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Article
September 1957

Penicillin-Sensitive Streptococcal Endocarditis: Report of Four Cases Treated for Two Weeks with Oral Phenoxymethyl Penicillin and Intramuscular Streptomycin

Author Affiliations

Cincinnati

From the Infectious Disease Laboratory, Department of Medicine, University of Cincinnati College of Medicine; the Cincinnati General Hospital, and the Veterans' Administration Hospital.

AMA Arch Intern Med. 1957;100(3):359-363. doi:10.1001/archinte.1957.00260090015004
Abstract

Intramuscular injection of procaine penicillin every 6 hours and streptomycin every 12 hours for two weeks has become an accepted plan of therapy for subacute bacterial endocarditis caused by penicillin-sensitive streptococci.1-4 Oral penicillin G has not been employed in this disease because of the relatively unpredictable blood levels associated with its administration. With the use of the recently developed phenoxymethyl penicillin (penicillin V), higher blood levels are maintained because of its greater stability in acid gastric contents.5-7 It has been used successfully in a wide variety of infections where the organisms are sensitive to penicillin.

Because of the attendant decrease in discomfort to the patient when oral medication is substituted for intramuscular, it seemed desirable to determine whether oral phenoxymethyl penicillin could be employed in the treatment of bacterial endocarditis. Quinn 8 has reported four cases treated for six weeks with oral phenoxymethyl penicillin, either alone or in

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