The reply discusses the effectiveness of benzathine penicillin G prophylaxis in preventing rheumatic fever recurrences, suggesting strong support for its use.
In Reply.— The report by Nordin1 of one patient with rheumatic fever who had a recurrence during prophylaxis with monthly benzathine penicillin G states in the abstract that this form of prophylaxis "is a real risk." Nordin ignores the documented evidence that benzathine penicillin G has been used to prevent occurrences for more than 30 years and that while it is not 100% effective, it is far superior to any other method. Nordin fails to cite any of the studies of large series of patients with rheumatic fever who were maintained on benzathine penicillin G prophylaxis; such studies show that the risk of a recurrence is very small.2,3
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Milton Markowitz (1984) studied this question.
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