Changing Pattern in Sensitivity to Antibiotic Agents

The increasing tendency of drug fastness has threatened the therapeutic measure of antibiotics as if it drive back the medical practice to the preantibiotic era. In order to confirm such trend, 305 cases of orthopedic patients admitted to the College Hospital of Seoul National University were taken as a material to analyse the drug sensitivity of the isolated agents. The strains isolated from various lesions totaled 397, which were included 163 cases of pyogenic osteomyelitis, 38 cases of infected open fractures, 31 cases of traumatic wound infections. 27 cases of acute suppurative myositis and abscesses, 23 cases of septic arthritis and 23 cases of mixed infection with bone tuberculosis. The most probable agents were summarized as follows: Staphylococcus 60.2%, Hemolytic Streptococcus 9.6%, Pseudomonas 8.5%. E. coli 6.8%, Paracolon 6.0%, Proteus 4.8%, Aerobacter aerogenes 1.7%, Alcaligenes fecalis 1.3%, Corynebacterium 0.5%, and Cl. tetani 0.5%. The laboratory data were dased upon the routine technique of isolation and the single paper disc method of Spauldings technique, the results of data were divided into four period of time, two to three years apart, and put the percentage of drug fastness under the agent concerned. Generally speaking, as shown by table 5–8, there are marked tendency of increased drug fastness with times in several agents. particularly in staphylococcus. In view of such tendency the staphylococcus as an etiological agent of infection in orthopedic disease seemed to be the most important one, probably it may reside in the increase of resistant strains as a result of abuse of antibiotics, widespread of hospital infection, or both. On the other hand, most strains of streptococcus have kept their sensitivity to various antibiotics with fairly high level and also without much change in incidence of its infections. The various enteric bacteria isolated from the lesions have shown resistant to various drug. The role of such agents in mixed infections in connection with flora change seems to be an important problem to be done. In conclusion, it is suggested that successful chemotherapy in Korea may be consisted in, 1) avoidance of the abuse of antibiotics. 2)sufficient use of antibiotics in dosage and duration with multiple combination to eradicate the agent, according to the sensitivity of isolated agent to antibiotics.