1045 such as that due to Klebsiella sp. The combination of gentamicin and erythromycin has a wide antibacterial spectrum but would not be effective in psittacosis or Q fever. Nevertheless I now know of several cases of severe pneumonia where this combination has been rapidly effective where previous antibiotic therapy has failed. This shows that the combination is not incompatible in vivo and will deal with pneumonia due to organisms other than that of legionnaires’ disease. One would expect the erythromycin component to be effective against the
go into remission after a variable number of years. On evidence’-3 it seems reasonable to give maintenance treatment for an arbitrary period of six months or a year, and then to refer for surgical treatment patients who relapse with troublesome symptoms.
patients current
Department of Medicine II, St. George’s Hospital Medical School,
T. C. NORTHFIELD W. S. BLACKWOOD
London SW17 0RE
legionnaires’ organism. Ruchill Hospital, Glasgow G20 9NB
R.
HYPERTENSIVE RESPONSE TO LABETALOL IN PHÆOCHROMOCYTOMA
J. FALLON
SIR,-We have
ANTIBIOTICS FOR LEGIONNAIRES’ DISEASE
seen a
hypertensive
response
to
labetalol in
patient with a predominantly adrenaline-secreting pha:ochromocytoma. Labetalol, which has both alpha-adrenoceptor and beta-adrenoceptor blocking actions, was found by Rosei et al. to be useful in the management of phaeochromocytoma,4 but one of their five cases developed mild postural hypotension soon after the initial dose of labetalol, followed by severe hypertension. a
SiR,-As noted by Dr Pesanti (March 4, p. 506), penicillin
therapy causes death in the guineapig model of legionnaires’ disease under some conditions. In anticipation of this problem, in our study of antibiotic chemotherapy of guineapigs infected with the agent of legionnaires’ disease, we included two animals, uninfected with the legionnaires’ disease agent, to which we gave 100 000 units of penicillin per kg per day. These con trol animals survived, while six animals given 10 000-100 000 units of penicillin per kg per day and the legionnaires’ disease Fisher’s exact binomial test, one-tailed). agent died (p
go into remission after a variable number of years. On evidence’-3 it seems reasonable to give maintenance treatment for an arbitrary period of six months or a year, and then to refer for surgical treatment patients who relapse with troublesome symptoms.
patients current
Department of Medicine II, St. George’s Hospital Medical School,
T. C. NORTHFIELD W. S. BLACKWOOD
London SW17 0RE
legionnaires’ organism. Ruchill Hospital, Glasgow G20 9NB
R.
HYPERTENSIVE RESPONSE TO LABETALOL IN PHÆOCHROMOCYTOMA
J. FALLON
SIR,-We have
ANTIBIOTICS FOR LEGIONNAIRES’ DISEASE
seen a
hypertensive
response
to
labetalol in
patient with a predominantly adrenaline-secreting pha:ochromocytoma. Labetalol, which has both alpha-adrenoceptor and beta-adrenoceptor blocking actions, was found by Rosei et al. to be useful in the management of phaeochromocytoma,4 but one of their five cases developed mild postural hypotension soon after the initial dose of labetalol, followed by severe hypertension. a
SiR,-As noted by Dr Pesanti (March 4, p. 506), penicillin
therapy causes death in the guineapig model of legionnaires’ disease under some conditions. In anticipation of this problem, in our study of antibiotic chemotherapy of guineapigs infected with the agent of legionnaires’ disease, we included two animals, uninfected with the legionnaires’ disease agent, to which we gave 100 000 units of penicillin per kg per day. These con trol animals survived, while six animals given 10 000-100 000 units of penicillin per kg per day and the legionnaires’ disease Fisher’s exact binomial test, one-tailed). agent died (p
