Schwartz R H, Wientzen R L, Pedreira F, Feroli E J, Mella G W, Guandolo V L
JAMA. 1981 Oct 16;246(16):1790-5. doi: 10.1001/jama.246.16.1790.
The effect of duration of orally administered penicillin V potassium on the bacteriologic and clinical cure of group A streptococcal pharyngitis was evaluated. One hundred ninety-one middle-class patients received either seven days (96 patients) or ten days (95 patients) of therapy. Compliance with taking penicillin was assessed by multiple methods, including penicillinuria. Throat cultures were obtained during therapy and three times in the three weeks after therapy. M-precipitin and T-agglutinin typing were done on paired isolates of group A streptococci from patients who had recurrences. Patients treated for seven days had a significantly greater failure rate (30/96 [31%]) compared with patients receiving ten days of penicillin (17/95 [18%]). Compliance rates were high; 66% to 81% of patients showed penicillinuria throughout the study period. Treatment failure was not a function of poor compliance in either treatment group. The data support the current recommendation for ten full days of penicillin therapy and suggest that persistence of streptococci in the throat after adequate therapy may be common.
评估口服青霉素V钾的疗程对A组链球菌性咽炎细菌学治愈和临床治愈的影响。191名中产阶级患者接受了7天（96例患者）或10天（95例患者）的治疗。通过多种方法评估青霉素的服用依从性，包括检测青霉素尿。在治疗期间以及治疗后的三周内三次进行咽拭子培养。对复发患者的A组链球菌配对分离株进行M沉淀素和T凝集素分型。与接受10天青霉素治疗的患者（17/95 [18%]）相比，接受7天治疗的患者失败率显著更高（30/96 [31%]）。依从率很高；在整个研究期间，66%至81%的患者出现青霉素尿。治疗失败并非任何一个治疗组中依从性差的结果。这些数据支持目前推荐的青霉素全疗程治疗10天，并表明在充分治疗后链球菌在咽喉部持续存在可能很常见。
