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Penicillin Treatment and Immunity to Scarlatina 1
Author(s) -
STRÖM JUSTUS
Publication year - 1954
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1954.tb04027.x
Subject(s) - penicillin , medicine , immunity , incidence (geometry) , pediatrics , antibiotics , immunology , immune system , microbiology and biotechnology , physics , optics , biology
Summary The effect of penicillin on immunity following scarlatina has been investigated. Comparative studies were made of the incidence of second attacks in Stockholm during the pre‐penicillin period 1938–46 and during the penicillin period 1947–51. Parallel series in addition comprised treated and untreated cases. Early second attacks, or relapses, in hospital diminished considerably due to the lesser risk of cross‐infections. The frequency of early second attacks within the first three months of recovery was, however, as great as previously. Apart from the possibility of impaired immunologic conditions during this first period, the factors governing the recurrence of attack at this stage are nowadays the risk of infection from the home environment and also, to some degree, the lack of intensity in treatment. A reduction in the early second attacks should be obtainable as a result of effective treatment and after‐control of the patients and of eradication of bacteria from the environment. As regards the late second attacks (after three months) the frequency was many times higher in 0–14 year‐old children who had been treated with penicillin than in the untreated. With increase in age, moreover, the relative frequency of second attacks rose still more. The interval between attacks was much shorter than in the pre‐penicillin period. There was thus a marked deterioration in immunity, which was all the more pronounced as the children grew older. It proved probable that the risk of a new attack of scarlatina could be diminished by postponement of treatment. This is in agreement with the observation that second attacks among penicillin‐treated desquamation cases are very much less numerous than among treated cases of scarlatina. The value of penicillin in the treatment of scarlatina is so great that its use should be continued. The tendency to second attacks, even recurring attacks, is on the other hand so considerable, at least in built‐up areas, that a modification in the treatment should be introduced. Postponed treatment can be adopted in all cases in children except those exhibiting markedly toxic symptoms or purulent complications.