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Penicillin and Erythromycin Concentrations in TonsilsRelevance to Treatment Failures in Streptococcal Pharyngitis
J. Martin Kaplan, MD;
George H. McCracken, Jr., MD;
M. C. Culbertson, MD
Am J Dis Child. 1974;127(2):206-211.
Abstract
Penicillin and erythromycin concentrations were measured in sera and tonsils of children undergoing tonsillectomy. For two hours after the intramuscular administration of potassium penicillin G (5,000 units/kg), the levels of penicillin in tonsil were consistently greater than the minimal inhibitory concentrations (MIC) of most group-A, β hemolytic streptococci. Antibiotic was not detected in six of ten specimens obtained four to six hours after single or multiple doses of orally administered phenoxymethyl penicillin. Tonsillar levels of erythromycin were greater than the MIC for group-A, β hemolytic streptococci in eight of ten specimens obtained four to seven hours after single or multiple doses of orally administered erythromycin estolate. Data correlating tonsillar antibiotic levels, MIC values, and in vitro streptococcal kill curves may have relevance to relapse and treatment failures in streptococcal pharyngitis.
Author Affiliations
Dallas
From the departments of pediatrics and otolaryngology, The University of Texas Southwestern Medical School at Dallas.
Footnotes
Received for publication June 11, 1973; accepted Aug 30.
Reprint requests to 5323 Harry Hines Blvd, Dallas, 75235 (Dr. McCracken).
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