MedicinePharmacologyPharmacotherapyAntimicrobial PharmacologyAntimicrobial PharmacotherapyGastrointestinal PharmacotherapyAntibacterial AgentsAntibacterial PharmacologyAntimicrobial TherapyAntispasmodic TherapyGastrointestinal PharmacologyBacteriostatic ActivityBacteriostatic AgentsNarrow-spectrum Antimicrobial Therapy
The modern concepts of intestinal antisepsis have developed during the past 12 years. Initially, certain sulfonamides, which were poorly absorbed from the gastrointestinal tract, were found to act locally to alter the bacterial flora. These compounds had relatively narrow antimicrobial spectrums, had little effect against the gram-positive organisms, and acted primarily as bacteriostatic agents against the gram-negative bacteria found in the gastrointestinal tract of man. While many of the sulfonamides have some activity, it was not until succinylsulfathiazole (Sulfasuxidine) was used by Knotts, Lee, Inui and myself<sup>1</sup>that the gram-negative flora of the bowel could be altered significantly and consistently. Many sulfonamides were investigated, but ultimately only three could be used as practical intestinal antiseptics. They were, in the order discovered, succinylsulfathiazole,<sup>2</sup>phthalylsulfathiazole (Sulfathalidine),<sup>3</sup>and phthalylsulfacetamide (Thalamyd).<sup>4</sup>Of these three, succinylsulfathiazole was the most promising and satisfactory, because it not only altered the gram-negative flora of