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Unusual Micrococcal Cutaneous Reactions:  Review of Some Basic Tenets of Micrococcal Bacteriology and Drug Resistance and Presentation of Two Cases

MILTON ORKIN, M.D.
AMA Arch Derm. 1958;78(3):378-385. doi:10.1001/archderm.1958.01560090094019.
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The problem of antibiotic-resistant micrococci* is ubiquitous in contemporary medicine. As newer antibiotics are developed they not uncommonly control the organisms initially; however, within a short period micrococci develop resistance to the newer products. Another approach to this problem has been the use of combinations of antibacterial agents to delay the emergence of micrococcal resistance. However, Dowling and co-authors decry the general use of combined therapy for the following reasons: 1. Inadequate therapy may be encouraged by the use of fixed combinations. 2. An increase in hypersensitivity and toxicity may occur with the use of two drugs instead of one, and, in the event of a reaction, it may be impossible to tell which drug was responsible. 3. Bacterial resistance to either or both of the drugs is probable. 4. An accumulation of antibiotic-resistant bacteria will probably occur within hospitals or other semiclosed

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