Some Problems on Clinical Use of Antibiotics

Abstract

An introductory review is made on the development of antibiotics which are available in Japan.
Some problems of clinical use of them are discussed on the basis of various related data as follows
1) Selection of antibiotics: It is important to consider their distribution and passage in the body, as well as germs susceptibility. The author indicated that antibiotics distribute and stay in various organs in their own respective manners and that their excretion in the bile is quite characteristic in concentration and into duration. Clinical course of some patients treated with antibiotics is also presented suggesting the principles of therapy.
2) Combined Treatment with antibiotics: Antagonism and synergism of antibiotics are discussed, and the administration of ACTH or cortisone in the antibiotic therapy is also refered to.
3) Development of tolerant strains: A main problem is the development of penicillin resistant staphylococci and streptomycin resistant tuberculous bacilli. Recently, the author and his coworkers have found 33 penicillin resistant (over 10u/ml) strains in 110 staphylococcus strains. Their clinical and experimental studies suggest that the application of penicillinsol may develop the resistance faster than water-soluble penicillin.
4) By-effects of the antibiotic therapy: Adverse effects include direct side effects reactions due to death of germs, disturbance of utilization of vitamins (especially B₂)hypersensitivity to antibiotics and replacement of germs in therapy, especially development of moniliasis.
Anaphylactic shock caused by penicillin, the most serious accident in antibiotic therapy, has recently happened not rarely in Japan too. The author reports precautions and treatment of these unfortunate accidents in detail.