Bacteriostatic Effect of Sulfathiazole in Various Ointment Bases

Strakosch, Ernest A.

doi:10.1001/archderm.1942.01500130047003

Arch Dermatol

1942

DOI: 10.1001/archderm.1942.01500130047003

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Bacteriostatic Effect of Sulfathiazole in Various Ointment Bases

Ernest A. Strakosch¹

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1942

1946

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Cited by 8 publications

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“…The course of events was very similar in all cases : (a) the prompt development of constitutional symptoms including malaise, chilliness and elevation of temperature, (b) the local exacerbation of the lesions under treatment and (c) the generalized hematogenous "id"-like eruption, which was always pruritic and "explosive" in its onset. In many respects, the symp¬ toms are not unlike those described by Lyons and Balberor6 in a recent paper (also discussed in an edi¬ torial in The Journal.5 They described a so-called sulfonamide shock representing an acquired sensitivity to the sulfonamide as the result of oral administration 5 1941. of the drug, manifested on subsequent oral adminis¬ tration (after a five to fourteen day interval) of the same sulfonamide compound. Their evidence indicated "that approximately one third of all patients treated with sulfonamide drugs develop a sensitivity to these drugs sufficient to interfere with their subsequent use on these patients."…”

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“…It is not known how long the sensitivity to sulfathiazole persists; we have not had an opportunity to determine this in any of our patients. 5. We are not certain whether these patients can take other sulfonamides by mouth without reaction.…”

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confidence: 96%

“…Cutaneous tests with the chemically pure sulfonamide compound in an effort to predict reactivity are almost valueless. 5 4. The symptoms recur when sulfathiazole by mouth is resumed for a second and third time.…”

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confidence: 99%

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Sulfathiazole in Eczematous Pyoderma

Livingood¹,

Pillsbury²

1943

JAMA

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The induction of sensitivity to various sulfonamide compounds and the possible physiologic mechanisms responsible are subjects of increasing interest and importance. This paper is a report of a reaction which we have observed in 12 patients, in whom a sensitivity to sulfathiazole was apparently induced by local application of it to diseased skin, and in whom the evidence of sensitivity appeared when the drug was later administered by mouth. These patients all suffered from various forms of eczematous dermatitis complicated by some degree of low grade secondary pyococcic infection and were treated for more than five days with 5 per cent sulfathiazole emulsion type ointment and later given sulfathiazole by mouth. A characteristic explosive type of systemic and dermatologic reaction occurred. These patients were part of a series of more than 1,000 patients suffering from various dermatoses whom we have treated with the sulfonamide compounds applied locally.The several reports regarding the use of sulfathiazole ointment in the treatment of cutaneous pyogenic infections will not be completely summarized here.1In three reports some local reaction to sulfathiazole ointment was reported. Sams and Capland 2 observed a patient in whom the local application of sulfathiazole powder for chronic otitis externa produced an acute exacerbation. Later administration of sulfathiazole by mouth to this patient was followed by massive edema of the face and ears and a generalized erythematous macular and pustular eruption. Recently Miller3 reported that a patient with sycosis vulgaris had been given applications of 50 per cent and 25 per cent sulfathiazole ointment for a total of two weeks. Two months later the patient was given 1 Gm. of sulfathia¬ zole by mouth and within two hours the eyelids became swollen shut and an eruption appeared on the face, forearms, back, abdomen and thighs. In another study we4 reported on the treatment of 190 patients with sulfathiazole incorporated in bases of various types. In this paper we stated that "in a few patients with chronic eczematoid eruptions, flare-ups have been noted in conjunction with the use of sulfathiazole ointment but no exacerbation has been noted in a patient with a dermatosis primarily due to infection." None of the patients in this series had been given sulfathiazole bymouth after local application of the drug. It was demonstrated that sulfathiazole ointment (particularly when the ointment base is of the emulsion, water solu¬ ble type) is an extremely effective therapeutic agent in the treatment of impetigo, ecthyma and acute impetiginous dermatitis uncomplicated by other etiologic factors. However, it was emphasized that sulfathiazole ointment has a much less striking effect on eczematous lesions complicated by chronic bacterial infection than on acute pyodermas due solely to pyococci. Our sub¬ sequent experience in a large series of patients is in accord with this. In addition, certain limitations and contraindications to sulfathiazole ointment therapy have become apparent, and...

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Sulfathiazole in Eczematous Pyoderma

Livingood¹,

Pillsbury²

1943

JAMA

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The Value of Sulfáthiazole Ointment in the Treatment of Pyogenic Infections of the Skin

Winer¹,

Strakosch²

1942

JAMA

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in coronary occlusion and suggested the possibility that the disturbance in the cardiac mechanism may be due to myocardial anoxemia. In man deLavergne and his associates19 noted a transitory Stokes-Adams syndrome with brachycardia eight days after the injection of antistreptococcus serum for erysipelas, at which time serum sickness developed. Also, Harkavy20 observed certain cardiac arrythmias and angina pectoris in 3 patients when offended by certain allergens. The relation of the changes in the electrocardiograms to the anaphylactic shock in our case is conjectured. Nevertheless, there were abnormally broad P waves and flat Ts shortly after the shock which returned to normal later. SUMMARY A man aged 22 had severe anaphylactic shock two hours after an injection of tetanus antitoxin. The patient was gravely ill and laboratory examinations showed hemoconcentration with a red blood count of 6,910,000. On this basis, he was given 2,000 cc. of physiologic solution of sodium chloride intravenously during a period of two hours, which resulted in dramatic improvement with recovery. The red blood cell count dropped to 5,700,000 at the end of this therapy, to 5,000,000 within six hours and to 4,610,000 within twelve hours of administration of saline solution.

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Hypersensitivity Produced by the Topical Application of Sulfathiazole

Cohen¹

1943

JAMA

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Bacteriostatic Effect of Sulfathiazole in Various Ointment Bases

Cited by 8 publications

References 13 publications

Sulfathiazole in Eczematous Pyoderma

Sulfathiazole in Eczematous Pyoderma

The Value of Sulfáthiazole Ointment in the Treatment of Pyogenic Infections of the Skin

Hypersensitivity Produced by the Topical Application of Sulfathiazole

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