Medicine: Mixed Blessing

Physicians who are overconfident of germ-killing wonder drugs are living in a fool's paradise where their patients may die. This is a favorite theme of Boston's Dr. Maxwell Finland. Most doctors have rationalized that, although the sulfas and antibiotics let some resistant microbes slip by, they save so many lives that their occasional failures stand out more. The "increase" in such cases, they argue, is only relative, not real. Last week Dr. Finland attacked this defense. In his saddest jeremiad yet, he asserted that the antimicrobial drugs have caused an actual increase in severe infections and deaths from some hitherto harmless or uncommon germs.

To document his conclusion, Dr. Finland told the Association of American Physicians, he and two colleagues (Dr. Wilfred F. Jones Jr. and Research Technician Mildred W. Barnes) spent three years poring over the records of 10,000 patients who had severe infections at the time of death in Boston City Hospital. The researchers covered 24 years, beginning with 1935, to get data before the first sulfa changed the picture (1937). Deaths caused by bacterial infections in the bloodstream dropped steadily until 1947, they found. Since then, the rate has stayed low or dropped further for deaths caused by pneumococci and the dreaded streptococci—the organisms most vulnerable to sulfas and antibiotics. But in these twelve years there has been an absolute increase in deaths from other bacteria.

Among the worst offenders, said Dr. Finland, is Pseudomonas aeruginosa, or the "blue-pus organism," which nowadays crops up more often and with greater virulence. Surprisingly, another problem microbe is Aerobacter aerogenes, found naturally on many food plants and in water and milk, as well as in man's digestive tract. Once rated almost harmless, it is now a killer. In sum, optimists who think it is old-fashioned nonsense to talk about fatal "blood poisoning" are wrong. There are now more deaths from septicemia than there were before the antibiotic age, said Dr. Finland.