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Antimicrobial Monotherapy: A 1984 Phoenix

JAY P. SANFORD, M.D.
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Uniformed Services University of the Health Sciences; Bethesda, Maryland


Ann Intern Med. 1984;101(4):557-558. doi:10.7326/0003-4819-101-4-557
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The introduction of streptomycin in 1946 opened an era of debate about single versus combined therapy. Since then, acceptable indications for using two or more anti-microbial agents simultaneously have been defined, including initial use in serious suspected bacterial infections before precise bacteriologic identification of causative agents is obtained; anticipated synergism between two agents against an organism; management of polymicrobial infections caused by organisms with differing antimicrobial susceptibilities; prevention of the development of bacterial resistance; and reduction in dosage of a potentially toxic drug. In the 20 years since the introduction of gentamicin, near universal agreement has developed that an aminoglycoside

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