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September 29, 1951


JAMA. 1951;147(5):513-514. doi:10.1001/jama.1951.03670220153014

The introduction of a wide variety of active chemotherapeutic agents has led to the use of combinations of two or more of these agents in the hope of securing additive or even synergistic effects. Clinically effective combinations include dihydrostreptomycin and aureomycin in brucellosis and paraaminosalicylic acid and dihydrostreptomycin in tuberculosis. Such combinations not only may offer an increased antibacterialeffect but also may delay the appearance of drug-resistant organisms.

Recently considerable experimental evidence has been presented to indicate that under certain circumstances antimicrobial agents may, when combined, actually have an antagonistic action. Thus Lankford and Lacy1 studied the in vitro bacteriostatic action of aureomycin-penicillin and aureomycin-streptomycin mixtures on staphylococci and concluded that synergistic, additive, indifferent or antagonistic effects could be obtained, depending on the relative concentration of the two drugs. Spicer2 also demonstrated in vitro an interfering effect between certain antibiotics and concluded that, if an antibiotic to which