SUBACUTE BACTERIAL ENDOCARDITIS

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Abstract
Although there have been a few reports of favorable results from the use of sulfonamides in endocarditis, my own experience with them has been discouraging. While there have generally been some improvement in fever following the use of sulfanilamide, sulfathiozole and sulfadiazine and some decrease in the number of colonies in agar plate blood cultures, we have obtained no extended periods of negative blood cultures in a fairly large experience. In many instances the improvement obtained at first was not maintained, suggesting that perhaps the streptococci over a period of weeks or months became resistant to the action of the drugs employed. I have had no better results in endocarditis with sulfadiazine administered orally and given up to the limit of tolerance than with preceding sulfonamides, but it has seemed to me less toxic. It was, therefore, thought justifiable to try massive dosage of sodium sulfadiazine1 intravenously with the

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