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(Chest. 1949;16:661-666.)
© 1949 American College of Chest Physicians

The Effect of Streptomycin with Para-Amino Salicylic Acid on the Emergence of Resistant Strains of Tubercle Bacilli

EDWARD DUNNER M.D., F.C.C.P.1; WALTER B. BROWN M.D.2; and JACK WALLACE 3

1 Chief, Tuberculosis Service, The Department of Medicine and Surgery, Veterans Administration Hospital, Livermore, California.
2 Chief, Professional Services, The Department of Medicine and Surgery, Veterans Administration Hospital, Livermore, California.
3 The Department of Medicine and Surgery, Veterans Administration Hospital, Livermore, California.

In a pilot study to observe the rate of development of resistant strains of tubercle bacilli by the use of streptomycin and para-aminosalicylic acid, it appears that development of such strains is delayed.

Streptomycin-resistant tubercle bacilli are sensitive to para-aminosalicylic acid in vitro.

Strains of tubercle bacilli in three patients appeared to develop resistance to para-aminosalicylic acid. This matter needs further investigation.

Fifteen grams of para-aminosalicylic acid per day caused gastro intestinal disturbance with nausea, emesis and diarrhea. Blood levels ranged from 3 to 7 mgm. per cent four hours after PAS administration. Whether certain specific blood level maintenance is required for therapeutic efficacy requires further study. Prothrombin time was not altered by the above dosage.






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