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SULFONAMIDE RESISTANCE DEVELOPING DURING TREATMENT OF PNEUMOCOCCIC ENDOCARDITIS

Morton Hamburger Jr., M.D.; L. H. Schmidt, Ph.D.; J. M. Ruegsegger, M.D.; Clara L. Sesler, M.Sc.; Eda S. Grupen, B.Sc.
JAMA. 1942;119(5):409-411. doi:10.1001/jama.1942.72830220001009.
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An important question raised by recent investigations of the sulfonamide drugs concerns the development of sulfonamide-resistant organisms during treatment of clinical infections. Experimental studies, both in vivo and in vitro,1 have shown conclusively that sulfonamide-sensitive pneumococci can be readily converted into organisms that are highly resistant to these drugs. Available reports2 suggest that this may also occur during use of the sulfonamides in treating human infections.

During a study of the clinical aspects of this problem in our laboratories a case of pneumococcic endocarditis was encountered which proved to be of special interest. The pneumococci isolated from this case at progressive intervals during treatment showed as great a change in sulfonamide sensitivity as has been produced experimentally1 and a greater change than has been reported in any clinical case heretofore.2 The observations on this case are summarized here.

REPORT OF CASE 

History.—  A Negro woman

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