Materiały źródłowe

• #1 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Given the potentially devastating consequences of severe invasive group A streptococcal disease, attention has been directed toward the role of chemoprophylaxis and the optimization of management strategies. […] The present document summarizes key components of the recommendations for use by Canadian physicians. […] In 2006, Canadian guidelines were developed to address the prevention and control of invasive disease due to group A streptococcus (GAS). […] With respect to the role of chemoprophylaxis, the Canadian guidelines suggest the following: Chemoprophylaxis should only be offered to close contacts of a confirmed case of severe GAS, and to close contacts who have been exposed to the case during the period from seven days before the onset of symptoms in the case to 24 h after the initiation of antimicrobial therapy in the case.

• #2 Group A Streptococcal diseases: Risks and prevention – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/group-a-streptococcal-diseases/risks-prevention.html

  Anyone can become infected with Group A streptococcal (GAS) bacteria. […] It is always important to stay up to date with recommended vaccinations, including routine vaccines. […] It is important to stay up to date with influenza and chickenpox vaccines to help prevent iGAS. […] To reduce the risk of getting and spreading GAS, as well as many other infections, it is important to: clean your hands often, with soap and warm water or alcohol-based rub, especially before eating or preparing food, after coughing or sneezing, and after using the bathroom or changing diapers. […] clean and disinfect high-touch surfaces and objects frequently. […] cover coughs and sneezes with a tissue or bend of the arm. […] wear a well-fitting respirator or mask in indoor public settings. […] improve indoor ventilation, such as opening a window or door. […] stay home when you are sick.

• #3 Strep throat – symptoms, treatment and prevention | healthdirect

  https://www.healthdirect.gov.au/strep-throat

  Strep throat can cause complications such as rheumatic fever and scarlet fever. […] If you are at risk of complications, your doctor may give you antibiotics to treat strep throat. […] The following suggestions may help you prevent the spread of your strep infection to others: Avoid contact with other people until you have been taking treatment for at least 24 hours or until you feel well. […] People with strep throat should not go to childcare, preschool, school or work until they are no longer contagious.

• #4 Streptococcal Infections (invasive group A strep, GAS)

  https://www.health.ny.gov/diseases/communicable/streptococcal/group_a/fact_sheet.htm

  What can be done to help prevent invasive group A streptococcal infections? The spread of all types of group A streptococcal infections may be reduced by good hand washing, especially after coughing and sneezing, before and after preparing foods and before eating. Persons with sore throats should be seen by a physician who can perform tests to find out whether it is strep throat; if so, one should stay home from work, school or daycare for 24 hours or more after taking an antibiotic. All wounds should be kept clean. Wounds should be watched for possible signs of infection which include increasing redness, swelling and pain at the wound site. If these signs occur, especially in a person who also has a fever, consult a doctor immediately.

• #5 Preventing Group A Strep Infection | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/prevention/index.html

  There’s no vaccine to prevent group A strep infections. […] However, there are things people can do to protect themselves and others. […] Group A strep prevention activities vary by disease, but generally focus on three important goals: Limit exposure and spread of bacteria, Treat group A strep infections, Use preventive antibiotics when appropriate. […] Take antibiotics, if prescribed. Antibiotics treat the infection and help prevent serious complications, like rheumatic fever. They also prevent the bacteria from spreading to others. […] Preventive antibiotics help protect people with rheumatic fever from getting it again. They may need preventive antibiotics over a period of many years (often until 21 years old). Preventive antibiotics can include daily antibiotics by mouth or a shot into the muscle every few weeks. […] For patients with a serious infection, healthcare providers may give antibiotics to close contacts if they are 65 years or older or have other factors that increase their risk of getting a serious group A strep infection.

• #6 Group A Streptococcal Infections: Types & Symptoms

  https://my.clevelandclinic.org/health/diseases/5911-group-a-streptococcal-infections

  You can reduce your risk of getting a group A streptococcal infection or spreading infection by having good hygiene. Good hygiene includes: […] There are currently no vaccines to prevent group A streptococcal infections, but scientists are developing some. […] The bacteria is most contagious when you experience symptoms of being sick. You can prevent the spread of GAS bacteria by staying home if you’re sick, wearing a mask and treating any wounds you might have.

