KINETICS OF STREPTOCOCCUS-PYOGENES ERADIC ATION IN TONSILLITIS TREATED BY ANTIBIOTICS

During an open clinical trial, the kinetics of Streptococcus pyogenes eradication was followed daily in 48 patients with acute tonsillitis, treated by penicillin V (10 days) or josamycin (5 days). Both antibiot ics rapidly eliminated S. pryogenes, with a 3 - 4 log decrease, within 48 hours. Most patients were negative after 48 hours of treatment. Ea rly eradication was documented until two days after the treatment and confirmed with a selective enrichment medium, detecting even rare bact eria. During the 3 - 4 month follow-up, many patients were recontamine d with late recurrences and, in some cases, presented an M serotype sw itch. These results may question the meaning of the socalled bacteriol ogical failure, as assessed from cultures 3 to 6 weeks after antibioti c therapy, They emphasize the possible role of healthy carriers in the recontamination of cured patients.