ANTIBIOTICS AS CHEMOTHERAPEUTIC AGENTS 277 



tions, but has been used successfully in the treatment of relapsnig fever, 

 although excessive doses were required (223). 



Treatment of early syphilis cases with penicillin (614) indicated that 

 the therapy was responsible for the rapid and complete disappearance of 

 the infecting agent from the blood stream, as determined by various 

 tests. Penicillin was found to be actively spirocheticidal (225). A com- 

 parative study has been made of the action of penicillin and of other 

 antibiotic agents upon Tre-ponema pallidum (217). The immobilization 

 of spirochetes in vitro by penicillin preparations was found to be due to 

 the impurities present (218). The amount of penicillin required to 

 produce bacteriostatic titers in rabbits infected with Tr. 'pallidum is five 

 times greater than that needed for adult man by intramuscular injec- 

 tion. Although highly favorable effects were obtained in the treatment 

 of various types of syphilis in man, the need for more careful observa- 

 tions was indicated. 



Penicillin was also found to have an effect upon experimental typhus 

 rickettsiae (361, 654), bovine mastitis (857), and a variety of other 

 infections. 



As a result of treatment with penicillin of 300 patients, it has been 

 concluded (782) that this material is far superior to any of the sul- 

 fonamides in the treatment of S>. aureus infections with and without 

 bacteriemia, including acute and chronic osteomyelitis, cellulitis, car- 

 buncles of the lip and face, pneumonia and empyema, infected wounds 

 and burns. 



A study of 500 cases of infections treated with penicillin led to the 

 following conclusions (494, 588) : Penicillin can be administered intra- 

 venously, intramuscularly, or topically, but is ineffective when given by 

 mouth. As it is excreted rapidly in the urine, it must be injected continu- 

 ously or at intervals of 3 to 4 hours. Penicillin was found to be particu- 

 larly effective in the treatment of staphylococcic, gonococcic, pneumo- 

 coccic, and hemolytic streptococcus infections, especially sulfonamide- 

 resistant gonococcic infections, but not bacterial endocarditis. The usual 

 patient requires a total of 500,000 to i ,000,000 Oxford units, the best 

 results being obtained when treatment is continued for 10 to 14 days, 

 10,000 units to be given every 2 to 3 hours at the beginning of treat- 



