November 1980

Synergism Involving Penicillinase-Resistant Penicillin-Reply

Author Affiliations

USN Oakland, Calif

Arch Intern Med. 1980;140(11):1555-1556. doi:10.1001/archinte.1980.00330220093043

Thank you for your comments and for sharing your interesting data. Your points about the lack of clinical data are important. I regret that I could not provide information regarding clinical outcome. After all, what we really need to know is whether addition of gentamicin to PRP improves patient outcome in staphylococcal sepsis. This question cannot be meaningfully appraised in a retrospective study and must be explored prospectively. Fortunately, information regarding the effect of combined PRP-gentamicin therapy on the outcome of staphylococcal sepsis may be forthcoming from such a study.1

You are correct in observing that the bactericidal activities of the serum samples containing PRP were generally low. In the six patients for whom we have data, four had an MBC against the PRP used of 10 μg/mL or greater, one had an MBC of 2.5 μg/mL for methicillin, and the last had an MBC of 1.6 μg/mL

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