• #7 Saginaw County Health Department

  https://saginawpublichealth.org/hot-topics/strep-a/

  Good hand hygiene and respiratory etiquette can reduce the spread of group A strep bacteria. […] Treatment with an appropriate antibiotic for 12 hours or longer limits a person’s ability to transmit group A strep bacteria. […] Group A strep prevention activities vary by disease, but generally focus on three important goals: Limit exposure and spread of bacteria, Treat group A strep infections, Use preventive antibiotics when appropriate. […] Many daily healthy habits can help prevent infections: Care for fungal infections, Clean and care for wounds, Cover coughs and sneezes, Wash glasses, utensils, and plates after someone who’s sick uses them, Wash hands often. […] Antibiotics treat the infection and help prevent serious complications, like rheumatic fever. They also prevent the bacteria from spreading to others.

• #8 Streptococcal Infections (invasive group A strep, GAS)

  https://www.health.ny.gov/diseases/communicable/streptococcal/group_a/fact_sheet.htm

  What can be done to help prevent invasive group A streptococcal infections? The spread of all types of group A streptococcal infections may be reduced by good hand washing, especially after coughing and sneezing, before and after preparing foods and before eating. Persons with sore throats should be seen by a physician who can perform tests to find out whether it is strep throat; if so, one should stay home from work, school or daycare for 24 hours or more after taking an antibiotic. All wounds should be kept clean. Wounds should be watched for possible signs of infection which include increasing redness, swelling and pain at the wound site. If these signs occur, especially in a person who also has a fever, consult a doctor immediately.

• #9 Group A Streptococcal diseases: Risks and prevention – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/group-a-streptococcal-diseases/risks-prevention.html

  Anyone can become infected with Group A streptococcal (GAS) bacteria. […] It is always important to stay up to date with recommended vaccinations, including routine vaccines. […] It is important to stay up to date with influenza and chickenpox vaccines to help prevent iGAS. […] To reduce the risk of getting and spreading GAS, as well as many other infections, it is important to: clean your hands often, with soap and warm water or alcohol-based rub, especially before eating or preparing food, after coughing or sneezing, and after using the bathroom or changing diapers. […] clean and disinfect high-touch surfaces and objects frequently. […] cover coughs and sneezes with a tissue or bend of the arm. […] wear a well-fitting respirator or mask in indoor public settings. […] improve indoor ventilation, such as opening a window or door. […] stay home when you are sick.

• #10 Strep throat – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338

  To prevent strep infection: […] Proper hand-washing is the best way to prevent all kinds of infections. That’s why it’s important to wash your own hands regularly with soap and water for at least 20 seconds. Teach your children how to wash their hands properly using soap and water or to use an alcohol-based hand sanitizer if there is no soap and water available. […] Teach your children to cover their mouths with an elbow or tissue when they cough or sneeze. […] Don’t share drinking glasses or eating utensils. Wash dishes in hot, soapy water or in a dishwasher.

• #11 Group A Strep (GAS) Infection | Texas DSHS

  https://www.dshs.texas.gov/notifiable-conditions/invasive-and-respiratory-diseases-and-conditions/streptococcal-strep-diseases/group-a-strep-gas-infection

  The following steps will help prevent the spread of infection: […] Keep cuts, scratches, sores and wounds clean and covered […] Cover your mouth and nose when you sneeze and cough […] Wash your hands often using hot water and soap […] Don’t share toothbrushes or eating utensils […] Vaccinate children over one year of age against chickenpox (Some children get invasive GAS infection right after they’ve had chickenpox). […] The following steps will help prevent the spread of infection: […] Keep sores clean and covered. […] Cover your mouth and nose when you sneeze and cough. […] Wash your hands often using hot water and soap. […] Don’t share toothbrushes or eating utensils. […] Vaccinate children over 1 year of age against chickenpox (Some children get invasive GAS infection right after they’ve had the chickenpox).

