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The results are presented of a controlled trial comparing high dosage penicillin (3 mega units twice daily) with penicillin 1 mega unit twice daily plus streptomycin 0·5 g. twice daily, in the treatment of exacerbations of bronchitis, the treatment regimen being allocated at random. The clinical composition in the two groups was similar.
Assessment of the efficiency of therapy was judged by the conversion of the sputum to mucoid on the seventh and fourteenth day.
Sputum conversion occurred by the seventh day in 30 of the 36 patients (83 per cent.) treated with high dosage penicillin, as compared with 24 out of 40 patients (60 per cent.) treated with penicillin plus streptomycin. The superiority of the high dosage penicillin regimen is statistically significant.
Only 1 of the 17 cases whose sputum became mucoid on high dosage penicillin and 2 in whom this was achieved on penicillin plus streptomycin relapsed during the second week of therapy.
Only 1 patient complained of more than slight pain on injection; he was on high dosage penicillin.
Ten patients were treated for 1 week by Neodiazine, an aerosol containing neomycin plus sulphadiazine. In only 5 of these patients was the sputum converted to mucoid by the seventh day. Two of these 5 patients received treatment for a second week. In both cases the sputum was purulent on the fourteenth day. Following these poor results, Neodiazine treatment was discontinued.
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The research was partly supported by a grant from the Royal Victoria Hospital Tuberculosis Trust. Some of the cases were under the care of Dr. A. P. Littlewood, East Fortune Hospital, East Lothian.
© 1965 Ballière, Tindalli & Cassell. Published by Elsevier Inc.