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January 9, 1967

Antistreptococcal Prophylaxis

Author Affiliations

Syracuse, NY

JAMA. 1967;199(2):137. doi:10.1001/jama.1967.03120020131041

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To the Editor:—  One of the more gratifying developments of recent years has been the increasing application of modern, sophisticated techniques to medical research. It should be expected that the major by-product of their employment is to benefit the patient for whom the physician may be able to provide more effective and rational therapeutic procedures. Unfortunately, sophistication of methodology does not of itself guarantee that such will be the case. An illustration of this is the paper by Feinstein et al, entitled "Discontinuation of Antistreptococcal Prophylaxis" (197:-949, 1966). Despite careful selection of patients, their division into groups of comparable makeup, detailed observations, and preciseness of the mathematical calculations on the relative effectiveness of drug treatment and a placebo, this report, unfortunately, is susceptible to significant criticism.The effect of the exhibition of a therapeutic agent is not an all-or-none phenomenon. That one group of patients received penicillin and the