THE COMPARATIVE EFFECTS OF CONTINUOUS AND INTERMITTENT PENICILLIN THERAPY ON THE FORMATION OF ANTISTREPTOLYSIN IN HEMOLYTIC STREPTOCOCCAL PHARYNGITIS 1

Abstract

127 cases of hemolytic streptococcal pharyngitis were divided in rotation into 3 groups. One group served as an untreated control, the 2d was treated with 300,000 U. of penicillin daily in 1 dose, and the 3d received virtually continuous penicillin therapy (20-50,000 U. every 3 hrs.). Antistreptolysin titer response varied in the 3 groups. In the untreated group, the proportion of patients exhibiting a rise was comparable to that usually seen in streptococcal pharyngitis and scarlet fever (84.3%). The antistreptolysin response in the 3d group was of appreciably lower frequency and magnitude (13.8%). Patients who received intermittent penicillin treatment manifested an incidence and degree of antibody response intermediate between that of the untreated and continuously treated groups (63.8%). A modification of Todd''s original method was used for determining antistreptolysin titer. 5/5 patients who developed late sequelae manifested a rise in antistreptolysin titer prior to or coincident with the appearance of these sequelae. 0/5 who relapsed had developed a rise in antistreptolysin titer during the illness. Penicillin therapy suppresses the formation of antistreptolysin. The degree of suppression is proportional to the duration of the antibacterial action of penicillin maintained during the 24-hr. period.