Prevention of Rheumatic Fever by Treatment of Streptococcal Infections

Studies of the Carrier State Following Infection With Group a Streptococci. I. Effect of Climate*

“…Furthermore, additional analysis indicated that removal of the tonsils, and presumably the adenoids, was not responsible for the fewer positive nasal cultures in the Florida carriers. Indeed, the data suggested that the nasal carrier state may persist longer in those patients with a tonsillectomy, thus confirming the observations of Holmes and Williams (11 (13). More recently it has been shown the rheumatic fever may be prevented after a streptococcal sore throat if penicillin is given as late as 9 days after the onset of the streptococcal illness (14).…”

Bacterial determinants of persistent throat colonization and the associated immune response in a primate model of human group A streptococcal pharyngeal infection

“…Second, early antibiotic therapy inhibits the development of the anti-M protein antibody responses implicated in pathogenesis (Daikos and Weinstein, 1951;Denny et al, 1957;Siegel et al, 1961). Finally, therapeutic failures ± rheumatic fever that occurs after appropriate antibiotic therapy of the pharyngeal infection ± are associated with persistent throat colonization with GAS (Catanzaro et al, 1958). It is reasonable to conclude from these observations that, after the relatively brief symptomatic infection resolves, continued bacterial persistence in the throat is necessary for the development of anti-streptococcal immune responses.…”

Differences Among International Pharyngitis Guidelines: Not Just Academic

“…55,56,[59][60][61][62] They found a 0.3% to 3% reduction of the incidence of acute rheumatic fever if streptococcal angina was treated with parenteral penicillin. These fi ndings, however, have never been confi rmed in other trials with penicillin, [63][64][65] nor have they be confi rmed in consecutive prospective studies.…”