PEDIATRICS Vol. 70 No. 3 September 1982, pp. 507
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Letter to the Editor

Charles M. Ginsburg MD1 and George H. McCracken Jr MD1

1 Department of Pediatrics, University of Texas Health Science Center, Southwestern Medical School, Dallas, TX 75235

Boxerbaum has implied that we have questioned the concept of penicillin prophylaxis for patients with rheumatic fever. We did not! Rather, we provided pharmacologic data demonstrating that the concentrations of penicillin in serum may be inadequate to prevent colonization or disease with group A streptococci or pneumococci 18 days or longer after administration of the doses of benzathine penicillin G that are recommended by the American Heart Association. In fact, Boxerbaum's data support our contention—group A streptococci were isolated from 8% of his patients who had received intramuscular benzathine penicillin.