Value Of Penicillin Research Articles

John Lennard-Jones

John Edward Lennard-Jones was a pioneering gastroenterologist and an exceptional man in many ways. Known affectionately to his colleagues as “LJ,” he was a caring and astute physician, a gentle...

Value of penicillin in the prevention of pain, swelling and trismus following the removal of ectopic mandibular third molars

A double-blind randomised placebo-controlled study of the value of systemic penicillin in preventing pain, swelling and trismus following the removal of impacted mandibular third molars indicates that penicillin may be used justifiably in the more difficult cases.

Human Dissection and Experimentation With Drugs

Roger Bacon 1 in the 13th century stated the dilemma of the physician-investigator thus: The operative and practical sciences which do their work on insensate bodies can multiply their experiments till they get rid of deficiency and errors, but a physician cannot do this because of the nobility of the material in which he works. Confronted with this dilemma, some investigators substituted speculation for experimentation, others sought answers from the lower animals, and a few used humans as subjects. How well were the rights of these humans respected? In Walter Reed's experiments, in the early studies of the therapeutic value of penicillin, streptomycin, and poliomyelitis vaccine, and in hundreds of others, investigators were scrupulous in consulting each person before the experiment was performed. But examples illustrating a contrary attitude can be found. In 1836, a New Orleans physician wrote with regard to the shock-like state in cholera: I have been

Penicillin in late latent syphilis; results of therapy with procaine penicillin in aluminum monostearate.

So much attention has been centered on penicillin therapy of asymptomatic syphilis and efforts to stabilize and streamline it, that the use of this new type of treatment for late latent syphilis has been relegated to the background. This subject was undertaken in order to determine, among other objectives, the therapeutic value of penicillin in late latent syphilis cases as to the outcome of serologic tests. A review of the recent annual reports of the Philadelphia Department of Public Health reveals that late latent syphilis comprises better than one-half of the total syphilis cases reported. For the purpose of this paper late latent syphilis is defined as asymptomatic syphilis of more than four years' duration with no clinical or laboratory evidence except a positive blood serologic test. There are many reasons for this apparent lack of interest in the treatment of late latent syphilis with penicillin since opinions vary

THE TREATMENT OF SALMONELLOSIS WITH MASSIVE DOSES OF PENICILLIN COMPARED WITH OTHER METHODS OF THERAPY

Salmonellosis can be treated with intramuscular crystalline penicillin in large doses. Although the results are not consistently good, the clinical course and bacteriologic "cures" in 7 cases compared favorably with the results in 19 cases treated with chloramphenicol and other drugs. Serum penicillin levels varying from 4.2 to 48.0 units/ml. occur in time sera of patients receiving 150,000 units (0.090 gm.)/ kg./24 hr. of crystalline penicillin intramuscularly divided into 6 doses. The problem of dependable elimination of the carrier state in patients with salmonellosis by chemotherapeutic means remains unsolved. The value of penicillin in combination with an easily administered dosage form of probenecid deserves further investigation.

Differential diagnosis of rheumatic fever in office practice.

This discussion is based chiefly on experience gained in the examination of 2,639 children seen in consultation for the presence of active rheumatic fever and heart disease; it represents problems encountered by over 250 physicians in their practice. The errors in the early diagnosisof rheumatic fever and heart disease frequently result in labeling normal children rheumatic or cardiac. It is partly in hope of sparing some children needless invalidism that these observations are presented. The value of penicillin in the prevention of rheumatic fever also makes it important to accurately identify the rheumatic child so that he may be carefully maintained on long-term prophylaxis. HEART MURMURS AND HEART SOUNDS Systolic Murmur.— The finding which most often raises in the mind of the physician the question of the presence of rheumatic fever is the discovery of a systolic murmur. Eleven hundred fifty-one of the 2,639 children seen were referred for this

Penicillin treatment and immunity to scarlatina.

