Letter to the Editor
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 contentiongroup A streptococci were isolated from 8% of his patients who had received intramuscular benzathine penicillin.




