At two meetings1 held recently to discuss the end results of penicillin therapy, surgeons from two of the largest government hospitals for treatment of wounds of the extremities presented opinions serving to qualify prevailing optimism about the value of this agent. Although widespread use of penicillin has proved generally successful, both prophylactically and in the control of wound sepsis, there remain examples of indifferent success or outright failure which in our opinion may be based partly on inadequate technic.
Florey and Jennings2 have described the principal causes of failure in the use of penicillin as follows: Dead tissue, slough or sequestrum is the focus of infection; an infected area is not being reached by the drug; the dose is too small or application too infrequent; bacteria are not sensitive and penicillin is no longer potent. Assuming that a potent preparation is used on penicillin-susceptible organisms, the problem becomes
GRACE EJ, BRYSON V. TOPICAL USE OF CONCENTRATED PENICILLIN IN SURFACEACTIVE SOLUTION. Arch Surg. 1945;50(4):219-222. doi:10.1001/archsurg.1945.01230030227007