ANTIBIOTICS AS CHEMOTHERAPEUTIC AGENTS 275 



(147a) that (a) penicillin K is very unstable in the body, so that its 

 parenteral effectiveness is open to question j (b) penicillins G and X are 

 stable but they are rapidly excreted, which is a limiting factor in main- 

 taining a therapeutic level j (c) penicillin X is more active against 

 certain hemolytic streptococci, where its specific use is indicated. 



Chemotherapeutic Action. Penicillin has also found an important 

 place in the treatment of local and generalized infections in man. Flem- 

 ing was the first (261, 262) to recommend that it be employed for 

 dressing septic wounds. It appeared to be superior to dressings contain- 

 ing purely chemical agents. Isolated penicillin in a dry state was many 

 times more powerful than the most potent of the sulfonamide com- 

 pounds. Local applications include those to lesions of the eye produced 

 by S. aureus, in which early treatment resulted in the elimination of the 

 organism from the flora of the conjunctival sac (797). Weight for 

 weight, penicillin was found to be four times as potent as sulfathiazole 

 and 100 times as potent as sulfanilamide for the treatment of wound 

 infections (5, 269). 



Penicillin proved to be an especially effective agent for the treatment 

 of staphylococcal and hemolytic streptococcal infections in man (755), 

 including streptococcal meningitis and others. Many cases of infected 

 war wounds treated with penicillin gave, in 24 hours, a uniform drop 

 in the number of gram-positive organisms, including Clostridia, staphy- 

 lococci, streptococci, and corynebacteria ; the gram-negative bacteria 

 were not affected. Excellent therapeutic effects were also obtained in 

 surgical infections. Even crude culture filtrates of P. notatum, applied 

 locally, gave good results. It can be used in topical application and has 

 proved to be an ideal agent for the treatment of genito-urinary infec- 

 tions. It is readily absorbed and excreted following intravenous, sub- 

 cutaneous, and oral administration j a part of it is inactivated in the 

 body. 



In order to lessen the frequency of effective invasion of the nose by 

 bacteria and the subsequent infection of the nasopharynx, the local use 

 of penicillin has been suggested. The material acts as a prophylactic 

 against bacterial infections of the upper respiratory tract j the course of 

 a cold can thus be checked by preventing secondary bacterial infection. 

 The curing of nasal carriers of staphylococci or even the reduction of 



