In his masterful and comprehensive review of the biology of anaerobic infections, Prévot1 gives limited space to the antitoxin therapy of gas gangrene due to Clostridium perfringens. Essentially, he covers the entire subject with the statement: Contre la toxine circulante, seule la sérotherapie est efficace. Logically, this should cover the matter. However, surgeons with extensive knowledge of clinical gas gangrene are increasingly tending to deemphasize the role of antitoxin in clinical use, or have abandoned it altogether. The United States Army has recently dropped gas gangrene antitoxin from its standard stock list. The recommendations of the American College of Surgeons on the use of antitoxin are couched in cautious terms.2
Actually, there is relatively little independent proof of the existence in gas gangrene of a true "toxemia," and there is certainly considerable doubt extant on the question of whether there is a "circulating toxin." On the basis of
LINDSEY D, WISE HM, KNECHT AT, NOYES HE. Influence of Route of Administration on Effectiveness of Clostridial Antitoxin. AMA Arch Surg. 1959;78(2):328–330. doi:10.1001/archsurg.1959.04320020150023
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