COMBINED PENICILLIN AND SULFONAMIDE THERAPY

Before the advent of chemotherapy, pneumococcic meningitis was an almost invariably fatal disease. Recoveries were rare. The mortality was greater than 99 per cent. In 1927 a review of the literature revealed only 150 recoveries.¹With the appearance of the sulfonamides the mortality rate for the first time seemed less forbidding, varying, according to different authors, from 31 per cent to 80 per cent.² Since 1937 the use of type specific antipneumococcic rabbit serum in conjunction with sulfonamide therapy (sulfapyridine, sulfathiazole, sulfadiazine, sulfapyrazine and sulfamerazine) has come into fashion. There again reports of the comparative advantages of combined serum and sulfonamide therapy as opposed to sulfonamides alone are somewhat equivocal. Certainly the advantages of combined therapy are not particularly striking, and in many cases the overzealous use of serum may be actually deleterious. The use of intrathecal serum, for example, is probably ill advised, as is the pushing