Tonsillar diffusion of two antibiotics was compared in 61 children, 26 receiving 100 mg/kg/d of ampicillin, and the other 35 being treated with 50 mg/kg/d of triacetyloleandomycin during the 24 hours preceding tonsillectomy. Drug levels were measured by a microbiological method. The mean ampicillin level in the tonsil was 0,84 mcg/ml for a serum level of 4,1 mcg/ml 90 minutes before sampling, concentrations being absent in the tonsil in 12 cases (45 p. cent). Mean triacetyloleandomycin levels in the tonsil were 12,16 mcg/ml for a serum level of 2,27 mcg/ml 90 minutes before sampling, concentrations being absent in the tonsil in only 4 cases (11 p. cent). Very high concentrations of triacetyloleandomycin as against low or no levels of ampicillin were therefore detected in the tonsil. This suggest that macrolides should be employed in preference to ampicillin for the treatment of recurrent sore throats, and tonsillixis, and for preventive treatment of acute rheumatic fever.

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