On the assumption that bactericidal action of drugs is probably required for the effective treatment of melioidosis, in-vitro experiments were performed with five chemotherapeutic agents and six strains from clinical sources. Chloramphenicol, kanamycin, novobiocin and tetracycline, alone and in various combinations, were tested for bactericidal activity against reasonably heavy inocula by means of a tube-dilution technique with subculture for viable counts. Results are displayed by Loewe's method of isobolograms in a simplified form. The novobiocin-tetracycline combination produced a kill of 99·4 to 99·8 per cent. with five of the six strains at concentrations at which neither drug had any effect when used alone (2·5 to 10 μg per ml of novobiocin and 2 to 5 μg per ml of tetracycline). The synergistic effect of this mixture was demonstrable with as little as 0·2 μg per ml of novobiocin, or 0·003 of the concentration needed for its comparable independent effect; in clinical use the latter could be achieved systemically only with unusually high dosage. No bactericidal effect was found with one strain.

Sulphamylon showed a strong bactericidal effect at concentrations that might be achieved locally by topical applications to wounds and burns.


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