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June 15, 1963


JAMA. 1963;184(11):889. doi:10.1001/jama.1963.03700240081016

Fundamental changes in certain bacterial infections have appeared since the introduction of antibiotics. Recognizing that pathological aspects of specific infectious diseases may change secondarily to the alteration of infecting organisms, Wilson determined the anatomical end results of such a disease, bacterial endocarditis.1 Analysis was made of the pathological features of fatal bacterial endocarditis before the introduction of penicillin in 1943; the findings were compared with data obtained on this disease after that date. In the past 20 years there has been a major decrease in the incidence of non-beta-hemolytic streptococcus as a causative organism in fatal bacterial endocarditis. There has also been a reduction (from 95% to 70%) in mitral-valve involvement in fatal cases since 1943, but this has occurred only in instances of non-beta-hemolytic streptococcal infections; frequency of mitral involvement in non-streptococcal endocarditis has remained the same. These observations are indicative of the effectiveness of antibiotic therapy in