PEDIATRICS Vol. 2 No. 2 August 1948, pp. 163-174
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PARA-AMINOBENZOIC ACID IN THE TREATMENT OF ROCKY MOUNTAIN SPOTTED FEVER

A Report of Its Use in 17 Cases

SIDNEY ROSS M.D.1, PRESTON A. MCLENDON M.D.1, and HUGH J. DAVIS M.D.1

1 The Children's Hospital, Washington, D.C., and the George Washington University Medical School.

PABA was used in 17 cases of Rocky Mountain spotted fever during the summers of 1946 and 1947 with recovery of all patients. Both the morbidity and degree of toxicity were decreased. The earlier the initiation of PABA therapy, the better the response. Favorable therapeutic results can probably be expected if the drug is started before the seventh day. The optimal time for initiating treatment probably is during the fist four days after the onset of the disease. The importance of early diagnosis is emphasized.

There is considerable variation in the PABA blood level achieved with comparable dosage, there being no definite linear or curvilinear correlation between dosage and blood concentration. On the average, a dose of 0.9 gm./kg. body weight in 24 hours in a two-hour divided dosage schedule was found to be satisfactory in children.

PABA has few toxic manifestations. A leukopenia without granulocytopenia was found to occur in some cases. Cephalin flocculation tests showed an increase in positivity during PABA therapy. A reducing substance which produced a green or yellow reduction with Benedict's reagent was found in 55% of the urines examined during PABA therapy. This reducing substance is probably a benzoylglucuronide resulting from the conjugation of PABA with glucuronic acid.

Submitted on May 28, 1948