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Penicillin-Sensitive Streptococcal Endocarditis: Report of Four Cases Treated for Two Weeks with Oral Phenoxymethyl Penicillin and Intramuscular Streptomycin

Penicillin-Sensitive Streptococcal Endocarditis: Report of Four Cases Treated for Two Weeks with... Abstract Intramuscular injection of procaine penicillin every 6 hours and streptomycin every 12 hours for two weeks has become an accepted plan of therapy for subacute bacterial endocarditis caused by penicillin-sensitive streptococci.1-4 Oral penicillin G has not been employed in this disease because of the relatively unpredictable blood levels associated with its administration. With the use of the recently developed phenoxymethyl penicillin (penicillin V), higher blood levels are maintained because of its greater stability in acid gastric contents.5-7 It has been used successfully in a wide variety of infections where the organisms are sensitive to penicillin. Because of the attendant decrease in discomfort to the patient when oral medication is substituted for intramuscular, it seemed desirable to determine whether oral phenoxymethyl penicillin could be employed in the treatment of bacterial endocarditis. Quinn 8 has reported four cases treated for six weeks with oral phenoxymethyl penicillin, either alone or in References 1. Hunter, T. H.: Endocarditis , in A Textbook of Medicine , edited by R. L. Cecil and R. F. Loeb, Ed. 9, Philadelphia, W. B. Saunders Company, 1955, p. 1312. 2. Geraci, J. E.: Further Experiences with Short-Term (2 Weeks) Combined Penicillin-Streptomycin Therapy for Bacterial Endocarditis Caused by Penicillin-Sensitive Streptococci , Proc. Soc. Staff Meet. Mayo Clin. 30:192, 1955. 3. Hall, B.; Dowling, H. F., and Kellow, W.: Successful Short-Term Therapy of Streptococcal Endocarditis with Penicillin and Streptomycin , Am. J. M. Sc. 230:73, 1955.Crossref 4. Hamburger, M.: The Management of Bacterial Endocarditis , Am. Pract. & Digest Treat. 7:1085, 1956. 5. Linden, H.; Finegold, S. M., and Hewitt, W. L.: Serum Penicillin Concentrations Following Oral Administration of Penicillin V , in Antibiotics Annual 1955-1956 , edited by H. Welch and F. Marti-Ibañez, New York, Medical Encyclopedia, Inc., 1956, pp. 477-482. 6. White, A. C.; Couch, R. A.; Foster, F.; Calloway, J.; Hunter, W., and Knight, V.: Absorption and Antimicrobial Activity of Penicillin V (Phenoxymethyl Penicillin) , in Antibiotics Annual 1955-1956 , edited by H. Welch and F. Marti-Ibañez, New York, Medical Encyclopedia, Inc., 1956, pp. 490-501. 7. Peck, F. B., and Griffith, R. S.: Comparative Clinical Laboratory Studies of Penicillin V and Penicillin G , in Antibiotics Annual 1955-1956 , edited by H. Welch and F. Marti-Ibañez, New York, Medical Encyclopedia, Inc., 1956, pp. 506-509. 8. Quinn, E. L.; Colville, J. M.; Cox, F., Jr., and Truant, J.: Phenoxymethyl Penicillin (Penicillin V) Therapy of Subacute Bacterial Endocarditis , J. A. M. A. 160:931, 1956. 9. Hamburger, M., and Stein, L.: Streptococcus Viridans Subacute Bacterial Endocarditis: Two Week Treatment Schedule with Penicillin , J. A. M. A. 149:542, 1952. 10. Hunter, T. H.: Speculations on the Mechanism of Cure of Bacterial Endocarditis , J. A. M. A. 144:524, 1950. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

Penicillin-Sensitive Streptococcal Endocarditis: Report of Four Cases Treated for Two Weeks with Oral Phenoxymethyl Penicillin and Intramuscular Streptomycin

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References (13)

Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1957.00260090015004
Publisher site
See Article on Publisher Site

Abstract

Abstract Intramuscular injection of procaine penicillin every 6 hours and streptomycin every 12 hours for two weeks has become an accepted plan of therapy for subacute bacterial endocarditis caused by penicillin-sensitive streptococci.1-4 Oral penicillin G has not been employed in this disease because of the relatively unpredictable blood levels associated with its administration. With the use of the recently developed phenoxymethyl penicillin (penicillin V), higher blood levels are maintained because of its greater stability in acid gastric contents.5-7 It has been used successfully in a wide variety of infections where the organisms are sensitive to penicillin. Because of the attendant decrease in discomfort to the patient when oral medication is substituted for intramuscular, it seemed desirable to determine whether oral phenoxymethyl penicillin could be employed in the treatment of bacterial endocarditis. Quinn 8 has reported four cases treated for six weeks with oral phenoxymethyl penicillin, either alone or in References 1. Hunter, T. H.: Endocarditis , in A Textbook of Medicine , edited by R. L. Cecil and R. F. Loeb, Ed. 9, Philadelphia, W. B. Saunders Company, 1955, p. 1312. 2. Geraci, J. E.: Further Experiences with Short-Term (2 Weeks) Combined Penicillin-Streptomycin Therapy for Bacterial Endocarditis Caused by Penicillin-Sensitive Streptococci , Proc. Soc. Staff Meet. Mayo Clin. 30:192, 1955. 3. Hall, B.; Dowling, H. F., and Kellow, W.: Successful Short-Term Therapy of Streptococcal Endocarditis with Penicillin and Streptomycin , Am. J. M. Sc. 230:73, 1955.Crossref 4. Hamburger, M.: The Management of Bacterial Endocarditis , Am. Pract. & Digest Treat. 7:1085, 1956. 5. Linden, H.; Finegold, S. M., and Hewitt, W. L.: Serum Penicillin Concentrations Following Oral Administration of Penicillin V , in Antibiotics Annual 1955-1956 , edited by H. Welch and F. Marti-Ibañez, New York, Medical Encyclopedia, Inc., 1956, pp. 477-482. 6. White, A. C.; Couch, R. A.; Foster, F.; Calloway, J.; Hunter, W., and Knight, V.: Absorption and Antimicrobial Activity of Penicillin V (Phenoxymethyl Penicillin) , in Antibiotics Annual 1955-1956 , edited by H. Welch and F. Marti-Ibañez, New York, Medical Encyclopedia, Inc., 1956, pp. 490-501. 7. Peck, F. B., and Griffith, R. S.: Comparative Clinical Laboratory Studies of Penicillin V and Penicillin G , in Antibiotics Annual 1955-1956 , edited by H. Welch and F. Marti-Ibañez, New York, Medical Encyclopedia, Inc., 1956, pp. 506-509. 8. Quinn, E. L.; Colville, J. M.; Cox, F., Jr., and Truant, J.: Phenoxymethyl Penicillin (Penicillin V) Therapy of Subacute Bacterial Endocarditis , J. A. M. A. 160:931, 1956. 9. Hamburger, M., and Stein, L.: Streptococcus Viridans Subacute Bacterial Endocarditis: Two Week Treatment Schedule with Penicillin , J. A. M. A. 149:542, 1952. 10. Hunter, T. H.: Speculations on the Mechanism of Cure of Bacterial Endocarditis , J. A. M. A. 144:524, 1950.

Journal

A.M.A. Archives of Internal Medicine – American Medical Association

Published: Sep 1, 1957

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