Prevention of Rheumatic Fever by Treatment of Previous Streptococcal Infections

Chamovitz, Robert; Catanzaro, Francis J. Captain; Stetson, Chandler A.; Rammelkamp, Charles H.

doi:10.1056/nejm195409162511203

Cited by 105 publications

(24 citation statements)

References 9 publications

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“…55,56,[59][60][61][62] They found a 0.3% to 3% reduction of the incidence of acute rheumatic fever if streptococcal angina was treated with parenteral penicillin. These fi ndings, however, have never been confi rmed in other trials with penicillin, [63][64][65] nor have they be confi rmed in consecutive prospective studies.…”

Section: In T Er Nat Iona L Pha Ry Ngi T Is Guidel Inesmentioning

confidence: 99%

Differences Among International Pharyngitis Guidelines: Not Just Academic

Matthys¹,

Meyere²,

Driel³

et al. 2007

The Annals of Family Medicine

158

105

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PURPOSE Many countries have national guidelines for the treatment of pharyngitis. We wanted to compare the recommendations and the reported evidence in national guidelines for the management of acute sore throat in adults.METHODS Guidelines were retrieved via MEDLINE and EMBASE and through a Web-based search for guideline development organizations. The content of the recommendations and the underlying evidence were analyzed with qualitative and bibliometric methods. RESULTSWe included 4 North American and 6 European guidelines. Recommendations differ with regard to the use of a rapid antigen test and throat culture and with the indication for antibiotics. The North American, French, and Finnish guidelines consider diagnosis of group A streptococcus essential, and prevention of acute rheumatic fever remains an important reason to prescribe antibiotics. In 4 of the 6 European guidelines, acute sore throat is considered a self-limiting disease and antibiotics are not recommended. The evidence used to underpin these guidelines was different in North America and Europe. North American guidelines cited more North American references than did European guidelines (87.2% vs 48.0%; ods ratio, 4.6-11.9; P <.001).CONCLUSION Although the evidence for the management of acute sore throat is easily available, national guidelines are different with regard to the choice of evidence and the interpretation for clinical practice. Also a transparent and standardized guideline development method is lacking. These fi ndings are important in the context of appropriate antibiotic use, the problem of growing antimicrobial resistance, and costs for the community.

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Section: In T Er Nat Iona L Pha Ry Ngi T Is Guidel Inesmentioning

confidence: 99%

Differences Among International Pharyngitis Guidelines: Not Just Academic

Matthys¹,

Meyere²,

Driel³

et al. 2007

The Annals of Family Medicine

158

105

View full text Add to dashboard Cite

show abstract

“…The efficacy of the antibiotics used in secondary prophylaxis may be limited due to the uncertain quality of some products; 4. Other non-rheumatic causes of chorea, such as viral infections, tumors of the central nervous system, degenerative processes, among others, [18][19][20][21] have to be considered. This is especially so for those patients who present with recurrent isolated chorea while on adequate prophylaxis.…”

mentioning

confidence: 99%

Sydenham's chorea: clinical and evolutive characteristics

et al. 2002

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CONTEXT: During the last 12 years we have observed an increase in the frequency of Sydenham's chorea in our country. We have observed that some of our patients have presented recurrence of the chorea despite regular treatment with benzathine penicillin. OBJECTIVE: The aim of our study was to evaluate clinical and evolutive characteristics of Sydenham's chorea in a group of patients followed in our Pediatric Rheumatology Unit. TYPE OF STUDY: Retrospective study. SETTING: Section of Pediatric Rheumatology - Discipline of Allergy, Clinical Immunology and Rheumatology - Department of Pediatrics - UNIFESP - EPM. PARTICIPANTS: Two hundred and ninety patients with rheumatic fever followed between 1986 and 1999. METHODS: We reviewed the records of 290 patients with rheumatic fever followed between 1986 and 1999. All patients were diagnosed according to the revised Jones criteria (1992). We included 86 patients that presented Sydenham's chorea as one of the major criteria (one or more attacks) and evaluated their clinical and evolutive characteristics as well the treatment. RESULTS: Fifty-five patients were girls and 31 were boys. The mean age at onset was 9.7 years and mean follow-up period was 3.6 years. The 86 Sydenham's chorea patients presented 110 attacks of chorea. We observed isolated chorea in 35% of the patients, and 25 (29%) presented one or more recurrences. We included only 17 of the 25 patients for further analysis, with a total of 22 recurrences of which 14 were attacks of chorea, because it was not possible to precisely detect the interval between attacks in the other patients. The approximate interval between the attacks ranged from 4 to 96 months. In 71% of the patients there was no failure in the secondary prophylaxis with benzathine penicillin, which was performed every 3 weeks. CONCLUSION: Despite the regular use of secondary benzathine penicillin prophylaxis, children with rheumatic fever have a high risk of Sydenham's chorea recurrence.

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“…Die abnehmende Präva-lenz rheumatogener GAS-Stämme, immunologische Faktoren und bessere sozioökonomische Verhältnisse, die die Übertragung der GAS-Stämme reduzieren, werden vermutet [5,12]. Nur für die intramuskuläre Gabe von Penicillin konnte in amerikanischen Studien [6,24] aus den 50er Jahren nachgewiesen werden, dass sie zur Senkung der ARF-Inzidenz nach GAS-Tonsillopharyngitis beiträgt.…”

Section: Therapieunclassified

Gruppe-A-Streptokokken-Infektionen im Kindesalter

Toepfner

Berner

2011

Monatsschr Kinderheilkd

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Prevention of Rheumatic Fever by Treatment of Previous Streptococcal Infections

Cited by 105 publications

References 9 publications

Differences Among International Pharyngitis Guidelines: Not Just Academic

Differences Among International Pharyngitis Guidelines: Not Just Academic

Sydenham's chorea: clinical and evolutive characteristics

Gruppe-A-Streptokokken-Infektionen im Kindesalter

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