The sulphanilamide treatment of scarlet fever

Abstract

1. A series of 340 cases of scarlet fever was treated under controlled conditions, (a) with sulphanilamide or benzyl-sulphanilamide, and (b) without sulphanilamide.2. There was an even distribution of the individual cases in respect of factors known to influence the course of the disease, such as (a) the duration of the disease before admission to hospital, and (b) the severity of the infection.3. Treatment was carried out during the whole period of 4 weeks, which constitutes the average period of hospitalization in scarlet fever.4. The dose employed was large: (a) patients 5 years of age and over receiving 1 g. 4 hourly (i.e. 5 g. a day) for the first 14 days in hospital, thereafter 1 g. t.i.d. (i.e. 3 g. a day) for 14 days; a maximum total dose of 112 g., and (b) patients under 5 years of age receiving 0.5 g. 4 hourly (i.e. 2.5 g. a day) for the first 14 days in hospital, thereafter 0.5 g., t.i.d. (i.e. 1.5 g. a day) for 14 days; a maximum total dosage of 56 g.5. The results show that sulphanilamide had no significant effect upon the initial symptoms of scarlet fever, or upon the kind, incidence, or duration of later complications.6. A large number of toxic reactions followed the use of both sulphanilamide and benzyl-sulphanilamide.7. In view of all the evidence submitted, it is considered that there is no justification for the employment of sulphanilamide and benzyl-sulphanilamide in the treatment of scarlet fever.