• #12 Strep Throat Facts For Parents

  https://dph.illinois.gov/topics-services/diseases-and-conditions/infectious-diseases/cd-school-nurse-guidance/strep-throat-facts-for-parents.html

  The following steps can prevent the spread of strep throat: […] Wash your hands frequently with soap and water […] Avoid sharing eating utensils with someone who is sick with strep throat […] When you cough or sneeze, cover your mouth and nose with a tissue, or your upper sleeve or elbow if you don’t have a tissue.

• #13 Group A Streptococcal diseases: Risks and prevention – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/group-a-streptococcal-diseases/risks-prevention.html

  Anyone can become infected with Group A streptococcal (GAS) bacteria. […] It is always important to stay up to date with recommended vaccinations, including routine vaccines. […] It is important to stay up to date with influenza and chickenpox vaccines to help prevent iGAS. […] To reduce the risk of getting and spreading GAS, as well as many other infections, it is important to: clean your hands often, with soap and warm water or alcohol-based rub, especially before eating or preparing food, after coughing or sneezing, and after using the bathroom or changing diapers. […] clean and disinfect high-touch surfaces and objects frequently. […] cover coughs and sneezes with a tissue or bend of the arm. […] wear a well-fitting respirator or mask in indoor public settings. […] improve indoor ventilation, such as opening a window or door. […] stay home when you are sick.

• #14 Group A Streptococcal diseases: Risks and prevention – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/group-a-streptococcal-diseases/risks-prevention.html

  Anyone can become infected with Group A streptococcal (GAS) bacteria. […] It is always important to stay up to date with recommended vaccinations, including routine vaccines. […] It is important to stay up to date with influenza and chickenpox vaccines to help prevent iGAS. […] To reduce the risk of getting and spreading GAS, as well as many other infections, it is important to: clean your hands often, with soap and warm water or alcohol-based rub, especially before eating or preparing food, after coughing or sneezing, and after using the bathroom or changing diapers. […] clean and disinfect high-touch surfaces and objects frequently. […] cover coughs and sneezes with a tissue or bend of the arm. […] wear a well-fitting respirator or mask in indoor public settings. […] improve indoor ventilation, such as opening a window or door. […] stay home when you are sick.

• #15 Group A Streptococcal diseases: Risks and prevention – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/group-a-streptococcal-diseases/risks-prevention.html

  Anyone can become infected with Group A streptococcal (GAS) bacteria. […] It is always important to stay up to date with recommended vaccinations, including routine vaccines. […] It is important to stay up to date with influenza and chickenpox vaccines to help prevent iGAS. […] To reduce the risk of getting and spreading GAS, as well as many other infections, it is important to: clean your hands often, with soap and warm water or alcohol-based rub, especially before eating or preparing food, after coughing or sneezing, and after using the bathroom or changing diapers. […] clean and disinfect high-touch surfaces and objects frequently. […] cover coughs and sneezes with a tissue or bend of the arm. […] wear a well-fitting respirator or mask in indoor public settings. […] improve indoor ventilation, such as opening a window or door. […] stay home when you are sick.

• #16 Strep Throat: Diagnosis, Treatment, and Prevention | Rochester Regional Health

  https://www.rochesterregional.org/hub/strep-throat-2023

  Strep throat is caused by a bacterial infection stemming from a type of bacteria called A Streptococcus. This type of strep is highly contagious and is spread through respiratory droplets in the air, as well as direct contact. […] As with most bacterial infections, the best way to avoid getting sick is practicing good hand hygiene. Washing your hands thoroughly with anti-bacterial soap and water for at least 20 seconds is strongly encouraged. […] Avoid sharing utensils, cups, or other food or drink items used by a person with a strep infection. […] For individuals who are sick, covering their mouth and nose when sneezing or coughing can help to limit the spread of infection. Individuals with strep throat should avoid going out in public (e.g., work, school, daycare) until they go 24 hours without a fever and have been on an antibiotic for at least 24 hours. […] It seems simple, but staying home for 1-2 days can help to reduce the spread of infection, Dr. Haydanek said. The fewer people that a sick person comes into contact with, the fewer people risk becoming infected and becoming potential carriers of an illness themselves.

