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Article
February 21, 1948

ORAL PROPHYLAXIS OF RHEUMATIC FEVER WITH PENICILLIN: Resistant Hemolytic Streptococci

Author Affiliations

Chicago

From the Departments of Bacteriology and Cardiovascular Research, Medical Research Institute of Michael Reese Hospital.

JAMA. 1948;136(8):536-538. doi:10.1001/jama.1948.02890250024005
Abstract

When military populations are undergoing mass chemoprophylaxis with moderate doses of sulfonamide drugs various workers have shown that group A hemolytic streptococci readily become resistant to the drugs. The dosage employed usually varied from 0.5 to 1 Gm. daily. Earlier reports1 acclaimed these so-called prophylactic dosages of sulfonamide drugs as being effective in preventing outbreaks of infections with hemolytic streptococci as well as recurrences of rheumatic fever. Later it became evident that epidemics of hemolytic streptococcus infections occurred despite prophylaxis as a result of the development of resistant strains.2 Increasing the daily prophylactic dose to as much as 2 Gm. failed to check the course of such epidemics.2b

While it is known that hemolytic streptococci may readily acquire resistance to penicillin in vitro3 and in vivo,4 there have been no reports to our knowledge on the development of resistant hemolytic streptococci following oral prophylaxis with

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