In pneumococcal (Lobar) Pneumonia Penicillin is preferable to sulphonamide if the infection is severe or if the patient is elderly. Acute bronchitis or bronchopneumonia may respond to benzyl penicillin alone, but this antibiotic should be combined with streptomycin if a mixed infection is responsible, especially if H. influenzae is one of the invaders, as is often the case. In these circumstances ampicillin may prove to be even more efficacious, particularly in the elderly who tolerate streptomycin poorly. An empyema can be treated by aspiration of the pus and the injection of 500,000-1,000,000 units of benzylpenicillin into the pleural cavity, provided the organism is sensitive to penicillin.
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