PEDIATRICS Vol. 43 No. 4 April 1969, pp. 608-610
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Oral Antibiotics in Patients with Heart Disease: Case Report of Child Facing Oropharyngeal Surgery with Oropharyngeal Viridans Streptococci Resistant to Penicillin and, Following Oral Erythromycin Therapy, to Penicillin, Erythromycin, and Lincomycin

Katherine Sprunt M.D.1, Winifred M. Redman B.A.1, and Grace Leidy M.A.1

1 Babies Hospital and Department of Pediatrics Columbia University College of Physicians and Surgeons New York, New York

The patient to be described illustrates dramatically one of the potential hazards of theoral use of antibiotics in patients with heart disease.

Case Report

A. S., a 3-year-old girl, was admitted to the Babies Hospital for repair of a cleft palate. She was noted at birth to have acyanotic congenital heart disease, which was diagnosed at 5 months as atrial and ventricular septal defects with multiple pulmonary artery stenosis. From the time of diagnosis, she had received penicillin prophylactically in various forms. Recently, for more than 6 months, she had received phenoxymethyl penicillin syrup (Pen Vee), 200,000 units orally, twice a day.