• #17 Group A streptococcal (GAS) pharyngitis: A practical guide to diagnosis and treatment | Canadian Paediatric Society

  https://cps.ca/documents/position/group-a-streptococcal

  GAS pharyngitis can lead to suppurative complications, including peritonsillar and retropharyngeal abscess, and sepsis. Non-suppurative complications, such as post-streptococcal glomerulonephritis and ARF, are postulated to result from aberrant immune reactions in tissues following immunologically significant GAS infection (i.e., when anti-GAS antibodies are produced). Antibiotic treatment of GAS pharyngitis has been shown to prevent suppurative complications and ARF, but not post-streptococcal glomerulonephritis. […] In settings where the disease burden is high, interventions to improve living conditions, ensure early diagnosis and treatment of GAS pharyngitis through public and health care provider education, and improve access to medical care have been shown to reduce ARF incidence. […] Testing for GAS pharyngitis is recommended for children presenting with moderate to severe sore throat, fever, absence of cough and rhinorrhea, and purulent and/or inflamed tonsils. Microbiological confirmation of GAS pharyngitis using RADT and/or culture is recommended before initiating antimicrobial therapy in low-risk populations. Treatment of first choice for GAS pharyngitis is 10 days of amoxicillin or penicillin.

• #18 Primary prevention of acute rheumatic fever

  https://www1.racgp.org.au/ajgp/2021/may/primary-prevention-of-acute-rheumatic-fever

  Acute rheumatic fever (ARF) is an abnormal immune reaction following Streptococcus pyogenes (Strep A) infection of the throat, and likely the skin. Primary prevention is the prompt and appropriate antibiotic treatment of Strep A infection, and it can reduce the risk of developing ARF and subsequent rheumatic heart disease. […] People at increased risk of ARF should be offered empirical antibiotic treatment of Strep A infections to reduce this risk. […] Primary prevention involves the identification of Strep A infections and delivery of appropriate antibiotic treatment to prevent ARF (as distinct from antibiotic treatment to shorten the duration of infection, heal the sores or provide symptomatic relief). The evidence that treatment of Strep A throat infections can prevent ARF is strong, albeit based on historic studies.

• #19 Streptococcal Infections (invasive group A strep, GAS)

  https://www.health.ny.gov/diseases/communicable/streptococcal/group_a/fact_sheet.htm

  What can be done to help prevent invasive group A streptococcal infections? The spread of all types of group A streptococcal infections may be reduced by good hand washing, especially after coughing and sneezing, before and after preparing foods and before eating. Persons with sore throats should be seen by a physician who can perform tests to find out whether it is strep throat; if so, one should stay home from work, school or daycare for 24 hours or more after taking an antibiotic. All wounds should be kept clean. Wounds should be watched for possible signs of infection which include increasing redness, swelling and pain at the wound site. If these signs occur, especially in a person who also has a fever, consult a doctor immediately.

• #20  

  http://www.bccdc.ca/health-info/diseases-conditions/streptococcal-disease-invasive-group-a

  Group A streptococcal disease (GAS) is caused by a bacteria called Streptococcus pyogenes, group A. […] There is no vaccine to prevent group A streptococcal infections. Antibiotics are recommended for certain close contacts of severe cases of iGAS (for example, persons living in the same household). Wash hands well, especially after coughing and sneezing and before preparing foods or eating. Keep all cuts and wounds clean and watch for possible signs of infection such as redness, swelling, drainage, and pain at the wound site. If there are signs of an infected wound, especially with fever, see a doctor as soon as possible.

• #21 Streptococcal Infections (invasive group A strep, GAS)

  https://www.health.ny.gov/diseases/communicable/streptococcal/group_a/fact_sheet.htm

  What can be done to help prevent invasive group A streptococcal infections? The spread of all types of group A streptococcal infections may be reduced by good hand washing, especially after coughing and sneezing, before and after preparing foods and before eating. Persons with sore throats should be seen by a physician who can perform tests to find out whether it is strep throat; if so, one should stay home from work, school or daycare for 24 hours or more after taking an antibiotic. All wounds should be kept clean. Wounds should be watched for possible signs of infection which include increasing redness, swelling and pain at the wound site. If these signs occur, especially in a person who also has a fever, consult a doctor immediately.

