Unpublished data made available to us suggested that a new antibiotic, aureomycin,3 was of low toxicity, was highly effective against a variety of experimental infections in animals, and, therefore, warranted a clinical trial. The bacteriological studies which were conducted as part of the clinical evaluation of this agent are presented in this paper. SENSITIVITY OF VARIOUS BACTERIA Aureomycin hydrochloride was found to have considerable antibacterial action in vitro against a wide range of gram-positive and gram-negative bacteria. The sensitivities to aureomycin of 186 strains of organisms recently isolated from patients in the Boston City Hospital are presented in table 1. Among the strains of the various organisms tested, only those of Proteus vulgaris and of Pseudomonas aeruginosa were regularly found to be relatively resistant to aureomycin. COMPARATIVE SENSITIVITY TO THREE ANTIBIOTICS The sensitivity to aureomycin, penicillin, and streptomycin of a selected group of microorganisms is presented in table 2. Weight for weight, aureomycin was found to be less effective than penicillin, but more effective than streptomycin, in the case of most coccal organisms. Aureomycin was about as effective as streptomycin against most gram-negative bacilli. Aureomycin possesses equal antibacterial activity against penicillin-sensitive and penicillin-resistant staphylococci as well as against streptomycin-sensitive and streptomycin-resistant bacteria. It is also effective against streptomycin-dependent organisms. FACTORS INFLUENCING ANTIBACTERIAL ACTIVITY OF AUREOMYCIN The concentration of antibiotic which is necessary to inhibit any bacterium depends upon many factors, some of which are concerned chiefly with the antibiotic and others of which have largely to do with the microorganisms. Those
OME of the preliminary findings on the toxicity of aureomycin and its effect in experimental infections that were made available to us by the workers of the Lederle Laboratories suggested that this agent was relatively non-toxic, was effective by mouth, and gave promise of being highly active against certain viral and rickettsia1 infections. Studies in vitro by the same workers, which were confirmed and extended in this laboratory, also indicated that it was effective against a wide range of human pathogenic bacteria. This new antibiotic, therefore, seemed worthy of clinical trials in bacterial infect,ions in order to determine its range of usefulness.Certain laboratory studies which were carried out as part of the clinical trials are reported separately.'! To date, about 100 patients with a variety of bacterial infections have been treated with aureomycin by mouth at the Boston City Hospital. The results obtained in these patients are summarized in this communication. lnfections Treated and General ResultsThe types of infection .treated, the dosage used, and a rough estimation of clinical effect of aureomycin in these cases are listed in TABLE 1. It should be borne in mind that most of these patients were treated before there was much knowledge of the toxicity of the drug in humans and the dosage employed was gradually increased in successive patients until considerably greater amounts were used than any that had previously been given by mouth. These patients received no other chemotherapy or antibiotic during the aureomycin treatment, although many of them had been treated unsuccessfully with such agents before the aureomyoin was started.Good results were obtained in most of the coccal infections. The effects in most of the patients with typhoid fever, Salmonella infections and severe urinary tract infections were difficult to evaluate. In most of the patients in whom the results are listed as doubtful, definite clinical and bacteriological evidence of beneficial effects was noted during treatment with aureomycin, but the results were either transient or the role of the antibiotic in effecting the results could not be evaluated.
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