Roos K, Holm S E, Ekedahl C
Scand J Infect Dis. 1985;17(4):357-65. doi: 10.3109/13813458509058775.
13/169 outpatients (8%) with streptococcal tonsillitis developed a new tonsillitis with the same strain within 2 weeks of completion of therapy (clinical treatment failures) and 24 (14%) remained carriers (bacterial treatment failures) after treatment with phenoxymethylpenicillin (penicillin V) 12.5 mg/kg body weight twice daily for 10 days. The mean serum concentration 60 min after penicillin V administration was 7.84 micrograms/ml. Very large individual differences in serum concentration were found but these differences could not be correlated to treatment failure. About 60% of the patients showed salivary concentrations around 0.03 micrograms/ml. Three strains of streptococci (groups C and G) from patients with bacterial treatment failure had MIC values of 0.06 and 0.12 micrograms/ml. A majority of the patients with clinical treatment failures had contact with individuals with high carrier rates of beta-hemolytic streptococci. It therefore seems likely that some so-called treatment failures in reality are new infections. In clinical treatment failures group A streptococci were twice as common as groups C + G. In bacteriological treatment failures the ratio between A and C + G was 1:1. Patients with nonstreptococcal tonsillitis as well as carriers of groups C and G may appear among bacterial treatment failures.
13/169例（8%）患链球菌性扁桃体炎的门诊患者在完成治疗后2周内又发生了由同一菌株引起的新的扁桃体炎（临床治疗失败），并且在用苯氧甲基青霉素（青霉素V）12.5mg/kg体重每日2次、共10天治疗后，24例（14%）仍为带菌者（细菌学治疗失败）。青霉素V给药后60分钟的平均血清浓度为7.84μg/ml。发现血清浓度存在很大的个体差异，但这些差异与治疗失败并无关联。约60%的患者唾液浓度约为0.03μg/ml。来自细菌学治疗失败患者的3株链球菌（C组和G组）的最低抑菌浓度值为0.06和0.12μg/ml。大多数临床治疗失败的患者与β溶血性链球菌带菌率高的个体有接触。因此，一些所谓的治疗失败实际上可能是新的感染。在临床治疗失败中，A组链球菌的出现频率是C组和G组合计的2倍。在细菌学治疗失败中，A组与C组和G组的比例为1:1。非链球菌性扁桃体炎患者以及C组和G组的带菌者可能出现在细菌学治疗失败的患者中。
