Intravenous Drip Transfusion in Infants
Authors: D. MacCarthy
Journal: BMJ (1943)

Sonne Cases treated with Sulphanilamnide.-Twenty-ninecases were treated; the average duration of stay in hospital was 23.8 days, while the average number of days before becoming bacteriologically negative was 13.9.These cases were divided into 9 acute cases and 20 convalescent carriers.Sonne Cases-No Chemotherapy.-Fifty-sevencases were treated ; the average duration of stay in hospital was 19 days, while the average number of days before becoming bacteriologically negative was 9.5.These were divided into 18 acute cases and 39 convalescent carriers.Biochemical Findings Sulphaguanidine.-Bloodconcentrations usually varied from 3 mg.per 100 c.cm. to a trace, but in one case 9 mg.was found, in 2 cases 8 mg., in 1 case 7 mg., and in one other case 6 mg. per 100 c.cm.The concentration in faeces varied from a trace to as high as 10,000 mg. per 100 c.cm.At the beginning ef the series leucocyte counts were done as a routine in each case, but as these were invariably normal this examination was discontinued.Sulphanilamide.-Blood concentrations were lower than in the case of sulphaguanidine-treated cases, the highest con- centration in the blood being 3.3 mg. and the lowest 0.1 mg. per 100 c.cm.In the main they varied between 1 and 2 mg.Concentrations in the faeces varied between a trace and 840 mg. per 100 c.cm., the average being between 300 and 400 mg. Toxicity of DrugsIn no case treated with either sulphaguanidine or sulphanilamide was any evidence of toxicity observed, judged by the standards of nausea, 'cyanosis, vomiting, pyrexia, rash, or haematuria.The urine was examined every second day for blood and albumin, but this practice was later reduced to twice weekly on account of lack of toxic symptoms.Older patients were also questioned with regard to any disagreeable effects, but these were remarkable by their absence.Gastro-enteritis in Infants Four cases were treated with sulphaguanidine; 3 of these patients died without any improvement in the stools or in the general condition.All were male babies, varying in age from 1 to 2 months and presenting varying degrees of dehydration, with frequent loose, green, and offensive stools from which no specific organism was obtained.The dosage used was 3 g.during the first 24 hours as a loading dose, followed by 2 g. daily for 4 days, but in none of the cases did the concentration in the blood exceed 0.8 mg. per .100c.cm., although the con- centration in the faeces went as high as 25,000 mg.We can only conclude that the dehydration and the frequency of the stools were so pronounced that the drug had no time to be absorbed and was passed rapidly through the intestines.Paratyphoid B Fever Eight cases treated with sulphaguanidine were taken, varying in age from 3 months to 53 years.Sulphaguanidine had no effect on the stools, which remained positive throughout the course and for a considerable time afterwards, although in two cases a distinct improvement in clinical condition was noted.These patients were exceedingly listless, with marked lose of appetite, but within 48 hours of starting treatment with sulphaguanidine their general condition had greatly improved.The dosage varied from 5.25 g. daily for 6 days to a maximum of 10.5 g. daily for 14 days.Summary 273 cases of tacillary dysentery treated in the City (Infectious Diseases) Hospital, Aberdeen, during 1941-2 are described, together with 4 cases of gastro-enteritis of infants and 8 cases of paratyphoid B fever.Of the cases of bacillary dysentery 140 received no drug, 83 were treated with sulphaguanidine, and 50 had sulphanilamide.The series receiving no chemotherapy were given 2 drachms of sodium sulphate night and morning for an adult and 1 drachm night and morning for a child.Those receiving sulphaguanidine were given a 5-day course based on body weight, the initial loading dose during the first 24 hours being 0.5 g. per kilo of body weight,