• #22 Strep Throat: Symptoms, Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/4602-strep-throat

  The best way to prevent strep throat is by practicing good hygiene. You should wash your hands frequently with soap and water for 20 seconds. Its especially important to wash your hands before eating (to protect yourself) and after coughing and sneezing (to protect others). There are other steps you can take to prevent strep throat, including: […] If you dont have a fever, you can return to regular activities 24 hours after taking your first dose of an antibiotic. […] No, strep throat wont go away on its own. A type of bacteria causes strep throat, and antibiotics treat infections caused by bacteria. Strep throat can lead to more serious illnesses if not treated, so its important to start on antibiotics immediately.

• #23 Group A streptococcal (GAS) infection – symptoms, prevention, treatment | healthdirect

  https://www.healthdirect.gov.au/group-a-streptococcal

  Group A streptococcus (GAS) is a type of bacteria often found in the throat and on the skin. […] The best way to prevent group A streptococcal infections is to follow good hygiene practices and stay home when you’re sick. […] You can help prevent group A streptococcal infections by maintaining good hygiene. To decrease the spread of bacteria, wash your hands often, especially after sneezing or coughing and before preparing, serving or eating food. […] If you or your child have strep throat or another form of GAS infection, you should stay home from pre-school, school or work for at least 24 hours after starting antibiotic treatment. […] Talk to your doctor if you have been in close contact with someone with an invasive group A streptococcal infection. Your doctor may recommend you take a course of antibiotics to reduce your risk of infection.

• #24 Streptococcal infection – group A | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/streptococcal-infection-group-a

  Prevention, early diagnosis and treatment are important to reduce the risk of acute rheumatic fever. Preventing recurrent GAS infections helps reduce the risk of rheumatic heart disease. […] The best way to protect against getting or spreading GAS infection is to practice good hand washing and personal hygiene. People with GAS infection should not share utensils or prepare food for others while unwell. […] People who have been exposed to GAS bacteria and have an increased risk of infection, serious illness or are part of an outbreak may be recommended to receive preventive antibiotic medication. […] Children with GAS infection must not go to school, kindergarten, childcare or other childrens settings until they have received at least 24 hours of antibiotic treatment and feel well. It is important to complete the entire course of antibiotic treatment.

• #25 Preventing Group A Strep Infection | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/prevention/index.html

  There’s no vaccine to prevent group A strep infections. […] However, there are things people can do to protect themselves and others. […] Group A strep prevention activities vary by disease, but generally focus on three important goals: Limit exposure and spread of bacteria, Treat group A strep infections, Use preventive antibiotics when appropriate. […] Take antibiotics, if prescribed. Antibiotics treat the infection and help prevent serious complications, like rheumatic fever. They also prevent the bacteria from spreading to others. […] Preventive antibiotics help protect people with rheumatic fever from getting it again. They may need preventive antibiotics over a period of many years (often until 21 years old). Preventive antibiotics can include daily antibiotics by mouth or a shot into the muscle every few weeks. […] For patients with a serious infection, healthcare providers may give antibiotics to close contacts if they are 65 years or older or have other factors that increase their risk of getting a serious group A strep infection.

• #26 Preventing Group A Strep Infection | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/prevention/index.html

  There’s no vaccine to prevent group A strep infections. […] However, there are things people can do to protect themselves and others. […] Group A strep prevention activities vary by disease, but generally focus on three important goals: Limit exposure and spread of bacteria, Treat group A strep infections, Use preventive antibiotics when appropriate. […] Take antibiotics, if prescribed. Antibiotics treat the infection and help prevent serious complications, like rheumatic fever. They also prevent the bacteria from spreading to others. […] Preventive antibiotics help protect people with rheumatic fever from getting it again. They may need preventive antibiotics over a period of many years (often until 21 years old). Preventive antibiotics can include daily antibiotics by mouth or a shot into the muscle every few weeks. […] For patients with a serious infection, healthcare providers may give antibiotics to close contacts if they are 65 years or older or have other factors that increase their risk of getting a serious group A strep infection.

