PROPHYLAXIS AGAINST GROUP A STREPTOCOCCAL INFECTIONS IN RHEUMATIC FEVER PATIENTS

Abstract

There are two effective methods now available for the prevention of rheumatic fever or its recurrences. Prompt and vigorous treatment of the initiating streptococcal infection with one of the antibiotic drugs may prevent the complication of rheumatic fever, or the maintenance of continuous antibiotic therapy in the rheumatic subject may prevent recurrences by affording protection against infection by group A streptococci.¹Penicillin promises to be the antibiotic of choice for the prevention of rheumatic fever by either of the above methods for several reasons: its action is bactericidal rather than bacteriostatic²; the streptococcal pharyngeal carrier state is eliminated most effectively by treatment with adequate doses of penicillin³; strains of group A streptococci resistant to penicillin have not emerged, despite the widespread use of this drug⁴; and fatal or serious toxic reactions are relatively rare. The problem of employing penicillin as a prophylactic agent is largely a