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Tampons and Toxic Shock Syndrome-Reply

Arthur L. Reingold, MD; Allen W. Hightower, MS; Kathryn N. Shands, MD; Walter F. Schlech III, MD
JAMA. 1983;249(8):1005. doi:10.1001/jama.1983.03330320012010.
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In Reply.—  We would like to thank the TSTSSS participants for their comments. However, the assertion that we have misinterpreted either our results or those of the TSTSSS is unwarranted. Both studies demonstrated clearly that, after taking absorbency into account, use of Rely brand tampons was associated with a significantly increased risk of TSS developing. We do not agree that it is inappropriate to analyze the data by tampon brand, particularly since one of the goals of our study was to determine whether or not a single brand was, irrespective of style, associated with an increased risk of TSS.The assessment of absorbency as a risk factor independent of chemical composition for users of other tampon brands remains an open question, which neither the CDC study nor the TSTSSS can answer adequately because of the small number of cases occurring in persons not using Rely (the TSTSSS contained only 28

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