Chemotherapy: Drug-Resistance and Superinfection
In the Individual Patient
The use of two drugs in combination to delay the emergence of a drug-resistant strain is now a well established principle and is almost universally used in the treatment of tuberculosis. A change in the drug sensitivity of an infecting bacterium during a single short course of treatment does not in fact occur very frequently. On the bacterial side the only organisms likely to show such a change are staphylococci and conform bacilli. When antibiotics have to be given for long periods the danger is increased, and is particularly great in the case of tuberculosis, since tubercle bacilli are nearly as adaptable to antibacterial drugs as are staphylococci and coliform bacilli.
Although staphylococci appear to be able to develop resistance to almost any antibiotic, this usually only follows continued use of the antibiotic in a hospital where strains are spreading from patient to patient. With streptomycin, erythromycin, novobiocin and Fucidin, however, resistance develops so rapidly that a gross change in sensitivity of an infecting strain is not infrequent after antibiotic Read more [...]
