Chapter 11 



Utilization of Antibiotics in Clinical 

 Medicine and Other Applications 



Before the advent of inotlei'ii chemo- 

 therapy, the treatment of disease in general 

 and of infectious diseases in particular by 

 means of chemical agents was arbitrary and 

 fragmentary in nature. In most instances, 

 justification for the particular method of 

 treatment was specula ti\'e rather than 

 scientific. 



The use of plant products offers an inter- 

 esting illustration. Since ancient times or 

 long before the role of microbes in the causa- 

 tion of infectious diseases was recognized, 

 certain plants have been used for the treat- 

 ment of \'arious infections. Reference to this 

 is found in the Herbals of the Chinese, in the 

 p]bers papyrus of Egypt (the use of onions), 

 in the Old Testament (Isaiah ad^'ised the 

 use of figs for the ti'eatment of a l:)oil of 

 Hezekiah), in the writings of ancient Greece 

 (Theophrastus) and Rome (Dioscorides), as 

 well as in folk medicine in South Africa and 

 in Central and South America. Cinchona 

 bark has been used in the treatment of 

 malaria. Chaulmoogra oil for leprosy and the 

 use of certain alkaloids may be cited as other 

 classic examples of plant products that have 

 found, even up to recent times, extensive 

 application in the treatment of various 

 diseases. Mention may also be made of the 

 use of cepharantine in Japan in the treatment 

 of tuberculosis. Among the other plant 

 products that possess marked antimicrobial 

 substances, the phenolic compounds occupy 

 a prominent place. 



We now know that various plants produce 

 chemical sulostances which possess antibac- 

 terial properties. However, it is neither these 

 nor the enzyme-rich plants (such as figs) that 

 have found extensive application in the 

 treatment of infections caused by microbes, 

 but rather the products of microbes them- 

 selves, namely, the antibiotics. 



At first, to combat infections, came the 

 use of certain preparations, in the form of 

 vaccines, serums, and antitoxins, obtained 

 from the causative microbes. These prepara- 

 tions were used, and many still continue to 

 be used, either as prophylactics or as thera- 

 peutics. They range from common cold and 

 smallpox vaccines to Calmette-Guerin bacil- 

 lus (BCG) and polio vaccines, from diph- 

 theria and tetanus antitoxins to antistaphyl- 

 ococcal serums. Strictly speaking, however, 

 none of these come under the category of 

 chemotherapy. They are to be considered as 

 immunotherapeutic methods rather than as 

 chemotherapeutic procedures. This is true 

 despite the fact that some of these prepara- 

 tions, such as the diphtheria nncl tetanus 

 antitoxins, have been isolated in a purified 

 chemical state. 



The field of modern chemotherapy is based 

 largely upon the disco^'ery of four types of 

 compounds: (1) salvarsan and other arseni- 

 cals; (2) sulfanilamide and other sulfa drugs, 

 including the sulfones; (3) other synthetic 

 chemical compounds, notably 7>-aminosali- 

 cylic acid and isoniazid; (4) the antibiotics. 



114 



