caused by susceptible organisms because of the unpredictable rate of diffusion of the antibiotic into the eerebrospinal fluid. Baeteremia due to gram-negative bacilli was controlled in five instances, but in the four cases in which well-established tissue foci of infection were present, streptomycin therapy had no effect on. the lesions. Surgical drainage of abscesses, where possible, is necessary in such patients. Ro serious toxic reactions were encountered. T. J. c. Oral Penicillin.
Editorial.
south.
X. J. 41: 18;1, February,
1348.
The advantages of drugs taken by mouth instead of parenterally are obvious. Wfectiveness of oral penicillin has been studied rather extensively in the past, two years, and it would appear that if it is given in quantities four or five times the intramuscular dose an effective blood concentration is obtained.‘Husson,z of T\‘ew York University, has observed blood concentrations obtainable in normal infants from one week to five months of age, all free from infection. Calculating amounts and timing dosage from previous work of several investigators on the subject, Husson dissolved 20,000 units of penicillin in 5 to 10 C.C. of water, and administered it in the first ounce of the infant’s formula. He concluded that an adequate serum concentration was 0.06 units per c.c., and estimated the serum concentration at various intervals after ingestion. Several of the infants 672
Hugh J. Morgan Nashville, Term.
and Am.
-% review of the present-day knowledge of streptomycin and a report of 45 additional These cases represented examples of suseases treated with the antibiotic are presented. ceptible infections selected by the committee on chemotherapeutics and other agents of the National Research Council for more extensive clinical trial of streptomycin. The need for a simple method of estimating levels of streptomycin in body fluids is stressed. Estimation of such levels by methods of bioassay is difficult and subject to erfol The authors feel that only general rules for optimum dosage unless carefully controlled. of streptomycin in various infections can be laid down because of the wide variation in the susceptibility in vitro to streptomycin of different bacterial species and of different strains of the same species. They emphasize the importance of in vitro tests of the SUSceptihility of bacteria to streptomycin in order to insure the administration of adequate doses of the antibiotic and to minimize the risk of acquired resistance to it. They are in agreement with other investigators who recommend the institution of treatment of susceptible infections with large doses of streptomycin in order to bring about rapid control of the infection and to prevent the development of resistant bacterial strains. All parenterally administered streptomycin was given by repeated intramuscular injections, and the authors feel that multiple or continuous intravenous injections are They believe that intrathecal rarely necessary in the treatment of severe infections. administration of streptomycin is advisable in cases of meningitis caused by susceptible organisms because of the unpredictable rate of diffusion of the antibiotic into the eerebrospinal fluid. Baeteremia due to gram-negative bacilli was controlled in five instances, but in the four cases in which well-established tissue foci of infection were present, streptomycin therapy had no effect on. the lesions. Surgical drainage of abscesses, where possible, is necessary in such patients. Ro serious toxic reactions were encountered. T. J. c. Oral Penicillin.
Editorial.
south.
X. J. 41: 18;1, February,
1348.
The advantages of drugs taken by mouth instead of parenterally are obvious. Wfectiveness of oral penicillin has been studied rather extensively in the past, two years, and it would appear that if it is given in quantities four or five times the intramuscular dose an effective blood concentration is obtained.‘Husson,z of T\‘ew York University, has observed blood concentrations obtainable in normal infants from one week to five months of age, all free from infection. Calculating amounts and timing dosage from previous work of several investigators on the subject, Husson dissolved 20,000 units of penicillin in 5 to 10 C.C. of water, and administered it in the first ounce of the infant’s formula. He concluded that an adequate serum concentration was 0.06 units per c.c., and estimated the serum concentration at various intervals after ingestion. Several of the infants 672