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August 15, 1977

Prescribing of Tetracycline to Children

JAMA. 1977;238(7):579. doi:10.1001/jama.1977.03280070019005

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To the Editor.—  I read with interest the paper by Ray, Federspiel, and Schaffner and the editorial by Yeager (237:2101, 1977). I shall not attempt to defend the antibiotic-prescribing habits (as regards tetracycline) of practicing physicians in Tennessee; however, there is one situation that frequently arises that may require the use of tetracycline and to which neither Ray et al nor Yeager addressed themselves: namely, suspected Rocky Mountain spotted fever (RMSF).In our part of the country, RMSF accounts for considerable morbidity and mortality. The same can be said of much of the southeastern part of the United States, including Tennessee where Ray et al conducted their survey. Generally, RMSF appears variably from March through September, or over a seven-month span. During this time, it is not unusual for many children to be brought to practitioners with a history of one or two days of headache, fever, muscle aches, and