Sulfadiazine Pneumonia Therapy in the Canal Zone

With Especial Reference to Bradycardia

¹ From the Colored Male Medical Service, Gorgas Hospital, Ancon, Canal Zone

One hundred consecutive and unselected pneumonia patients in the Canal Zone were treated with sulfadiazine following the dosage originally recommended by the Council on Pharmacy and Chemistry⁸ with the following observations:

1) There were 45 lobar and 55 broncho pneumonias.

2) The average length of time between onset of symptoms and hospital admission was 4.07 days.

3) Bacteriologically there were 42 typed pneumococcic (including 10 type I), 7 hemolytic streptococcic and 51 cases of undetermined etiology.

4) The average sulfadiazine dosage was 40.5 gms.

5) The maximum sulfadiazine concentrations varied from 8 mg. per cent to 30.8 mg. per cent.

6) The temperature returned to normal by crisis within 48 hours in 78 patients, by lysis in 21 (1 death).

7) Pneumonia and drug complications with complete recovery in all cases were as follows: Jaundice, 1; serous pleural exudate, 2; nausea and vomiting, 1.

8) There was one death, a mortality rate of 1 per cent.

9) Most noteworthy and inexplicable was the fact that 63 of the 100 patients developed a sinus bradycardia with occasional heart rates as slow as 36 beats per minute during or immediately following sulfadiazine treatment. These 63 included 13 with pulse rates between 50 and 40, and 7 cases under 40 beats per minute.