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February 14, 1948


Author Affiliations

Tucson, Ariz., and Barlow Sanatorium, Los Angeles.

JAMA. 1948;136(7):490. doi:10.1001/jama.1948.02890240056022

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To the Editor:—  Patients with tuberculosis are being treated with streptomycin in homes, offices and institutions throughout the country. Certain good effects suggest that this agent will find a place in the scheme of therapy. It is probably being used far oftener than truly indicated. The drug fails in some cases and leaves an infectious condition more hazardous to future contacts than existed before its use. This possible hazard is a result of the resistance which tubercle bacilli often develop to streptomycin. Perhaps two thirds of the human subjects with pulmonary tuberculosis have a resistant strain in their lesions and bronchial secretions after the drug has been used in full doses for a few months, or even a few weeks. The bacilli are resistant thereafter to further doses of any size, both in culture or animals, and even after repeated transfers.The clinical implications can easily be seen: a patient

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