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April 21, 1951


JAMA. 1951;145(16):1269-1270. doi:10.1001/jama.1951.02920340047016

Considerable speculation has prevailed as to whether, in the use of antibiotics, it is desirable to sustain their concentration in the body at effective levels or whether they may be given discontinuously, with long periods during which the serum concentrations are below the effective threshold. This uncertainty reflects the fact that conclusive information is not available as to whether the mechanism of their action in vivo is the same as that in vitro or whether host factors may supervene to augment and to supplement their direct bactericidal effect.

Recent studies have helped to clarify this situation in the case of penicillin. It has been shown in a number of experimental infections that the concentrations maximally effective in the animal are essentially the same as those similarly effective in the test tube.1 Further, with most bacterial strains studied, penicillin continued to exert a bactericidal effect only as long as it remained