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How to reduce the levels of ASO titre?

Q: My daughter is 17 years old and her ASO titre is – 750 IU. Her treating doctor prescribed Pentid-400 for her. She took the medicine for one year and now her blood count has reduced to 550 IU. But due to the intake of Pentid she is regularly suffering from liver problems. Please advise.

A:High ASO (anti-streptolysin O) titre (more than 200 IU/ml) indicates infection with bacteria called Streptococcus pyogenes. Since these germs can adversely affect heart valves, long acting injectable penicillin (sold under the brand name of Pencom LA 1.2 million units) are given once in three weeks. Oral penicillins such as Pentid-400 are not very effective, because the active ingredient is not properly absorbed and moreover gets destroyed in the stomach. It is not clear as to why injectable long-acting penicillin was not prescribed. Pencom will have no adverse effect on the liver, apart from being more effective.

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