SummaryThe effect of penicillin on immunity following scarlatina has been investigated. Comparative studies were made of the incidence of second attacks in Stockholm during the pre‐penicillin period 1938–46 and during the penicillin period 1947–51. Parallel series in addition comprised treated and untreated cases.Early second attacks, or relapses, in hospital diminished considerably due to the lesser risk of cross‐infections. The frequency of early second attacks within the first three months of recovery was, however, as great as previously. Apart from the possibility of impaired immunologic conditions during this first period, the factors governing the recurrence of attack at this stage are nowadays the risk of infection from the home environment and also, to some degree, the lack of intensity in treatment. A reduction in the early second attacks should be obtainable as a result of effective treatment and after‐control of the patients and of eradication of bacteria from the environment.As regards the late second attacks (after three months) the frequency was many times higher in 0–14 year‐old children who had been treated with penicillin than in the untreated. With increase in age, moreover, the relative frequency of second attacks rose still more. The interval between attacks was much shorter than in the pre‐penicillin period. There was thus a marked deterioration in immunity, which was all the more pronounced as the children grew older.It proved probable that the risk of a new attack of scarlatina could be diminished by postponement of treatment. This is in agreement with the observation that second attacks among penicillin‐treated desquamation cases are very much less numerous than among treated cases of scarlatina.The value of penicillin in the treatment of scarlatina is so great that its use should be continued. The tendency to second attacks, even recurring attacks, is on the other hand so considerable, at least in built‐up areas, that a modification in the treatment should be introduced. Postponed treatment can be adopted in all cases in children except those exhibiting markedly toxic symptoms or purulent complications.

The treatment of granuloma inguinale, lymphogranuloma venereum, chancroid, and gonorrhea.

PHYSICIANS interested in the treatment of venereal disease have been stimulated by the advent of the antibiotics to investigate the potentialities of these drugs in this field of endeavor. This discussion is concerned with the value of the commonly used antibiotics in the treatment of gonorrhea and its cutaneous manifestations, chancroid, lymphogranuloma venereum, and granuloma inguinale. More studies have been conducted to evaluate these drugs in the treatment of gonorrhea than in any other one of the venereal diseases, primarily because of the predominance of this infection. This report presents a review of the current literature as well as a summary of the work done in the department of dermatology and syphilology at the University of Maryland School of Medicine. GONORRHEA Penicillin.— There have been numerous reports attesting the value of penicillin in the treatment of gonorrhea. 1 It is an established fact that penicillin in doses sufficient to produce

Subacute bacterial endocarditis due to streptobacillus moniliformis.

Cases of rat bite fever due to Streptobacillus moniliformis have been extensively reported in recent years, and this disease has been distinguished from that due to Spirillum minus. 1 Bacterial endocarditis due to S. moniliformis has been reported rarely, a survey of the literature revealing but four cases of this complication. 2 An additional unpublished case has come to our knowledge. 3 All these cases have ended fatally. Three of them occurred in the prepenicillin era, and two occurred soon after the use of penicillin was begun and prior to the recognition of the importance of massive doses of the drug in the treatment of endocarditis. The value of penicillin in S. moniliformis infections was experimentally demonstrated by Heilman, 4 and this drug has been shown to be clinically effective by many workers. 5 The present case is reported because it is the first apparent cure of subacute bacterial endocarditis

