Carbenicillin in the first nine months of unrestricted use. A chapter in the natural history of an antibiotic.

During the first nine months following its release for general use, carbenicillin was administered to forty-two patients in Hahnemann Hospital. Thirty-nine available records of patients receiving the drug for other than urinary infection were reviewed. Among children, all but one had mucoviscidosis: most were given acceptable therapeutic regimens; survival rate was 80%, and their physicians were favorably impressed. Among adults, underlying disease was usually life threatening; most were inadequately treated; survival rate was 31%, and their physicians were not favorably impressed. The multiplicity of variables precludes objective evaluation of the drug under the circumstances of its use, but one that could have been avoided was the inconsistency of the therapeutic regimen, which in adult patients was too often insufficient. As used, therefore, carbenicillin has not provided the benefits predicted from its earlier controlled evaluation, and the large expenditure of money, particularly by adult patients, has been largely wasted.