278 DISEASE CONTROL 



ment, either by continuous intravenous injection or by interrupted in- 

 travenous or intramuscular injections. Good results were obtained by 

 injections of 100,000 to i6o,ooo units over a period of 2 to 3 days. In 

 the treatment of empyema or meningitis it was found advisable to use 

 penicillin topically by injecting it directly into the pleural cavity or the 

 subarachnoid space. Toxic effects were extremely rare. Occasional chills 

 with fever or headache and flushing of the face were noted. 



A summary of the response of different bacteria in septic gunshot 

 fractures is given in Table 44. Staphylococci and streptococci are rapidly 

 responsive to penicillin therapy. Anaerobic cellulitis due to the proteo- 

 lytic bacteria of putrid wound infection responds to penicillin, but the 

 bacteria may persist in the presence of devitalized tissue or wound 

 exudates. The pyocyaneus organism is not susceptible to penicillin, but 

 it is considered to be relatively unimportant as a single pathogen in the 

 surgical management of the wounds (269). 



A summary of the results of extensive use of penicillin in the North 

 African campaign of World War II led to the conclusion that in the 

 treatment of recent soft-tissue wounds penicillin brought about the vir- 

 tual elimination of infection and saved much hospitalization time. 

 Treatment of fractures also gave good results, though some penicillin- 

 resistant cocci appeared. Favorable results were also obtained in various 



TABLE 44. RESPONSE OF DIFFERENT BACTERIA FOUND IN WOUNDS 

 TO PENICILLIN TREATMENT 



From Lyons (587). 