PENICILLIN TREATMENT OF STREPTOCOCCAL PHARYNGITIS

Article1 October 1948PENICILLIN TREATMENT OF STREPTOCOCCAL PHARYNGITISJ. PHILIP LOGE, M.D., EDWIN D. KILBOURNE, M.D.J. PHILIP LOGE, M.D.Search for more papers by this author, EDWIN D. KILBOURNE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-29-4-698 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring recent years the commonplace and ubiquitous entity of "streptococcus sore throat" has been the object of intensive study. Interest in hemolytic streptococcal pharyngitis has been heightened both by its importance as an acute epidemic disease during the war, and by its current recognition as a primary excitant of rheumatic fever and glomerulonephritis. Coincidentally, the discovery of effective antistreptococcal agents has aroused interest in the treatment of the acute disease and the prevention of its sequelae.The critical appraisal of any treatment demands the establishment of strict control groups and accurate delineation of the natural history of the disease in...Bibliography1. KILBOURNELOGE EDJP: The comparative effects of continuous and intermittent penicillin therapy on the formation of antistreptolysin in hemolytic streptococcal pharyngitis, Jr. Clin. Invest., 1948, xxvii, 418. CrossrefGoogle Scholar2. RANTZBOISVERTSPINK LAPJWW: Hemolytic streptococcal and nonstreptococcal respiratory disease. A comparative clinical study, Arch. Int. Med., 1946, lxxviii, 369. CrossrefGoogle Scholar3. : Endemic exudative pharyngitis and tonsillitis, Jr. Am. Med. Assoc., 1944, cxxv, 1163. Google Scholar4. WEINSTEIN L: Effect of types of treatment on development of antistreptolysin in patients with scarlet fever, Proc. Soc. Exper. Biol. and Med., 1946, lxiii, 449. CrossrefGoogle Scholar5. MCDERMOTT W: Personal communication. Google Scholar6. RAMMELKAMPKIRBY CHWM: Factors determining the dosage of penicillin in the treatment of infections, Bull. New York Acad. Med., 1945, xxi, 656. Google Scholar7. DICKDICK GFGH: Scarlet fever, 1938, Year Book Publishers. Google Scholar8. RANTZBOISVERTSPINK LAPJWW: Hemolytic streptococcic sore throat: the post streptococcic state, Arch. Int. Med., 1947, lxxix, 401. CrossrefGoogle Scholar9. PLUMMERDUERSCHNERWARRENROGLIANOSLOAN NDRHDFTRA: Penicillin therapy in hemolytic streptococcic pharyngitis and tonsillitis, Jr. Am. Med. Assoc., 1945, cxxvii, 369. CrossrefGoogle Scholar10. RANTZBOISVERTSPINK LAPJWW: Hemolytic streptococcal sore throat Antibody response following treatment with penicillin, sulfadiazine and salicylates, Science, 1946, ciii, 352. CrossrefGoogle Scholar11. HIRSHDOWLINGSWEET HLHFLK: Treatment of various infections with penicillin X, with a preliminary note on the value of penicillin X in scarlet fever, Ann. Int. Med., 1946, xxv, 78. Google Scholar12. HIRSHROTMAN-KAVKADOWLINGSWEET HLGHFLK: Penicillin therapy of scarlet fever: comparison with antitoxin and symptomatic therapy, Jr. Am. Med. Assoc., 1947, cxxxiii, 657. CrossrefGoogle Scholar13. HOYNEBROWN ALRH: Penicillin for scarlet fever, Jr. Am. Med. Assoc., 1947, cxxxiii, 661. CrossrefGoogle Scholar14. RANTZBOISVERTSPINK LAPJWW: Etiology and pathogenesis of rheumatic fever, Arch. Int. Med., 1945, lxxvi, 131. CrossrefGoogle Scholar15. TODD EW: Antihaemolysin titers in hemolytic streptococcal infection and their significance in rheumatic fever, Brit. Jr. Exper. Path., 1932, xiii, 248. Google Scholar16. COBURNPAULI AFRH: Studies on the immune response of the rheumatic subject and its relationship to activity of the rheumatic process, Jr. Exper. Med., 1935, lxxii, 129. CrossrefGoogle Scholar17. RANTZRANDALL LAE: Antibacterial precipitating antibodies in group A hemolytic streptococcus sore throat, Am. Jr. Med., 1947, 551. CrossrefMedlineGoogle Scholar18. MOTEJONES RJTD: Studies of hemolytic streptococcal antibodies in control groups, rheumatic fever and rheumatic arthritis, Jr. Immunology, 1941, xli, 35. Google Scholar19. DOWLINGHIRSH HFHL: The inability of penicillin to inactivate the Dick and Schick toxins, Proc. Soc. Exper. Biol. and Med., 1946, lxiii, 163. Google Scholar20. JONESGOERNERMASSELL TDJRBF: Use of penicillin in the treatment of carriers of beta-hemolytic streptococci among patients with rheumatic fever, New England Jr. Med., 1947, ccxxxvii, 576. Google Scholar21. RUBENSTEINFOLEY ADGE: The effect of chemotherapy on the duration of the carrier state following scarlet fever, New Eng. Jr. Med., 1945, ccxxxiii, 315. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication July 17, 1948.From the Station Hospital, Ft. Monmouth, N. J.†Department of Medicine, Washington University, St. Louis, Mo.‡The Rockefeller Institute for Medical Research, New York City.§Typings were obtained on 80 patients (62.2 per cent); of these 56 were type 23 and 24 were type 19. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFACTORS INFLUENCING CONTROLLED CLINICAL DRUG EVALUATION IN SELF-LIMITING DISEASEPANEL DISCUSSIONSevere Streptococcal DiseaseAttempts to influence antibody formation by tetracyclineA comparison of “symptomatic treatment,” gamma globulin, and penicillin in the treatment of scarlet feverINFLUENZA A PRIME: A CLINICAL STUDY OF AN EPIDEMIC CAUSED BY A NEW STRAIN OF VIRUS*EDWIN D. KILBOURNE, M.D., J. PHILIP LOGE, M.D. 1 October 1948Volume 29, Issue 4Page: 698-714KeywordsGlomerulonephritisHospital medicineNatural history of diseasePenicillinPharyngitisRheumatic feverStreptococcal pharyngitisStreptococcus Issue Published: 1 October 1948 PDF downloadLoading ...

Penicillin in the Treatment of Diphtheria and the Diphtheria Carrier State

THE importance of diphtheria has been reemphasized lately by experiences with the disease in foreign countries during the war and its aftermath and by slight but statistically significant increases in the prevalence of diphtheria in this country. The clinical manifestations and complications have been completely described in the older literature. An important aspect of the problem now being developed is the application of antibiotics in treatment. The value of penicillin in diphtheria has been established in extensive clinical trials by Karelitz et al.1 and by Weinstein.2 The following investigations confirm their findings in a series of 97 additional penicillin-treated cases . . .

