LXXXVI The Local use of the Sulfonamides, Gramicidin (Tyrothricin) and Penicillin in Otolaryngology

Practically all infections of the ears and sinuses are secondary to an acute coryza or nasopharyngitis. The number of ear and sinus complications seen by the otolaryngologist is growing less each year,· due to the widespread use of sulfonamides during the early stages of infection. There are objections to giving large doses of these drugs by mouth and saturating the entire body in order to cure or pre! vent a local infection. A more satisfactory method of using the sulfonamides to prevent sinus and ear infections is suggested by the publication of Pickrell! on the treatment of extensive skin burns. It has long been known that infection is a serious complication of burns, and Pickrell finds it may be prevented by spraying the burned area with a 2.5 per cent solution of sulfadiazine (2 sulfanilamidopyrimidine) in 8 per cent triethanolamine. This mixture has a pH of about 8.7, is not toxic and is readily absorbed by the tissues. To be effective it must be sprayed on the burned area freely and at frequent intervals, at least every hour during the first day, every two hours the second day, etc. Enough of the drug is absorbed under this treatment to maintain a high blood level, but the pre-