• #27 Group A Streptococcal (GAS) Infections Treatment & Management: Approach Considerations, Pharmacologic Therapy, Monitoring

  https://emedicine.medscape.com/article/228936-treatment

  Long-term antibiotic therapy to prevent streptococcal infection is indicated for patients with a history of acute rheumatic fever or rheumatic heart disease. The recommended regimen is 1.2 million international units of benzathine penicillin G injected every 3-4 weeks, 250 mg of oral penicillin V twice daily, or 0.5-1 g of sulfadiazine daily. […] The role of prophylaxis for household contacts of individuals with either acute streptococcal disease or nonsuppurative complications is uncertain. The currently available evidence does not justify routine chemoprophylaxis in close contacts. Some authorities recommend that cultures be obtained from all contacts if a family history of rheumatic fever is noted or when a patient with acute glomerulonephritis is identified. […] Continuous antimicrobial prophylaxis is not recommended except to prevent the recurrence of rheumatic fever in patients who have experienced a previous episode of this disease.

• #28 Saginaw County Health Department

  https://saginawpublichealth.org/hot-topics/strep-a/

  Preventive antibiotics help protect people with rheumatic fever from getting it again. They may need preventive antibiotics over a period of many years (often until 21 years old). Preventive antibiotics can include daily antibiotics by mouth or a shot into the muscle every few weeks. […] For patients with a serious infection, healthcare providers may give antibiotics to close contacts if they are 65 years or older or have other factors that increase their risk of getting a serious group A strep infection.

• #29 Preventing Group A Strep Infection | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/prevention/index.html

  There’s no vaccine to prevent group A strep infections. […] However, there are things people can do to protect themselves and others. […] Group A strep prevention activities vary by disease, but generally focus on three important goals: Limit exposure and spread of bacteria, Treat group A strep infections, Use preventive antibiotics when appropriate. […] Take antibiotics, if prescribed. Antibiotics treat the infection and help prevent serious complications, like rheumatic fever. They also prevent the bacteria from spreading to others. […] Preventive antibiotics help protect people with rheumatic fever from getting it again. They may need preventive antibiotics over a period of many years (often until 21 years old). Preventive antibiotics can include daily antibiotics by mouth or a shot into the muscle every few weeks. […] For patients with a serious infection, healthcare providers may give antibiotics to close contacts if they are 65 years or older or have other factors that increase their risk of getting a serious group A strep infection.

• #30 Group A Streptococcal (GAS) Infections Treatment & Management: Approach Considerations, Pharmacologic Therapy, Monitoring

  https://emedicine.medscape.com/article/228936-treatment

  Long-term antibiotic therapy to prevent streptococcal infection is indicated for patients with a history of acute rheumatic fever or rheumatic heart disease. The recommended regimen is 1.2 million international units of benzathine penicillin G injected every 3-4 weeks, 250 mg of oral penicillin V twice daily, or 0.5-1 g of sulfadiazine daily. […] The role of prophylaxis for household contacts of individuals with either acute streptococcal disease or nonsuppurative complications is uncertain. The currently available evidence does not justify routine chemoprophylaxis in close contacts. Some authorities recommend that cultures be obtained from all contacts if a family history of rheumatic fever is noted or when a patient with acute glomerulonephritis is identified. […] Continuous antimicrobial prophylaxis is not recommended except to prevent the recurrence of rheumatic fever in patients who have experienced a previous episode of this disease.

• #31 Poststreptococcal Illness: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0415/p517.html

  Antibiotics are warranted for any active GABHS infection and for secondary prophylaxis to prevent recurrent acute rheumatic fever. Monthly intramuscular injections of penicillin G benzathine are recommended for secondary prophylaxis in patients with carditis with or without valvular disease, and should be continued until the patient is an adult and has no recurrence for 10 years.