Carcinoma of the Bronchus with Especial Reference to its Treatment by Radiotherapy

1. The incidence, ætiology, pathology, symptomatology and diagnosis of carcinoma of the bronchus are briefly described, and the extreme importance of early diagnosis emphasised. 2. Although pneumonectomy is the treatment of choice in suitable cases, it is pointed out that the number of operable cases is small, not more than about 10 per cent. 3. The contradictory opinions as to the value of radiotherapy are referred to. 4. The techniques of treatment by deep X-rays, which I have employed, are described, and the value of penicillin during the course of treatment stressed. 5. A series of 213 cases of carcinoma of the bronchus, seen in Mount Vernon Hospital during the years 1942–6, is analysed. 6. The results of radiotherapy are evaluated under the headings of possibility of cure, prolongation of life, and relief of symptoms.

The Value of Penicillin in Surgery

The Value of Penicillin in Surgery

TODAY'S TREATMENT OF SYPHILIS

The fluid state of the treatment of early syphilis during the past ten years and the uncertain status today of the value of penicillin seem reasons enough for this paper. Twenty years ago it was not difficult to present in a summary several treatment programs for the various manifestations of syphilis because it was thought then that the limitations and the accomplishments of the remedies employed were well known. Today it does not seem advisable to summarize the results of evaluation studies or to attempt to estimate the future of penicillin therapy of syphilis, because new ideas and concepts are constantly developing in regard to it. The appraisal of penicillin is still going on and must be continued for several years before the real value of this remedy in syphilis will be known. It is impossible now to present to the physician who occasionally treats patients with syphilis new treatment

PENICILLIN IN THE TREATMENT OF SYPHILIS IN CHILDREN

Although there are many reports on the use of penicillin in the treatment of syphilis in adults, little information is available regarding the value of penicillin in the treatment of the disease in children. Congenital syphilis is often severer than the acquired infection. Doses of penicillin comparable to those effective in adults are not entirely satisfactory in the treatment of the infantile infection, and further investigation of this problem is necessary. Moreover, such syphilitic manifestations as interstitial keratitis, eighth nerve deafness and Clutton's arthritis are found predominantly in the congenital infection, and detailed observations on the response of these diseases to penicillin are lacking. It is the purpose of this report to present the results of treatment with penicillin in 61 children with various manifestations of syphilis. <h3>INFANTILE CONGENITAL SYPHILIS</h3> During the past twenty months we have treated with penicillin alone 32 children with infantile congenital syphilis. The results of

INFECTIOUS DISEASES

THE RESULTS of continued research on antibiotic agents and their practical application hold the chief interest in the field of infectious diseases. Much knowledge has accrued concerning the value of penicillin, streptomycin and other agents when used in the treatment of certain infections and their lack of effect when used in the treatment of others. Intensive investigation of the chemical structure of antibiotics and development of better methods for their commercial production are in progress. The use of penicillin to combat many serious infections, such as the bacterial pneumonias, infections with hemolytic streptococci and subacute bacterial endocarditis, has brought about a great reduction in their incidence and mortality rate. The mortality from degenerative cardiac, renal and other diseases has also declined as a result of the control of incidental infections, which commonly cause death in such patients. 1 This decline, however, has been continuous for many

