I'm curious, as I'm sure many are, about recurrent group A streptococci in some of our patients ("Amoxicillin Failure in Strep Throat," ID Consult, September 2007, p. 10).
The theory expressed by Dr. Michael E. Pichichero brings up some interesting possibilities with regard to inducing resistance by "coaggregation." There is one aspect that I'm not quite sure I follow in this thought process: If indeed it is an induced resistance by neighboring bacterial strains, why do all of these kids still improve dramatically in 12-24 hours, almost universally on amoxicillin? I fail to see how this wouldn't keep these children from improving initially and throughout the amoxicillin ...