EXPERIMENTAL STUDIES ON THE MEDICAL TREATMENT OF SUPPURATIVE MENINGITIS

Abstract

en-abstract=The experimental study was done on the medical treatment of suppurative meningitis using sulfa drugs such as domian, thiazine and supronal, and antibiotics such as penicillin (P), streptomycin (SM), chlortetracyclin (CTC), oxytetracyclin (OTC), tetracyclin (TC), chloramphenicol (CM) and erythromycin (EM). The drugs were given to normal and diseased rabbits by oral route, intravenous or intramuscular injection. I. The dispersion into the cerebrospinal fluid. In the sulfa-drugs, the best dispersion was seen with domian, next with supronal and then with thiazine. When the drugs were given intravenously, the dispersion into the spinal fluid and also the elimination from the spinal fluid were remarkably faster than that of oral administration. However, the concentration in the spinal fluid did not show remarkable difference when the drugs were given intravenously or orally, suggesting that the initial dose to be given intravenously in urgent cases, and followed by oral maintenauce doses. In the antibiotics, the best dispersion was shown by CM and TC and then OTC, CTC, SM, EM and P in order. In the rabbits with meningitis, the effective concentration of CM and TC in the cerebrospinal fluid was maintained for 6 hours after the injection but the effective concentration of the other antibiotics was maintained for 3 hours after the injection in most of the cases. Though 'CM, TC and OTC were effective in the treatment of meningitis other antibiotics were less effective in the treatment because of lower concentration, short duration of effective concentration and uncertain dispersion. II. Meningeal irritation Sulfa drugs were strongly irritative and inappropriate for the intrathecal use. Among the antibiotics, P, TC and OTC were slightly irritative, CTC and SM were moderately irritative and CM and EM were most irritative. Among these antibiotics, OTCwas least irritative. P, TC and OTC were thought to be most appropriate for the intrathecal use. III. Elimination of drugs from the cerebrospinal cavity. In the normal rabbits, P, OTC, TC and CM in the cerebrospinal fluid were eliminated quickly and disappeared in 6_??_7 hours from the spinal cavity. SM, CTC and EM were eliminated slowly and considerable amount of the antibiotics remained in the fluid even 24 hours after the injection. In the rabbits with meningitis, the elimination of the drugs from the cerebrospinal cavity was retarded, effective concentration being kept for 18_??_24 hours. IV. Drugs to promote the dispersion of the antibiotics into the cerebrospinal fluid. Hyaluronidase, methobromine, amid of nicotinic acid and immidarin were given togather with CM, EM and P, and the change in dispersion of these drugs in the cerebrospinal fluid was studied using the normal rabbits. These drugs except immidarin increased the dispersion of the antibiotics into the cerebrospinal fluid, particularly that of EM and P.