A BACTERIOLOGIC STUDY OF THE FACTORS AFFECTING THE EFFICACY OF STREPTOMYCIN THERAPY OF URINARY TRACT INFECTIONS 12

Open Access
Publisher Website
Google Scholar
Abstract
In 45 patients given 52 courses of streptomycin for urinary tract infections due to Gram negative bacilli, determinations of sensitivities were made by the test tube method. In 44 cases a single organism was isolated; the commonest bacilli recovered were Aerobacter aerogenes and Pseudomonas aeruginosa. 52 of 59 organisms isolated prior to therapy were sensitive to 16 [gamma]/ml. or less of drug. The most striking finding was the rapid development of fastness to streptomycin in previously sensitive organisms. A. minimum of 0.6 g. was necessary to assure a blood level of 10 [gamma]/ml. and a urine level above l00[gamma]/ml.; 1.5 to 2.0 gs. were necessary to maintain a blood level above 16 -[gamma]/ml. In 56% of the infections treated, the urine became sterile before the completion of therapy. The occurrence of bacteriologic failures could not be correlated with susceptibility of the organism in vitro, daily dose of drug, or levels of streptomycin in blood and urine. Effectiveness of therapy was not dependent upon the duration of infection before institution of therapy, but was greatly decreased by the presence of a complication, such as foreign body, obstruction to urinary flow, source of constant reinfection, or impaired renal function. Development of fastness was the commonest cause of therapeutic failure. Fastness to streptomycin developed in a minimum of 8 hrs. and to a high degree; once acquired, it was a permanent characteristic of the organism.

This publication has 2 references indexed in Scilit: