The Chemotherapy of Gonorrheal Urethritis in the Male

Abstract

medication was changed to sulfacetimide she had none. Three patients could not tolerate either sulfanilamide or sulfathiazole but had no ill effects from sulfacetimide. Seven patients with acute pyelonephritis of pregnancy were treated. All were given an eight day course of 30 tablets (15 Gm.). In each case the urine became sterile three days after treatment was started, and after the course was finished the patients required no repeti¬ tion of sulfacetimide. Chills, fever and pain disappeared immediately after the first day. Repeat stains of urinary sediment have all been negative, and deliveries have been uncomplicated. Two other patients treated post partum, and 1 after cesarean section, recovered.Three children are included in this series. One child aged 5 years had been treated with mandelates, sulfanil¬ amide and intramuscular azosulfamide with no reduc¬ tion of the temperature nor elimination of the chills and fever. A dose of 0.25 Gm. of sulfacetimide was given twice a day for two days, and the course was completed with 0.25 Gm. once a day for five days. The chills, fever and costovertebral pain disappeared on the third day. The urine became sterile-after hav¬ ing had many pus cells and gram-negative bacilli for four months-and remained sterile on repeated exami¬ nations over a period of nine consecutive months. Two patients, each 10 years of age, recovered from acute attacks of infection of the lower part of the urinary tract with the administration of sulfacetimide and have been without symptoms for eight months.In this group of 200 patients we found that 21 had been on sulfanilamide before sulfacetimide was given. Sulfanilamide was discontinued, either because of no response to the drug or because of reactions. After treatment with sulfacetimide, 17 patients were classed as recovered, 3 showed improvement and 1 did not respond. This is an 80.9 per cent improvement over sulfanilamide. Eleven patients who did not respond to the mandelates recovered with sulfacetimide, while 4 did not respond-a 73.3 per cent improvement over the mandelates. Three patients who did not respond to azosulfamide recovered on sulfacetimide therapy. Table 5.-Summary Number Per Cent Total number oí cases. 200 100.0 Recovered. . 171 85.5 Improved". 25 12.5 Unimproved. 4 2.0 Reactions. 8 4.0Six patients had previous sulfathiazole therapy : 2 could not tolerate it and 4 did not respond to it. These 6 patients recovered when placed on sulfacetimide therapy. Nine other patients who had taken some other form of oral therapy without response recovered when placed on sulfacetimide therapy. SUMMARY Two hundred cases of bacillary infection of the uri¬ nary tract were treated with sulfacetimide. The per¬ centage of recoveries was 85.5; 12.5 per cent showed improvement and 2 per cent showed no response to the drug.Sulfacetimide has been more effective in the treat¬ ment of these infections of the urinary tract than has sulfanilamide and the mandelates. In 80.9 per cent of the sulfanilamide-resistant cases recovery occurred when sulfacetimide...