A problem of considerable importance in the chemotherapy of infectious diseases has been the development and dissemination of sulfonamide resistant strains of bacteria. Strains of micro-organisms within the different species known to be highly susceptible to the antibacterial action of the sulfonamides have acquired the characteristic of multiplying in the presence of high concentrations of the drugs. This acquired resistance appears to be a permanent property of these strains, and the resistant organisms are justas invasive as their sulfonamide sensitive progenitors. The mechanism whereby species of bacteria become relatively resistant to the sulfonamides is not completely understood, but it is related to the exposure of sensitive organisms to sublethal concentrations of the sulfonamides. Clinicians are rapidly becoming aware of the increasing incidence of gonorrhea in patients in whom the disease cannot be eradicated with intensive sulfonamide therapy. To a lesser extent this also applies to other bacterial infections such as
SPINK WW, HALL WH, FERRIS V. CLINICAL SIGNIFICANCE OF STAPHYLOCOCCI: WITH NATURAL OR ACQUIRED RESISTANCE TO THE SULFONAMIDES AND TO PENICILLIN. JAMA. 1945;128(8):555–559. doi:10.1001/jama.1945.02860250001001
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