When lobar pneumonia is associated with leukopenia instead of the usual leukocytosis, a therapeutic problem is presented as to the propriety of administering sulfapyridine. On the one hand it is known that sulfapyridine itself is capable of producing serious or even fatal leukopenia and neutropenia. Thus there would seem to be a justifiable hesitation in using this drug, lest it further depress the low leukocyte count to a dangerous degree. On the other hand, sulfapyridine is probably the most valuable single agent in the treatment of lobar pneumonia. Its use appears particularly indicated in cases of lobar pneumonia with leukopenia because these cases usually represent severe infections and present the worst prognosis. Middleton and Gibbon1 noted that all their patients with leukopenia of less than 5,000 leukocytes per cubic millimeter died. Even those patients with relative leukopenia (5,000 to 10,000 leukocytes per cubic millimeter) had a much higher mortality
FRIEDBERG CK. SULFAPYRIDINE THERAPY IN LOBAR PNEUMONIA ASSOCIATED WITH LEUKOPENIA. JAMA. 1941;116(4):270–272. doi:10.1001/jama.1941.02820040004002
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