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Previous studies have established the fact that penicillin treatment of acute streptococcal pharyngitis results in a marked suppression of antibody formation (1, 2, 3). This is in contrast to the failure of penicillin treatment to alter the immune response in patients with pneumococcal pneumonia (4). It has been suggested that in the latter case, sufficient pneumococcal antigen is formed during the early phases of pneumonia to provide a maximal antigenic challenge before penicillin therapy is instituted (4). The capacity of penicillin to suppress the production of streptococcal antibodies suggests that in streptococcal infections the antigenic challenge may be presented more gradually. Under such circumstances, it would be expected that the effectiveness of penicillin in this regard would be related to the time of institution of therapy. Since no definitive information on this point has hitherto been obtained, the present study was designed to test this hypothesis.

the journal of clinical investigation/the journal of clinical investigation

STUDIES ON THE PREVENTION OF RHEUMATIC FEVER: THE EFFECT OF TIME OF INITIATION OF TREATMENT OF STREPTOCOCCAL INFECTIONS ON THE IMMUNE RESPONSE OF THE HOST 1