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I am in basic agreement with the comments of Dr Keeney. I do not advocate the use of tetracycline as routine therapy for H influenzae respiratory illness in children who are in an age group that may develop tooth staining. However, that risk should not rule it out where one is forced with a choice of risks. Tetracycline-induced benign intracranial hypertension is innocuous without the concomitant presence of a diagnostic zealot.I will take issue with his recommendation for combined therapy with penicillin V or G with a sulfonamide and, to a lesser degree, with the combination of erythromycin with sulfonamides. The probability of having a significantly ampicillin-resistant H influenzae organism that is, at the same time, sensitive to one of the other penicillins is remote, leaving only the sulfonamide as effective therapy (which, if properly chosen, it would be) in the use recommended.My original version of
Kitto W. Chloramphenicol Today-Reply. JAMA. 1975;234(10):1016. doi:10.1001/jama.1975.03260230016003