THE TREATMENT OF LOBAR PNEUMONIA WITH SULFAPYRIDINE AND SODIUM SULFAPYRIDINE, WITH OBSERVATIONS UPON EFFECTIVE BLOOD LEVELS

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Abstract
The authors report observations made on 135 patients ill with pneumo-coccus, lobar or atypical pneumonia treated with sulfapyridine and Na sulfapyridine under the Pneumonia Control Program of the District of Columbia Health Dept. In 114 patients, a single pneumococcus type, and in 21 patients, more than one type was obtained from the sputum by the Neufeld reaction. In 58% of the cases, Type I to VIII pneumococcus was the etiological factor. Type II was found infrequently. Bacteremia was discovered in 18.8% of the cases. A mortality rate of 11.1% was found in the entire group. Among 99 non-bacteremic cases the death rate was 8%; among 23 bacteremic cases, 21%. No deaths occurred in 23 Type I-treated cases. In 93 patients the temp. fell by crisis to 100[degree] in an average elapsed time of 16 hrs. In 23 patients defervescence occurred by lysis, and in 19 patients the drug apparently exerted no beneficial effect. The average total dose given was 29.6 gm. The only complications of the disease noted were sterile pleural effusion occurring in 6 patients (4%) and empyema in 5 patients (3.7%). In 250 separate determinations of the "free" sulfapyridine conc. in 65 patients, 90% of patients with blood levels above 6 mg.% recovered by crisis, and only 66% of those with levels below 6 mg.% recovered in this manner. Studies on the soluble Na sulfapyridine in 25 patients showed it to be of value in the treatment of severely ill patients, or in those whose response to the oral preparation was poor. Toxic reactions to sulfapyridine and Na sulfapyridine correlated closely with the findings of other investigators.