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ARTICLE |

Treatment of Group A Streptococcal Pharyngotonsillitis FREE

Itzhak Brook, MD
[+] Author Affiliations

Edited by John D. Archer, MD, Senior Editor.


JAMA. 1982;247(18):2496-2496. doi:10.1001/jama.1982.03320430020007
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To the Editor.—  I read the excellent article by Schwartz et al (1981; 246:1790) and the editorial by Patricia Ferrieri, MD (1981;246:1813). These presentations dealt with the most important issue of the adequate length of treatment of group A streptococci pharyngitis. However, both the article and the review mentioned the enigma of the failure of penicillin to eradicate the streptococci in 18% of the patients. This was noted in the article by Schwartz et al in a rate similar to the one found by Gastanaduy et al,1 who also described the higher failure rates (30% to 50%) in the second and third courses of penicillin therapy. The reasons for that phenomenon are still unknown and speculative. I would like to present the data we have obtained that may shed some light on this phenomenon and may suggest a new approach of resolving this enigma.We have been studying the

REFERENCES

Gastanaduy AS, Kaplan EL, Huwe BB, et al:  Failure of penicillin to eradicate group A streptococci during an outbreak of pharyngitis . Lancet 1980;;2:498-502.
Brook I, Yocum P, Friedman EM:  Aerobic and anaerobic flora recovered from tonsillar tissue of children with recurrent tonsillitis . Ann Otol Rhinol Laryngol 1981;;90:261-263.
Brook I, Leyva F:  The treatment of carrier state of group A beta-hemolytic streptococci with clindamycin . Chemotherapy 1981;;27:360-367.
Simon HJ, Sukair W:  Staphylococcal antagonism to penicillin group therapy of hemolytic streptococcal pharyngeal infection: Effect of oxacillin . Pediatrics 1963;;31:463-469.
Brook I, Gillmore J, Coolbaugh JC, et al:  In vivo protection of group A beta-hemolytic streptococci from penicillin by Bacteroides sp . Read before the 21st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Nov 4, 1981 .

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Gastanaduy AS, Kaplan EL, Huwe BB, et al:  Failure of penicillin to eradicate group A streptococci during an outbreak of pharyngitis . Lancet 1980;;2:498-502.
Brook I, Yocum P, Friedman EM:  Aerobic and anaerobic flora recovered from tonsillar tissue of children with recurrent tonsillitis . Ann Otol Rhinol Laryngol 1981;;90:261-263.
Brook I, Leyva F:  The treatment of carrier state of group A beta-hemolytic streptococci with clindamycin . Chemotherapy 1981;;27:360-367.
Simon HJ, Sukair W:  Staphylococcal antagonism to penicillin group therapy of hemolytic streptococcal pharyngeal infection: Effect of oxacillin . Pediatrics 1963;;31:463-469.
Brook I, Gillmore J, Coolbaugh JC, et al:  In vivo protection of group A beta-hemolytic streptococci from penicillin by Bacteroides sp . Read before the 21st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Nov 4, 1981 .
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