Treatment of Group A Streptococcal Pharyngitis in Children

Time to negative throat culture following initiation of antibiotics for pharyngeal group A Streptococcus: a systematic review and meta-analysis up to October 2021 to inform public health control measures

“…Five studies reported intramuscular penicillin therapy; results were consistent with our findings for antibiotics overall [31,34,40,54,55]. Snellman et al found 1/15 (6.7%) children were culture-positive at 24 h following single dose benzathine penicillin [31].…”

“…Five studies included individuals with scarlet fever, but none provided disaggregated results for this sub-group [32,36,[56][57][58]. Three studies included individuals with asymptomatic carriage [44,54,59], but only Hoskins et al reported distinct results for this sub-group. This was a small paediatric study in which throat cultures were repeated 3-4 days after starting co-trimoxazole, at which point 4/13 (30.8%) children remained culturepositive.…”

“…Brook et al [65] Edmond et al [59] Edmond et al [59] Schalet et al [60] Schalet et al [60] Schwartz et al [32] Snellman et al [31] Gerber et al [45] Gerber et al [45] Gerber et al [ [35] Heterogeneity between groups: p = 0.841 Pooled estimate: 10.4% (95% CI: 8.6-12.5) Block et al [94] Block et al [94] Pooled estimate: 10.2% (95% CI: 6.3-16.2) Pooled estimate: 10.5% (95% CI: 7.9-13.9) Lester et al [34] Block et al [94] Watkins et al [37] Milatovic et al [93] Pacifico et al [58] Ginsburg et al [33] Ginsburg et al [89] Watkins et al [37] Block et al [94] Pichichero et al [95] Aronovitz et al [85] Gerber et al [45] Howie et al [54] Aronovitz et al [85] Lennon et al [50] Gerber et al [45] Lennon et al [50] Howie et al [54] Lennon et al [50]…”

Susceptibility of group A beta-hemolytic Streptococcus isolates to penicillin and erythromycin

“…Recently some clinicians have noted an increased incidence of treatment failure as compared with data relating to treatment results derived 2 decades ago (6,7,(10)(11)(12)14). In view of these findings, we have evaluated antibiotic susceptibilities of group A beta-hemolytic Streptococcus strains recently isolated from patients in Oklahoma.…”

“…Although in vitro resistance to penicillin has not been described for group A beta-hemolytic Streptococcus, a trend of increasing resistance to erythromycin has been reported (2)(3)(4)9). Recently some clinicians have noted an increased incidence of treatment failure as compared with data relating to treatment results derived 2 decades ago (6,7,(10)(11)(12)14). In view of these findings, we have evaluated antibiotic susceptibilities of group A beta-hemolytic Streptococcus strains recently isolated from patients in Oklahoma.…”