The early laboratory and clinical experiences with streptomycin have already indicated that the problem of acquired resistance may be of considerably greater importance with this agent than with the sulfonamides or with penicillin.1 The rapid development of extreme degrees of streptomycin fastness during the course of seemingly adequate treatment in a number of consecutive cases of urinary tract infections caused by a variety of gram-negative bacteria that were initially sensitive to streptomycin has prompted this report.
CASES, MATERIALS AND METHODS
The cases of urinary tract infections selected for therapeutic trial with streptomycin were in persons with chronic pyelonephritis or cystitis due to gramnegative bacilli and preferably uncomplicated by other major pathologic conditions of the genitourinary tract. All had moderate or advanced pyuria and bacilluria which had failed to respond to treatment by the usual methods. Cases of infections associated with a single organism were desired but 2 with multiple