A Controlled Study of Penicillin Therapy of Group A Streptococcal Acquisitions in Egyptian Families

A two-year controlled trial of benzathine penicillin G treatment of persons who acquired group A streptococci, identified by semimonthly throat cultures, was carried out in Egypt in 110 apparently normal families and 84 families with a child suspected of having rheumatic heart disease. Penicillin treatment was associated with a marked decrease in prevalence of the organism (l9.0%–5.41%) and a modest decrease in introductions into families (0.79–0.54 single introductions per person per year) but no decrease in spread within nonrheumatic families. Results in suspected-rheumatic families were similar. It was concluded that the schedule of penicillin treatment used had a minimal effect on streptococcal spread and is unlikely to be an effective control tool. Spread within families was most intense in those episodes in which the household contacts were two to 14 years of age, the introducer had sought medical care, or the introducer ultimately carried the streptococcal strain for three or more months.