October 2, 1948


JAMA. 1948;138(5):381. doi:10.1001/jama.1948.02900050049024

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To the Editor:—  In the July 24 issue of The Journal there appeared a letter from Dr. David Lehr criticizing the conclusions of Zeller, Hirsh, Sweet and Dowling, who found that the disadvantages of using a mixture of sulfadiazine and sulfamerazine outweigh the advantages. Inasmuch as the article by Zeller and associates seemed to be a valid interpretation of carefully observed clinical phenomena, it is important to evaluate the usefulness of the sulfonamide mixtures from a theoretical point of view.Although Lehr's observations on the independent solubilities of sulfonamide drugs are widely known and accepted, few persons realize how little there is to gain by using such mixtures. It is relatively simple to calcuate just how much extra sulfonamide compound can be dissolved through the use of the mixtures.Without added alkali, the urine of the average patient with a bacterial infection is rather acid. For the sake of simplicity, let

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