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May 14, 1982

Treatment of Group A Streptococcal Pharyngotonsillitis

JAMA. 1982;247(18):2496. doi:10.1001/jama.1982.03320430020007

To the Editor.—  I read the excellent article by Schwartz et al (1981; 246:1790) and the editorial by Patricia Ferrieri, MD (1981;246:1813). These presentations dealt with the most important issue of the adequate length of treatment of group A streptococci pharyngitis. However, both the article and the review mentioned the enigma of the failure of penicillin to eradicate the streptococci in 18% of the patients. This was noted in the article by Schwartz et al in a rate similar to the one found by Gastanaduy et al,1 who also described the higher failure rates (30% to 50%) in the second and third courses of penicillin therapy. The reasons for that phenomenon are still unknown and speculative. I would like to present the data we have obtained that may shed some light on this phenomenon and may suggest a new approach of resolving this enigma.We have been studying the