Fundamental considerations in the chemotherapy of acute pneumonias

Abstract

The present treatment programs prescribed for the acute pneumonias have been helpful in reducing mortality and morbidity rates. Attainment of truly satisfactory results, however, has not been reached despite the availability of many antimicrobial agents. Many infections simple to treat, such as pneumococcic pneumonia, have been made more complicated by the common prescription of antibiotics in excessive, clumsy and expensive fashion. Other pneumonias, viral in origin, are being needlessly treated with drugs and probably often should not be. Klebsiella pneumonia can be made a less morbid and mortal infection in certain instances by combined therapy with massive amounts of both penicillin and streptomycin, in addition to one of the tetracyclines. These and other considerations in the chemotherapy of acute pulmonary infections have been discussed. Most importantly, however, it is emphasized that unless each patient with pneumonia is studied carefully and even exhaustively prior to prescription of drugs, knowledge will not be increased and the unsolved problems will remain needlessly enigmatic. It has been shown that the morbidity and mortality of acute pulmonary infections can be reduced impressively; from 1900 to 1948 there were yearly improvements. However, they are not yet perfect and should be better. The empiric prescription of antimicrobial agents for all pneumonia may be lulling too many physicians into a state of false security about the infection. Further careful and detailed studies into the many unanswered problems about pneumonia are warranted and are encouraged.