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October 6, 1945


JAMA. 1945;129(6):435-438. doi:10.1001/jama.1945.02860400019006

Recently several papers have appeared which have emphasized the ability of penicillin to prevent the development of empyema. In the issue of The Journal of June 23 three papers appeared by Healy and Katz, by Rudensky, Sprong and Woods and by Hirshfeld, Buggs, Abbott and Pilling which stressed the value of penicillin in this respect.

My purpose in this paper is to point out not only the value but also the limitations of penicillin in the prophylactic treatment of empyema and stress the need for surgical drainage of established empyema. Penicillin has undoubtedly proved of great value in preventing empyema when it is administered in large quantities during the incipient stages, before frank pus has formed. This is especially true of postpneumonic pleural effusions, particularly of the pneumococcic variety, as indicated by the several favorable reports in the literature. Tillett, Chambier and McCormack1 report 8 pneumococcic infections of the