Combined Bacteriostatic Activity of Sulfanilamide and Azochloramid upon Group A Hemolytic Streptococcus and Enterococcus

Abstract

The therapeutic effectiveness of sulfanilamide may be markedly enhanced in the presence of other antibacterial agents, notably immune serums. The question presents itself as to whether or not a similar synergistic action may be obtained by the combined use of two different chemotherapeutic substances. In vitro studies on the combined bacteriostatic activity upon pneumococci of sulfapyridine or sulfathiazole and optochin hydrochloride (ethylhydrocupreine hydrochloride) or beta hydroxyethylapocupreine dihydrochloride (Parke, Davis & Co.) failed to reveal such a synergistic effect. On the other hand, it could be shown that with E. coli as test organism, the combined use of pyridium (phenylazo-alpha-alpha-diamino-pyridine mono-hydrochloride) and sulfamido compounds resulted in bacteriostatic effects beyond that exerted by either compound alone. The activity of sulfamido compounds and azochloramid used in combination against hemolytic streptococcus Group A and enterococcus is reported in the following communication. Azochloramid (N, N'x-Dichloroazodicarboxamidine) (Wallace and Tiernan products) was chosen as a representative of chlorine compounds. It is a bacteriostatic and bactericidal agent which is relatively stable and whose effectiveness in the presence of organic matter is inhibited to a slight degree only. As test microörganisms a strain of beta hemolytic streptococcus (Group A Lancefield) which was isolated from the chest fluid of a patient with empyema and a strain of hemolytic enterococcus that was isolated from the urine of a patient with infection of the urinary tract, were used. Brain heart infusion and 1/4% maltose phenol red broth (Difco) were employed as culture media. Sulfanilamide [p-aminobenzenesulfonamide, prontylin, repurified for injection (Winthrop)] and sulfathiazole [2-sulfanilamidothiazole (Squibb)] were dissolved in appropriate amounts in broth by heating in a water bath. These solutions as well as the broth media were sterilized by autoclaving at 15 lb pressure for 12 minutes.