Adaptability of Gonocoecus to Four Bacteriostatic Agents, Sodium Sulfathiazole, Rivanol Lactate, Promin, and Penicillin.

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Abstract
-The effectiveness of all chemo-therapeutic agents against any bacterial population is strikingly limited by the tendency of the bacteria to acquire resistance against these agents upon continued contact. It has been repeatedly found that the gonococcus becomes sulfonamide-fast both in vitro and in vivo, and, more recently penicillin-fast strains have been demonstrated. Inasmuch as the limitations of drug therapy result from use of a single agent, a study was made of the anti-bacterial effect on the gonococcus in vitro of the combination of 4 therapeutic agents, namely, Na sulfathiazole, rivanol lactate, promin, and penicillin. Comparative tests on the tendency of the gonococcus to become resistant to each of these drugs individually were also made. 5 non-resistant strains of the gonococcus were selected. The basic medium in which the organisms were grown was Douglas''s broth with 0.05% KN03, 0.04% KH2PO4, and 5% lapine blood. The 5 strains were grown in this medium with gradually increasing concs. of each agent separately. All cultures were transferred to the same conc. of drug in which they were growing and to a greater conc. every 48 hrs. for 4 months. The degree of resistance acquired toward each drug after 4 months'' exposure varied somewhat with the individual strain of the gonococcus, but in no case were extraordinarily large variations observed. On the whole, the final tolerated conc. was roughly characteristic of the agent used. Slight adaptation to 3 combined drugs (Na sulfathiazole, rivanol lactate, and promin) was attained when the strains were exposed to gradually increased cones. When, however, penicillin was added to the mixture of the same 3 drugs, no acquired resistance in any of the 5 strains was observed. Thus, it is indicated that the simultaneous use of multiple bacteriostatic agents on the gonococcus leads to the annihilation of bacterial population because the drug combination eradicates the potentiality of adaptation.

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