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April 1957

The Clinical Use of Antibiotics in Combination

AMA Arch Intern Med. 1957;99(4):536-538. doi:10.1001/archinte.1957.00260040036003

The recent appearance on the market of preparations containing two antibiotics in the same capsule calls for an appraisal of the rationale of such therapy. Theoretical or practical reasons for administering more than one antibiotic to a patient at one time are as follows:

  1. A second antibiotic may delay the emergence of bacteria resistant to the first antibiotic.

  2. Two antibiotics may be synergistic with one another.

  3. In the initial emergency treatment of seriously ill patients where the establishment of an etiological diagnosis and appropriate antibiotic sensitivity tests may be delayed, two or more drugs may properly be used as "insurance."

  4. Mixed infections caused by more than one micro-organism may be better treated by antibiotics found most effective against each one.

  5. Reduction of dosage of each of two "additive" drugs may result in lowered incidence of toxic effects to each, as in the case of streptomycin-dihydrostreptomycin.

The emergence of streptomycin-resistant tubercle

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