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:

The problem with seven day treatment of group A streptococcus tonsillitis /pharyngitis

Although the article makes a definitive argument for the seven day
treatment of Group A streptococcus pharyngitis/tonillitis with penicillin
v, The authors seem to ignore that such a course of treatment, though
superior to a three day course, is inadequate for the prevention of
the sequalae of Group A streptococcus rheumatogenic strains
M type 1,3,5,6,14,18,19,27,28. it is uncertain from the laboratory data
presented whether typing was carried out.

The traditionally recommended teatment for group A streptococcus
upper respiratory infections is for 10 days, which has been found out to
prevent the subsequent onset of acute rheumatic fever(*).

Munir E Nassar, M.D.

(*)- Dajani A S, Taubert K, Ferrieri P, et al.:
Treatment of streptococcal pharyngitis and
prevention of rheumatic fever. Pediatrics
96:758, 1995

Competing interests: No competing interests

17 January 2000
Munir E Nassar
volunteer tutor URMC, rochester, N Y