Oral penicillin prophylaxis of recurrences of rheumatic fever; interim report on method after a 3 year study.

Abstract

It is generally believed that Lancefield group A hemolytic streptococci are involved in all or part of the pathogenesis of rheumatic fever. 1 Although penicillin is an unsatisfactory therapeutic agent for this disease, 2 this antibiotic should be excellent for prophylaxis of recurrences because of its ability to control the hemolytic streptococcus in vivo. This use of penicillin has been mentioned hopefully in the literature since 1946. 3 The relative infrequency of complications and sequelae are obvious advantages of penicillin in addition to its low toxicity in large dosages. 3a Since penicillin, like the sulfonamide drugs, apparently fails to influence the onset and course of an attack of rheumatic fever if given after the preceding hemolytic streptococcic infection, 3a it becomes mandatory to eliminate hemolytic streptococci entirely during the period preceding a possible recurrence. Massell, Dow and Jones 4 reported a lowered incidence of recurrences of rheumatic fever when they