• #32 Public Health Response for Outbreaks | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/php/public-health-strategy/index.html

  Most people exposed to someone with a group A strep infection don’t require prophylaxis (antibiotics given to prevent illness). However, in some situations, prophylaxis may be recommended for someone exposed to an invasive group A strep infection. […] State, tribal, local, and territorial public health officials may investigate clusters or outbreaks of invasive group A strep infections. The goal is generally to determine what measures can control spread, thus preventing future infections. Control measures vary depending on the setting. […] In healthcare settings, infection prevention and control are critical for preventing group A strep outbreaks. Strengthening infection control practices is key to interrupting transmission of group A strep in ongoing outbreaks.

• #33 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Given the potentially devastating consequences of severe invasive group A streptococcal disease, attention has been directed toward the role of chemoprophylaxis and the optimization of management strategies. […] The present document summarizes key components of the recommendations for use by Canadian physicians. […] In 2006, Canadian guidelines were developed to address the prevention and control of invasive disease due to group A streptococcus (GAS). […] With respect to the role of chemoprophylaxis, the Canadian guidelines suggest the following: Chemoprophylaxis should only be offered to close contacts of a confirmed case of severe GAS, and to close contacts who have been exposed to the case during the period from seven days before the onset of symptoms in the case to 24 h after the initiation of antimicrobial therapy in the case.

• #34 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Given the potentially devastating consequences of severe invasive group A streptococcal disease, attention has been directed toward the role of chemoprophylaxis and the optimization of management strategies. […] The present document summarizes key components of the recommendations for use by Canadian physicians. […] In 2006, Canadian guidelines were developed to address the prevention and control of invasive disease due to group A streptococcus (GAS). […] With respect to the role of chemoprophylaxis, the Canadian guidelines suggest the following: Chemoprophylaxis should only be offered to close contacts of a confirmed case of severe GAS, and to close contacts who have been exposed to the case during the period from seven days before the onset of symptoms in the case to 24 h after the initiation of antimicrobial therapy in the case.

• #35 Invasive group A streptococcal disease: Management and chemoprophylaxis | Canadian Paediatric Society

  https://cps.ca/documents/position/Invasive-group-A-streptococcal-disease

  Reporting of severe invasive group A streptococcal disease (IGAS) has increased in Canada over the past decade, highlighting the importance of optimal chemoprophylaxis and management strategies. […] This practice point updates relevant aspects of these guidelines, with a focus on chemoprophylaxis of contacts of IGAS cases and clinical management of IGAS. […] In 2006, Canadian guidelines were developed to address the prevention and control of IGAS. […] Chemoprophylaxis should only be offered to close contacts of a confirmed case of severe IGAS who have been exposed during the period from 7 days before the onset of symptoms in the index case to 24 h after initiating antimicrobial therapy in the case. […] Chemoprophylaxis should be started as soon as possible, preferably within 24 h of identifying the case, but is still recommended up to 7 days after the last contact with the case.

• #36 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Given the potentially devastating consequences of severe invasive group A streptococcal disease, attention has been directed toward the role of chemoprophylaxis and the optimization of management strategies. […] The present document summarizes key components of the recommendations for use by Canadian physicians. […] In 2006, Canadian guidelines were developed to address the prevention and control of invasive disease due to group A streptococcus (GAS). […] With respect to the role of chemoprophylaxis, the Canadian guidelines suggest the following: Chemoprophylaxis should only be offered to close contacts of a confirmed case of severe GAS, and to close contacts who have been exposed to the case during the period from seven days before the onset of symptoms in the case to 24 h after the initiation of antimicrobial therapy in the case.

