II. Signs
- Recurrent episodes Streptococcal Pharyngitis
- GAS Pharyngitis diagnosed with every new cold
- Pharyngitis presumed due to non-GAS cause
III. Diagnosis (Test when patient is well and asymptomatic)
- Throat Culture
- Streptococcal Antibody titer (ASO)
- Obtain baseline value
- Repeat in 4-6 weeks
IV. Indications for Antibiotic treatment for GAS carriers
- Acute Rheumatic Fever outbreak
- Poststreptococcal Glomerulonephritis outbreak
- GAS Pharyngitis outbreak in closed community
- Rheumatic Fever Family History
- Multiple symptomatic GAS Pharyngitis episodes in family
- Excessive family worry regarding GAS Pharyngitis
- Tonsillectomy considered for GAS Carriage
- Household contact with episode of severe GAS infection
V. Management: Eradication of Streptococcal Carriage
- Indications as listed above
- First-Line: Clindamycin
- Child: 20 mg/kg/day PO divided tid for 10 days
- Adult: 600 mg PO tid for 10 days
- Alternative agents
- Amoxicillin-Clavulanate (Augmentin)
- Combination
- Rifampin 10 mg/kg PO bid for 4 days and
- Benzathine Penicillin
VI. References
- (2000) AAP Red Book, p. 532
- Mandell (2000) Principles Infectious Disease, p. 353