TREATMENT OF VARIOUS INFECTIONS WITH PENICILLIN X, WITH A PRELIMINARY NOTE ON THE VALUE OF PENICILLIN X IN SCARLET FEVER

Article1 July 1946TREATMENT OF VARIOUS INFECTIONS WITH PENICILLIN X, WITH A PRELIMINARY NOTE ON THE VALUE OF PENICILLIN X IN SCARLET FEVERHAROLD L. HIRSH, M.D., HARRY F. DOWLING, M.D., F.A.C.P., LEWIS K. SWEET, M.D.HAROLD L. HIRSH, M.D.Search for more papers by this author, HARRY F. DOWLING, M.D., F.A.C.P.Search for more papers by this author, LEWIS K. SWEET, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-25-1-78 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPenicillin X is a fraction obtained from cultures of the same mold (Penicillium notatum) which produces penicillin G (or "regular" penicillin). It differs from penicillin G in the method by which it is extracted, and is usually found more abundantly in flask-grown penicillin. We have tested the relative sensitivity of various bacteria to penicillin X and penicillin G and have found that two to 16 times as much penicillin G is required as penicillin X, unit for unit, to kill many bacteria in vitro. The details of this study will be published elsewhere. Other investigators1-3have reported similar results. In...Bibliography1. WELCHPUTNAMRANDALLHERWICK HLEWARP: Penicillin X: Successful treatment of gonorrhea with a single intramuscular injection, Jr. Am. Med. Assoc., 1944, cxxvi, 1024. CrossrefGoogle Scholar2. ORYMEADSFINLAND EMMM: Penicillin X: Comparison with penicillin G with respect to sensitivity of pathogenic organisms and serum levels, Jr. Am. Med. Assoc., 1945, cxxix, 257. CrossrefGoogle Scholar3. LIBBYHOLMBERG RLNL: The activity of penicillin G and X in vitro, Science, 1945, cii, 303. CrossrefGoogle Scholar4. HIRSHDOWLING HLHF: Observations on the continuous intramuscular method of administering penicillin, Am. Jr. Med. Sci., 1945, ccx, 435. CrossrefGoogle Scholar5. WELCHPRICECHANDLER HCWVL: Prolonged blood concentrations after oral administration of modified penicillin, Jr. Am. Med. Assoc., 1945, cxxviii, 845. CrossrefGoogle Scholar6. SWEETLEPPER LKMH: Acute serous meningitis in scarlet fever, Jr. Pediat., 1944, xxiv, 295. CrossrefGoogle Scholar7. MEADSFLIPSEBARNESFINLAND MMEMWM: Penicillin treatment of scarlet fever, Jr. Am. Med. Assoc., 1945, ccxxiv, 785. CrossrefGoogle Scholar8. DOWLINGHIRSH HFHL: The inability of penicillin to inactivate streptococcus erythrogenic toxin. To be published. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Washington, D. C.*Received for publication November 26, 1945.From the George Washington Medical Division and the Pediatric and Infectious Disease Service, Gallinger Municipal Hospital, and the Department of Medicine and Pediatrics, George Washington University.†Supplied by Lederle Laboratories, Inc., Pearl River, New York. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBibliography*A comparison of “symptomatic treatment,” gamma globulin, and penicillin in the treatment of scarlet feverA Comparative Study of Penicillins X and G and Crystalline Penicillin G 1 July 1946Volume 25, Issue 1Page: 78-87KeywordsBacteriaHospital medicineInfectious diseasesPenicillinRiversScarlet fever ePublished: 1 December 2008 Issue Published: 1 July 1946 PDF downloadLoading ...

Penicillin in the Treatment of Syphilis

IT is generally agreed that probability of cure in syphilis can only be assumed if, during five years after treatment, there have appeared no signs, clinical or pathological, of relapse or progression. Penicillin was first used in the treatment of syphilis as recently as 1943, and it is now known that the doses originally used were inadequate. We cannot, therefore, begin to estimate the value of penicillin as an agent for the permanent cure of syphilis.

PENICILLIN IN THE TREATMENT OF CHRONIC INFECTIONS OF THE LUNGS AND BRONCHI

Penicillin is the most effective and least toxic antibiotic in general use today. As with all new chemotherapeutic agents, the initial widespread use of penicillin will become more completely defined as its field of usefulness becomes more fully understood. The value of penicillin in the treatment of acute medical and surgical infections is well established. Only by clinical investigation can its value be determined in the treatment of chronic diseases. Chronicity in pulmonary infection introduces factors not present during the acute stage. The presence of complicating mechanical factors such as tissue destruction, fibrosis, avascularity and bronchial occlusion all influence the efficacy of penicillin therapy. Furthermore, chronic pulmonary infections have a varied bacterial flora, and some of the organisms may not be penicillin sensitive. In contrast to the unparalleled value of penicillin in the treatment of acute pulmonary infections, it is of more limited value in the treatment of chronic pulmonary

THE TREATMENT OF ACUTE RHEUMATIC FEVER WITH PENICILLIN

The probable relationship of Lancefield group A hemolytic streptococcic disease to rheumatic fever has led to the therapeutic trial of various antistreptococcic substances in this disease. Swift¹and Jones²have described the effects of sulfanilamide in acute rheumatic fever. Swift³and his co-workers⁴have also reported the results of streptococcic antiserums in.this disease. Both of these entirely unrelated substances were found to be of no therapeutic value, and the evidence is suggestive that at times they may have been harmful. In view of these observations, when penicillin became available there was little cause for optimism that it would be beneficial in this disease. However, because of the great need for a more satisfactory therapeutic agent for rheumatic fever and the knowledge that the value of penicillin in this disease would eventually need to be determined, it was felt that an organized study by producing an answer