Wallace E. Herrell, M.D.
JAMA. 1958;168(14):1875-1879. doi:10.1001/jama.1958.03000140037010.
Text Size: A A A
Published online

The indiscriminate use of antibiotics has created serious problems. Two episodes here given illustrate the misuse of penicillin. Patients for whom it is ordered should be questioned as to evidence of sensitivity, and after an injection they should be watched by a physician or nurse for 30 minutes. Reactions, if they occur, should be treated not with oxygen but with epinephrine or with steroids intravenously. The use of streptomycin is rarely followed by major complications, but its minor side-effects include contact dermatitis, and its toxic effects on the eighth cranial nerve, though not life-endangering, are distressing. Preliminary studies indicate that dihydrodesoxystreptomycin is less toxic. The fact that the tetracyclines are highly effective and can be given by mouth has resulted in widespread misuse. They can cause blood dyscrasia and anaphylactic reactions, but the most serious major hazard is superimposed staphylococcic enterocolitis and wound infections. There is a definite association between chloramphenicol and aplastic anemia. The rational use of antibiotics in the future depends on a return to strict aseptic technique in hospitals. The occasional temporary exclusion of one or more antibiotics from the hospital, long enough for the common pathogens to regain their sensitivity to it, would greatly improve the effectiveness and increase the safety of antibiotic medication.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.