To the Editor.

I enjoyed the supplement to Pediatrics(1996;97:945–998) concerning group A streptococcal infections. In a “Review of the Rationale and Advantages of Various Mixtures of Benthazine Penicillin G,” Dr Bass concludes that the combination of 900 000 units of benzathine penicillin G plus 300 000 units of procaine penicillin offers optimal parenteral treatment for streptococcal pharyngitis in all children who weigh <140 lb. Does Dr Bass reconcile this recommendation with the 1994 “Report of the Committee on Infectious Diseases” of the American Academy of Pediatrics, which on page 435 states, “Although supporting data are limited, the combination of 900 000 units benzathine penicillin G and 300 000 units of procaine penicillin G will satisfactorily be used for children who weigh <60 lb.” In review of this recommendation, much to the distress of my plumper patients, I have returned to using 1.2 million units of benzathine penicillin G as a single intramuscular shot. Thank you for reviewing this contradiction.