To the Editor: Thank you for your thoughtful letter of August 12th.
You are, I believe, only partially right in suggesting that penicillin take the whole brunt of battle against β-streptococcal infection without testing or considering any other drugs.
There are a number of considerations and situations that either practically or theoretically require that we have therapeutic modalities available and use them. Here are three: (1) Some children are already penicillin sensitive. (2) Penicillin sensitivity may be developed by repeated penicillin use. Some of this sensitivity could be avoided by the use of other drugs at least part of the time. (3) Penicillin is by no means a perfect drug for streptococcal infection. Some other drug might be better. Although penicillin is invariably effective immediately in every series where the patients are followed for two months approximately 20% will recur either as an acute case or as a carrier within