A comparison of the effects and side-effects of penicillin V and ampicillin in the treatment of scarlet fever.

Abstract

SummaryA comparison of the effect of penicillin V and ampicillin in the treatment of scarlet fever has been made in two series of 110 patients each. Clinically and bacteriologically both drugs showed a very satisfactory effect, penicillin V being superior–half the dose of this drug bringing about a rather shorter period of fever, quicker elimination of bacteria, and less streptococcal recurrence. The serological reaction, judged from the antistreptolysin titre, was the same in the two series, and likewise the incidence of recurrences of scarlet fever.As regards sife‐effects there was a considerable difference. Exanthema, sometimes accompanied by fever, occurred on the eighth to tenth day of 10 ampicillin cases (9%) but in no penicillin V case. One patient on ampicillin had a mild mucocutaneous syndrome. In 11 (10%) of the ampicillin cases and 4 of the penicillin V cases there was a clinically inexplicable febrile condition of a fairly pronounced nature beginning on the third to eighth day. The author interpret the exanthema cases as an allergic reaction of the nature of serum disease, the febrile cases on the other hand as a non‐allergic type of drug fever, perhaps being brought about by a change in the intestinal flora. A knowledge concerning the latter type of reaction is of practical significance.