Acute Bronchopulmonary Suppuration: Therapy with Endoscopic Application of Oleaginous Penicillin

¹ Chief of Thoracic Medicine, St. Francis Hospital, Trenton, New Jersey. Associate in Medicine, Graduate School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

1) The clinical entity of acute bronchopulmonary suppuration is better classified as acute suppurative segmental bronchopneumonitis, obstructive in type since the primary focus is the bronchopulmonary segment which may be considered the pathological unit. This concept is also in harmony with the radiological as well as the bronchological aspects of this disease.

2) Antibiotic therapy via parenteral as well as aersol route has not been particularly effective in the author's experience in the treatment of the acute phase of this disease.

3) A new method of endobronchial instillation of oleaginous penicillin directly into the segmental bronchus involved is described as are the instruments required for this procedure.

4) A series of 10 patients with acute suppurative segmental bronchopulmonary pneumonitis, obstructive in type, in which this method was used with rather dramatic results is reported.

5) The method is also recommended for "poor-risk" patients of chronic suppurative bronchopneumonitis prior to definitive surgery.

6) Early therapy of acute suppurative segmental bronchopneumonitis, obstructive in type, with endobronchial penicillin is a powerful prophylactic method for avoiding the chronic sequellae of this entity.