Do antibiotics prevent complications?

Studies on the prevention of rheumatic fever were carried out using penicillin injections in military personnel in barracks after the second world war.1 The attack rates were high (0.3-5%), and the results may not be generalisable to a modern community setting with lower attack rates and where the likelihood of developing rheumatic fever or glomerulonephritis is the same in those who have and have not had oral antibiotics.2,3 The incidence of rheumatic fever has been falling since the turn of the century - well before antibiotics were discovered.4 General practitioners in Britain have about a one in five chance of every seeing a patient with either post-streptococcal glomerulonephritis or rheumatic fever after a sore throat.2,3

*This is the seventh in a series of articles examining some of the difficult decisions that arise in medicine

The main problem of prescribing to …