oa South African Medical Journal - The value of penicillin and sulphadiazine used separately and in combination in 200 cases of pneumonia
1. Two hundred cases of pneumonia in Bantu patients were allotted in strict rotation to one of 3 treatment schedules in which cases were treated with penicillin, sulphadiazine or a combination of these remedies. The groups were comparable in respect of age, sex, mean duration of illness before admission, mean temperature at the commencement of treatment, and the anatomical distribution of lesions. 2. The sputum bacteriology was obtained in 107 cases and in 82 of these the sensitvity in vitro of the causative bacteria towards 6 commonly used antibiotics was determined. It was found that very few of the bacteria isolated were resistant to terramycin, chloramphenicol or aureomycin, while approximately a quarter were resistant to penicillin and sulphadiazine. 3. There was no statistically significant difference in the results obtained by the 3 methods of treatment although the mean duration of pyrexia was longest in the combined treatment group; nor was there any increase in failures found in the groups in respect of toxic effects, complications or deaths. The results obtained withPenicillin appeared to be slightly superior to those obtained with the other two methods of treatment. 4. Delayed resolution was noted in patients with malnutrition, clinical but not latent jaundice, massive involvement of lung tissue and in those who developed pleural effusions. In cases with clinical jaundice it was shown that delayed resolution was associated with unusually extensive involvement of lung tissue. There was also a relationship, in the penicillin group. between delayed resolution and insensitivity in vitro of the bacteria isolated to the treatment prescribed. This relationship was not found when sulphadiazine was administered and the sensitivity tests were of little value in predicting the outcome of cases in the sulphadiazine group.
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