Table 2.

 Possible causes of recurrence of beta‐hemolytic group A streptococcal pharyngotonsillitis after treatment with penicillin V

Low compliance

Re‐infection from the environment

Eradication of alfa‐hemolytic streptococci by penicillin V

Increase in beta‐lactamase‐producing bacteria capable of inactivating penicillin V

Penicillin‐tolerant beta‐hemolytic group A streptococci

Low antibiotic concentration at the site of infection

Intracellular beta‐hemolytic group A streptococci capable of surviving therapy with penicillin V