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COMBINED PENICILLIN AND HEPARIN THERAPY OF SUBACUTE BACTERIAL ENDOCARDITIS:  REPORT OF SEVEN CONSECUTIVE SUCCESSFULLY TREATED PATIENTS

LEO LOEWE, M.D.; PHILIP ROSENBLATT, M.D.; HARRY J. GREENE, M.D.; MORTIMER RUSSELL
JAMA. 1944;124(3):144-149. doi:10.1001/jama.1944.02850030012003.
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In experimental thrombotic bacterial endocarditis1 the disappearance of vegetations requires the use of a suitable chemotherapeutic agent and an anticoagulant. The clinical application of this principle in subacute bacterial endocarditis has been disappointing; the technics of therapy are cumbersome, the toxicity of treatment has been excessive even for an otherwise fatal disease and the successes have been few and irregular.2 Early efforts made with sulfonamides, with or without heparin, have been mostly abandoned. The introduction of penicillin proved equally disappointing; the commission appointed by the National Research Council has already reported unfavorably and discouraged the use of the at present inadequate supply of the drug for the treatment of viridans endocarditis.3

The present report, which deals with the apparently successful treatment of 7 consecutive examples of subacute bacterial endocarditis, employs variations on previous technics. Penicillin4 is used to replace sulfonamide in the conjoint chemotherapeutic-anticoagulant attack and

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