Sulfd Debits & Credits

The sulfa drugs are wonderful--and dangerous unless properly used. It was clear last week that this simple fact, unrealized by a large part of the public, was also unrealized by many members of the medical profession. Sulfa experts were worried about the common use of the drugs where the use was not specifically indicated. They were worried by the tendency of some physicians to prescribe sulfa without subsequently keeping a close eye on the patient.

Toxic reactions from the drugs are frequent--a survey of sulfas taken internally shows that some toxic reaction occurred in 29.8% of sulfapyridine cases, 11.8% of sulfathiazole and 7.7% of sulfadiazine. Most of these reactions are not dangerous, merely a nuisance (e.g., nausea, vomiting, dizziness, mild anemia, lack of appetite, tingling sensation), and do not interrupt treatment. But some rare reactions may prove fatal unless caught early. Even the less toxic sulfa derivatives can cause trouble: three cases at Johns Hopkins Hospital suffered not only kidney damage but brain injury from sulfathiazole; two majors in the Army Medical Corps last winter stated that seven out of 38 patients had kidney complications after sulfadiazine. Some of the danger signals are: headache, body ache, low urine output, high temperature, yellowish eyeballs, pallor and rash.

Sulfa deaths are very rare compared with the lives saved and considering the estimated ten or 15 million U.S. cases treated with sulfa drugs in a year. The great weight on sulfa's credit side can be gauged by New York City's mortality records: if the pre-sulfa mortality rate had prevailed, 10,341 New Yorkers would have died from 1936 to 1941, of 14 diseases now treated with sulfa drugs. Actually only 4,475 died. For every 685 pneumonia deaths there was only one fatal sulfa reaction--a risk doctors and citizens agree is well worth taking.

This file is automatically generated by a robot program, so reader's discretion is required.