Intended for healthcare professionals

Rapid response to:

General Practice

Penicillin for acute sore throat: randomised double blind trial of seven days versus three days treatment or placebo in adults

BMJ 2000; 320 doi: (Published 15 January 2000) Cite this as: BMJ 2000;320:150

Rapid Response:

Length of penicillin treatment of streptococcal infections

The author recommends a 7 days treatment for streptococcal
infections as opposed to 3 days. For several decades we were educated to
continue penicillin for such cases for a period of 10 days , and no less !
The rationale was that eradication of streptococci is necessary to prevent
rheumatic fever and was achievable only after 10 days of treatment . This
was apparently based on bacteriological, epidemiological and clinical
observations. The cost of oral penicillin is almost negligible and I think
we need more assurance to be persuaded to cut treatment to only 7 days.
Is there any study that will prove that 7 days are as effective as 10 for
preventing rheumatic fever ?

Ref: Christie A.B. Infectious Diseases: Epidemiology and Clinical
Practice, E.& S. Livingstone editors ,1969 p.983.

Competing interests: No competing interests

15 January 2000
Dan Michaeli
Chairman , Board of Directors
Clalit Health Services, Israel