Prophylaxis of upper respiratory infections in children treated with oral penicillin

Abstract

Summary 1. One hundred and forty-eight children from 8 months to 10 years of age have been given 50,000 units of oral penicillin as buffered tablets one-half to one hour before breakfast and supper for twelve months, with a control group of 110 children receiving no medication. 2. The control group experienced no reduction in the average number of upper respiratory infections or the average number of febrile days in the twelve months of observation, as compared with the previous twelve months. 3. The group given penicillin prophylaxis experienced a reduction in the average number of upper respiratory infections from 5.05 in the previous year of no penicillin prophylaxis to 2.3 in the year of penicillin prophylaxis (45.5 per cent) and the group experienced a reduction in the number of febrile days from 16.76 days in the previous year to 4.24 days in the year of penicillin prophylaxis (25.3 per cent). 4. No penicillin levels are reported for this study but English and late American sources are quoted to show that such dosage would, in children of these ages and weights, produce levels definitely bactericidal. 5. The literature is reviewed to show the very controversial nature of the widely held belief that this prophylactic procedure would do harm by the production in vivo of penicillin-insensitive organisms; no such cases occurred in the 148 now reported and the 100 previously reported. 6. The suggestion is made that if these results can be corroborated in largerseries over a longer period of time, a relatively inexpensive and harmless prophylaxis of upper respiratory infections in young infants and children will be possible.