The clinical use and toxic reactions of the sulfonamide compounds

Abstract

Local therapy with the sulfonamide compounds is of value in the prevention and treatment of certain infections which are of a more or less superficial nature. The sulfonamide compounds when used locally rarely cause toxic reactions. Their use apparently does not interfere with the healing of wounds. Sulfanilamide and sulfathiazole are the drugs of choice, and they need not be sterilized before use. Systemic use is indicated in the treatment of the more severe infections and as a prophylactic measure before the extraction of infected teeth in patients suffering from rheumatic heart disease (to reduce the possibility of the development of subacute bacterial endocarditis). The occurrence of a previous toxic reaction is the principal contraindication to the use of these drugs. Treatment is begun early and orally, if possible. A large initial dose and a smaller maintenance dose are given. Soda bicarbonate is administered simultaneously, fluid output must be above 1200 c.c. per day, and special diet is unnecessary. In severe infections the level of the drug in the blood is determined. Use of the drug is stopped when convalescence is well established. Toxic reactions of importance include nausea and vomiting, cyanosis, acidosis, drug fever, skin eruptions, anemia, leucopenia, jaundice, cerebral complications, and urinary tract complications.