PMID: 7021717Sep 1, 1981Paper

The role of the carrier in treatment failures after antibiotic for group A streptococci in the upper respiratory tract

The Journal of Laboratory and Clinical Medicine
E L KaplanB B Huwe

Abstract

During a prospective study of endemic group A streptococcal upper respiratory tract infection and the streptococcal carrier state, we investigated persistence of group A streptococci after treatment with recommended doses of antibiotics. We evaluated clinical findings, culture results, and streptococcal antibody responses at the acute-stage clinic visit and at convalescent-stage visits 3 and 8 weeks later. Data from 280 children ill with pharyngitis and their family contacts were analyzed (mean age 13.3 years); 129 individuals (46%) had group A beta-hemolytic streptococci isolated at the initial visit. Despite antibiotic treatment, group A streptococci were not eradicated from the upper respiratory tract of 34 (26%) of the 129 culture-positive individuals. Thirteen of the 34 (38%) required a second course of antibiotic therapy before the infecting serotype was eradicated, but a majority, the remaining 21 (62%) patients, were not bacteriologically cured despite repeated courses of antibiotics. Streptococcal antibody data suggested that the majority of the treatment failures were streptococcal carriers. Only 5% of asymptomatic individuals with a positive culture for group A streptococci demonstrated an antibody rise. These bacter...Continue Reading

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