Abstract
Since the publication of Domagk, 1 presenting the results of his experiments with Prontosil-S in streptococcal infections, numerous other investigators 1-6 have not only confirmed his work but also extended the scope of the usefulness of the derivatives of this drug.
The position which the drugs have in anærobic infections, especially that of gas gangrene, has not been clearly established. Bliss et al., 5 and others 7 , 8 described the effective action of sulfanilamide and its derivatives in experimental animals which had been injected with Clostridium welchii. Bohlman 9 reported 5 cases of gas gangrene treated successfully with sulfanilamide. Other authors 10 , 11 have advocated the use of this drug in Clostridium infections. Unfortunately, the enthusiasm developing from these early reports was based largely on animal and in vitro experiments, which were not analogous to human infections. Recently, however, reports 12 , 13 have appeared in the literature of the successful use of sulfanilamide in gas gangrene resulting from war injuries.
Clinical infections of the peritoneum due to the Clostridium group are rare, especially when consideration is taken of the frequency with which there is contamination due to the escape of intestinal contents following the traumatic or infectious break of the intestinal tract. Apparently, the peritoneum is able to resist contamination with Clostridium welchii more effectively than muscle tissue. The sacchrolytic nature of these organisms is well known and may partially account for this tissue susceptibility. Using sulfanilamide and sulfapyridine, Stephenson and Ross 14 were able to protect mice against several lethal doses of Clostridium welchii injected intraperitoneally. However, these same drugs proved ineffectual against a single lethal dose of the organisms intramuscularly.
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