ABSTRACT
Pharyngeal infection with Group A Beta-Haemolytic Streptococci [GABHS] is a common threat to the paediatric and young population. The control of this alarming infection can possibly reduce the risk of contraction of rheumatic heart disease [RHD]. One hundred RHD patients [Group I] were studied together with 200" heart free, throat free" low risk patients [Group II] and 100 patients with GABHS pharyngo-tonsillitis [Group III]. Group I showed high susceptibility to carry GABHS than Group II. Tonsillectomy lowered the risk of contracting GABHS by 2.5 - 2.6 times as compared to Long Acting Penicillin [LAP]. In Group III 76% of GABHS were resistant to penicillin due to the presence of beta-lactamase producing organisms [BLPO]. In the absence of BLPO, LAP was found to be as effective as tonsillectomy in protecting from GABHS. Anti-BLPO combination therapy or cefuroxime ought to be the drugs of choice in the treatment of acute bacterial pharyngitis and tonsillitis. Repeated cultures of BLPO after acute pharyngo-tonsillitis is suggested as a new indication for tonsillectomy