PREVENTION OF RHEUMATIC FEVER BY PROMPT PENICILLIN THERAPY OF HEMOLYTIC STREPTOCOCCIC RESPIRATORY INFECTIONS

Abstract

The role of the hemolytic Streptococcus in the precipitation of both initial and recurrent attacks of rheumatic fever is now well established. Furthermore, it is general experience that hemolytic streptococcic respiratory infections in children and young adults who have previously had one or more attacks of rheumatic fever cause recurrence of the disease in 40 to 50% of instances. When the usefulness of sulfonamides in the treatment of streptococcic infections was first discovered, attempts were made at the House of the Good Samaritan to prevent such recurrences by prompt treatment of hemolytic streptococcic infections in known rheumatic subjects with a sulfonamide preparation in the hope that, by suppression of the growth of streptococci in the upper respiratory tract, absorption into the blood stream of the streptococcic substance responsible for precipitating the rheumatic process would be reduced to a subeffective level. These attempts were not successful.¹ Subsequently, when penicillin became