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Twice-Daily Therapy for Strep?

ELLIS C. GILL, MD
Am J Dis Child. 1989;143(9):997. doi:10.1001/archpedi.1989.02150210013002.
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Sir.—I read with interest the article by Gerber et al1 in the February 1989 issue of AJDC. I was especially interested in his final paragraph. In his conclusion he states that his findings support other recommendations, specifically those of the American Heart Association (AHA), that oral penicillin V potassium can be given in two or three divided doses for 10 days for the treatment of group A streptococcal pharyngitis. I referred to the article cited and found that in fact they do not list twice-daily therapy as an acceptable treatment to prevent rheumatic heart disease.2

For those of us in private practice, it would certainly help to have this issue clarified. Does the AHA approve of twice-daily therapy with penicillin y or any medication other than a salt of erythromycin, as adequate treatment for group A streptococcal pharyngitis?

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