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Combined Actions of Antimicrobial Drugs

  • Chapter
Concepts in Biochemical Pharmacology

Abstract

Physicians generally believe that antimicrobial drugs are widely effective and fairly harmless. Most physicians also have the vague feeling that if one antimicrobial drug is good, two should be better, and three should cure almost everybody of everything. This attitude may be responsible for the widespread use of antimicrobial drugs in combinations. At Johns Hopkins Hospital, 11% of 7094 patients admitted during a three-month period in 1963 received from two to five antimicrobial drugs (Cluff et al., 1964). Since that time several scientific and medical organizations have strongly opposed the widespread use of fixed combinations of antimicrobial drugs (A. M. A. Council on Drugs, 1970; Natl. Res. Council, 1969). In fact, fixed combinations have been removed from the market in the United States by action of the Food and Drug Administration. No evidence exists, however, that the prescribing of several antimicrobials simultaneously has diminished. It is therefore appropriate to reexamine the experimental basis of combined antimicrobial drug action and the clinical situations in which such combined antimicrobial action might be necessary or harmful. This review draws heavily on experimental work of our own group in the Department of Microbiology, University of California, San Francisco, and on previous summaries prepared by us (Jawetz and Gunnison, 1953; Jawetz, 1967; Jawetz, 1968). The literature in this field is vast and a complete survey is impractical. Therefore, only representative individual papers are cited.

This chapter was completed in January 1972.

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  1. E. Jawetz
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  1. Laboratory of Chemical Pharmacology, National Heart and Lung Institute, National Institutes of Health, Bethesda, Maryland, 20014, USA

    James R. Gillette  & Jerry R. Mitchell  & 

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Jawetz, E. (1975). Combined Actions of Antimicrobial Drugs. In: Gillette, J.R., Mitchell, J.R. (eds) Concepts in Biochemical Pharmacology. Handbuch der experimentellen Pharmakologie / Handbook of Experimental Pharmacology, vol 28 / 3. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-46314-3_14

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