Cures & Cautions

The world's top authorities on antibiotics met in Washington last week to exchange their latest findings, and the University of Illinois' Dr. Harry F. Dowling sounded the keynote: "As each antibiotic is introduced, we hear first of miraculous cures, second of deleterious reactions, and third of the appearance of resistant strains."

By the record, he was right. As the convention proceeded, there were optimistic reports of a new antibiotic, tetracycline (like aureomycin but with hydrogen replacing a chlorine atom in the molecule), and of a multibiotic. a triple-threat combination of streptomycin, bacitracin and polymyxin, for external use only. But there was also plenty of talk of deleterious effects. Boston's Dr. Ethan Allan Brown called today's enthusiastic but haphazard use of antibiotics "appalling." It is misleading, he said, to speak only of patients whose deaths are recorded as resulting from reactions to antibiotics. There are more deaths, said Dr. Brown, which do not get into print. Still more numerous are serious reactions short of death. Finally, there are countless allergic reactions. "In many cases," Dr. Brown said bitterly, "allergic reactions are not reported because the patient did not die from hem. What the medical reports fail to tress is how many had wished themselves lead. Of these exquisitely sensitive-to-penicillin patients, I am one."

If antibiotics are to be of full benefit to

mankind, said Dr. Brown, the manufacurers must do much more exacting studies

on animals) of the drugs' effects; medical

researchers must undertake more studies

if their own; and general practitioners

must report on tens of thousands of cases.

Concluded Dr. Brown: "If we [specialists]

how why and how to act, and fail to do

so. those who do not know how and why

'ill nevertheless act and flounder. And

his is the exact state . . . today."

Dr. Dowling himself explored the mater of resistant strains of germs, which appear after a patient has been given a particular antibiotic for some time, and may make further treatment useless. There s no need, he suggested, to fear that the world's bacterial population will learn to defeat man's antibiotic weapons. The varieties of bacteria which have not yet shown resistance to antibiotics probably never will learn to do so, said Internist Dowling. These, fortunately, include most of the bacteria which cause acute infections: the pneumococcus, more than half the streptococci, meningococcus, gonococcus and the spirochete of syphilis.

The bacterial world will probably reach an equilibrium, with resistant strains remaining constant, concluded Dr. Dowling. His advice to practitioners: give only one antibiotic at a time (unless there is unusually strong reason for giving more), and give that one no longer than necessary.

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