AMA Arch Intern Med. 1951;88(2):135-136. doi:10.1001/archinte.1951.03810080003001.
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Several recent papers1 again call attention to the dislocation of the normal bacterial flora of the upper air passages and of the gastrointestinal tract which may follow the administration of antibiotics. Weinstein2 first aroused interest in this subject in 1947 with an important paper in which he pointed out that, after suppression of certain groups of organisms by means of penicillin administration, other resistant and perhaps highly pathogenic bacteria might be enabled to enter the throat or, if already present in small numbers, might grow and produce disease. One of Weinstein's patients, for example, was a child treated with penicillin for bronchopneumonia. On the fourth day, a pure culture was obtained of Hemophilus influenzae type B from the pharynx, as well as a positive blood culture. Weinstein pointed out that in his patients the second infection was produced by organisms normally present in the nasopharynx and that it


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