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THE ROLE OF PENICILLIN IN THE MANAGEMENT OF INFECTION
Jose M. FerrerJr.
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Medical Corps, Army of the United States
1944 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1944; 26:522-531 
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Abstract

1. Penicillin is a powerful antibacterial agent, but its rôle is a limited one. Pathogenic bacteria should be divided into two groups, penicillin-sensitive and penicillin-resistant.

2. Penicillin has no serious toxic manifestations in humans.

3. Penicillin alone is effective in acute infections without suppuration or death of tissue.

4. Penicillin and surgery are equally important in acute infections with suppuration and death of tissue.

5. Penicillin is but one of a number of therapeutic agents in the treatment of chronic infection with suppuration and death of tissue. It is effective in permitting adequate surgery earlier and with more safety.

6. The use of penicillin will not obviate the need for good surgery. Sequestra and foreign bodies, in particular, must still be removed from wounds before they will heal.

7. Penicillin is a more effective antibacterial agent than the sulfonamides against penicillin-sensitive organisms. Its action is not affected by the presence of pus, blood, or tissue autolysates.

8. The chief disadvantages of penicillin are the necessity for administering it by frequent intramuscular or intravenous injections, and its instability at room temperature.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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