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Treatment of Group A Streptococcal Pharyngotonsillitis

John Goldenring, MD, MPH
JAMA. 1982;247(15):2096-2097. doi:10.1001/jama.1982.03320400016013.
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To the Editor.—  The recent article by Schwartz et al on "Penicillin V for Group A Streptococcal Pharyngotonsillitis" (1981;246:1790) is another good study by that group on the treatment of common problems faced daily by every clinician. I am perfectly ready to accept their suggestion of ten-day oral penicillin treatment for my patients here in California, where the incidence of rheumatic fever is virtually nil.However, if I practiced in an area where the incidence of rheumatic fever was higher, I would not be satisfied with giving an oral medication and having a 65% to 80% compliance rate. This is especially true since Schwartz et al are reporting on a population of middle-class suburbanites who would be expected to have the highest possible compliance. Most other populations should do far worse and have poorer follow-up.1Rather, I would opt to inject all my patients who have a positive Streptococcus


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