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January 7, 1950

ORAL PENICILLIN PROPHYLAXIS OF RECURRENCES OF RHEUMATIC FEVERInterim Report on Method After a Three Year Study

Author Affiliations

Chicago

From the Chicago Heart Association and the Department of Bacteriology and Virology, Medical Research Institute, Michael Reese Hospital.

JAMA. 1950;142(1):20-25. doi:10.1001/jama.1950.02910190022005
Abstract

It is generally believed that Lancefield group A hemolytic streptococci are involved in all or part of the pathogenesis of rheumatic fever.1 Although penicillin is an unsatisfactory therapeutic agent for this disease,2 this antibiotic should be excellent for prophylaxis of recurrences because of its ability to control the hemolytic streptococcus in vivo. This use of penicillin has been "mentioned hopefully" in the literature since 1946.3 The relative infrequency of complications and sequelae are obvious advantages of penicillin in addition to its low toxicity in large dosages.3a Since penicillin, like the sulfonamide drugs, apparently fails to influence the onset and course of an attack of rheumatic fever if given after the preceding hemolytic streptococcic infection,3a it becomes mandatory to eliminate hemolytic streptococci entirely during the period preceding a possible recurrence. Massell, Dow and Jones4 reported a lowered incidence of recurrences of rheumatic fever when they

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