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Penicillin-resistant Bacteria in the Mouths and Throats of Children Receiving Continuous Prophylaxis against Rheumatic Fever

RICHARD A. NAIMAN, M.D.; and J. GORDON BARROW, M.D., F.A.C.P.
Ann Intern Med. 1963;58(5):768-772. doi:10.7326/0003-4819-58-5-768
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Until recently, bacterial resistance to drugs used prophylactically against the recurrence of rheumatic fever has not been considered a problem. A theoretical disadvantage of any prophylaxis program is the possibility of replacement of the normal bacterial flora by drug-resistant strains. Fortunately, Group A beta-hemolytic streptococci have not been found to develop penicillin resistance; therefore, recurrence of rheumatic fever as a consequence of infection with penicillin-resistant strains in patients receiving penicillin prophylaxis has not been a problem. Little attention had been given the alpha-streptococcus (Str. viridans) as an organism capable of becoming penicillin resistant until Garrod and Waterworth (1) reported 2

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