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Laboratory and clinical studies of sulfonamides

Laboratory and clinical studies of sulfonamides

Chinese Medical Journal (English Edition) 93(4): 207-216

This paper reports the results of antibacterial, pharmacologic and clinical studies on the sulfonamides, trimethoprim (TMP) and sulfonamide-TMP combinations manufactured in China. Bacterial sensitivity tests of these drugs were carried out on 3549 strains of pathogens, belonging to 18 bacterial species, isolated clinically. When combined with TMP, the antibacterial activities of the sulfonamides were greatly enhanced particularly on Staphylococcus aureus, Escherichia coli, Enterobacter aerogenes and Proteus spp., which were approximately similar to those of kanamycin or gentamycin. Under similar conditions the blood and urine concentrations of 7 different kinds of sulfonamides and TMP administered orally, i.m. and i.v. were determined in a group of healthy volunteers. Sulfadiazine (SD), which for a long time had been considered as a short-acting drug and its dosage was greater than actually needed, is a medium-acting sulfonamide. In this study, SD was used in reduced dosage in the treatment of various infections and favorable clinical results were obtained with much fewer side effects. Sulfonamides alone and their combination with TMP were used in 2486 patients of typhoid fever, pneumononia, bacillary dysentery, acute and chronic urinary infections, etc., the effective rates being 83.3% and 92.5%, respectively. It is better to use sulfonamide compounds in patients suffering from various infections with the exception of meningococcal meningitis. In more severe cases, it is advisable to take the drug by parenteral routes at the start, in order that effective serum levels may be reached as early as possible. Preliminary data indicated that SD compound used instead of SMZ compound in various clinical situations is just as effective if not more so. Both sulfonamide compounds are commonly used in clinics at present.

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