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July 1959

The Prophylaxis of Streptococcal Infections in Patients with Rheumatic Fever: A Comparison Between Sulfadiazine and Erythromycin

Author Affiliations

Nashville, Tenn.; Cleveland
From the Department of Pediatrics, Vanderbilt University School of Medicine.; Assistant Professor of Pediatrics and Instructor in Physiology, Vanderbilt University School of Medicine (Dr. Stahlman); Assistant Professor of Pediatrics and Assistant Professor of Preventive Medicine, Western Reserve University School of Medicine (Dr. Denny).

AMA Am J Dis Child. 1959;98(1):66-71. doi:10.1001/archpedi.1959.02070020068008

The relationship between group A streptococcal infections and the subsequent occurrence of rheumatic fever has been well established. It has also been shown that initial and recurrent attacks of rheumatic fever can be prevented if streptococcal infections are prevented or effectively treated.1 Several antibacterial agents have been employed for the prophylaxis of streptococcal infections in patients with rheumatic fever or rheumatic heart disease.2 Sulfadiazine and penicillin are the two agents most widely used. Sulfadiazine prophylaxis has greatly reduced the incidence of streptococcal infections and recurrence of rheumatic fever, but protection is not complete and 5% to 10% of patients develop reactions to the drug.2 Penicillin prophylaxis has proved to be more effective than sulfadiazine prophylaxis, but reactions also develop in 2% to 5% of persons receiving penicillin.3 Because of the shortcomings of sulfadiazine and penicillin, it seemed desirable to investigate other antimicrobial drugs as prophylactic agents

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