OBSERVATIONS ON AN EPIDEMIC OF STREPTOCOCCAL INFECTIONS AND RECURRENCES OF RHEUMATIC FEVER AMONG CHILDREN TREATED WITH PENICILLIN

Abstract

An outbreak of streptococcal pharyngitis among children in a convalescent hospital has been described. Eleven of thirty-three subjects with rheumatic fever, under close observation, developed group A streptococcal infections while they received a single daily oral dose of 200,000 units of benzathine penicillin G. Treatment of the streptococcal infections was carried out with therapeutic doses of various penicillin preparations. Four children who received single injections of 600,000 units of benzathine penicillin G, developed recurrences of rheumatic fever. The results of the study indicate that a single daily oral dose of 200,000 units of benzathine penicillin G is inadequate for the prevention of streptococcal infections in a closed or semiclosed community of rheumatic fever subjects. It is suggested that at least twice this dosage be employed in such an environment. The data based on a small series of cases suggest that the treatment of acute streptococcal infections with a single intramuscular dose of 600,000 units of benzathine penicillin G will not prevent recurrences of rheumatic fever in highly susceptible patients.