To the Editor.—

In their study of penicillin treatment of group A streptococcal pharyngitis, Drs Kaplan and Johnson allude to “the possibility of initial eradication followed by recolonization” to explain the finding of positive throat cultures in 37% of patients at 10 to 14 or 29 to 31 days after treatment. They dismiss this possibility but provide no good reasons for doing so. Children with streptococcal pharyngitis usually contract the infection from peers, many of whom have mild symptoms that do not lead to medical attention. When treatment is discontinued, it is not surprising that a significant number become reinfected (not just recolonized). For the children in this study who were treated with penicillin V, what is wrong with the simple explanation that they contracted new infections from the same communities that were the sources of their original infections?

It would be helpful to have more follow-up information...

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