• #37 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Chemoprophylaxis of close contacts should be administered as soon as possible and preferably within 24 h of case identification, but chemoprophylaxis is still recommended for up to seven days after the last contact with an infectious case. […] Close contacts of all confirmed cases (ie, regardless of whether the case is a severe one) should be alerted to signs and symptoms of invasive group A streptococcal disease, and be advised to seek medical attention immediately should they develop febrile illness or any other clinical manifestations of group A streptococcal infection within 30 days of diagnosis in the index case. […] Chemoprophylaxis is recommended for all children and staff in family or home daycare settings if the above criteria are met. […] The first-generation cephalosporins (eg, cephalexin) are the preferred agents. […] Chemoprophylaxis is not routinely recommended for contacts of cases that are not severe (eg, bacteremia or septic arthritis).

• #38 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Chemoprophylaxis of close contacts should be administered as soon as possible and preferably within 24 h of case identification, but chemoprophylaxis is still recommended for up to seven days after the last contact with an infectious case. […] Close contacts of all confirmed cases (ie, regardless of whether the case is a severe one) should be alerted to signs and symptoms of invasive group A streptococcal disease, and be advised to seek medical attention immediately should they develop febrile illness or any other clinical manifestations of group A streptococcal infection within 30 days of diagnosis in the index case. […] Chemoprophylaxis is recommended for all children and staff in family or home daycare settings if the above criteria are met. […] The first-generation cephalosporins (eg, cephalexin) are the preferred agents. […] Chemoprophylaxis is not routinely recommended for contacts of cases that are not severe (eg, bacteremia or septic arthritis).

• #39 Invasive group A streptococcal disease: Management and chemoprophylaxis | Canadian Paediatric Society

  https://cps.ca/documents/position/Invasive-group-A-streptococcal-disease

  Chemoprophylaxis is not routinely recommended for contacts of non-severe IGAS cases (e.g., bacteremia without toxic shock; septic arthritis). […] Chemoprophylaxis is recommended for all children and staff in family or home child care settings, when any the above criteria are met. […] Chemoprophylaxis is generally not recommended in group or institutional child care centres and preschools. […] First-generation cephalosporins (e.g., cephalexin) are the preferred agents. […] Penicillin is less effective in eradicating GAS colonization than cephalosporins. […] Chemoprophylaxis for close contacts of severe IGAS cases should follow the definitions above and detailed in the PHAC Guideline.

• #40 Invasive group A streptococcal disease: Management and chemoprophylaxis | Canadian Paediatric Society

  https://cps.ca/documents/position/Invasive-group-A-streptococcal-disease

  Chemoprophylaxis is not routinely recommended for contacts of non-severe IGAS cases (e.g., bacteremia without toxic shock; septic arthritis). […] Chemoprophylaxis is recommended for all children and staff in family or home child care settings, when any the above criteria are met. […] Chemoprophylaxis is generally not recommended in group or institutional child care centres and preschools. […] First-generation cephalosporins (e.g., cephalexin) are the preferred agents. […] Penicillin is less effective in eradicating GAS colonization than cephalosporins. […] Chemoprophylaxis for close contacts of severe IGAS cases should follow the definitions above and detailed in the PHAC Guideline.

• #41 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Chemoprophylaxis of close contacts should be administered as soon as possible and preferably within 24 h of case identification, but chemoprophylaxis is still recommended for up to seven days after the last contact with an infectious case. […] Close contacts of all confirmed cases (ie, regardless of whether the case is a severe one) should be alerted to signs and symptoms of invasive group A streptococcal disease, and be advised to seek medical attention immediately should they develop febrile illness or any other clinical manifestations of group A streptococcal infection within 30 days of diagnosis in the index case. […] Chemoprophylaxis is recommended for all children and staff in family or home daycare settings if the above criteria are met. […] The first-generation cephalosporins (eg, cephalexin) are the preferred agents. […] Chemoprophylaxis is not routinely recommended for contacts of cases that are not severe (eg, bacteremia or septic arthritis).

• #42 Invasive group A streptococcal disease: Management and chemoprophylaxis | Canadian Paediatric Society

  https://cps.ca/documents/position/Invasive-group-A-streptococcal-disease

  Chemoprophylaxis is not routinely recommended for contacts of non-severe IGAS cases (e.g., bacteremia without toxic shock; septic arthritis). […] Chemoprophylaxis is recommended for all children and staff in family or home child care settings, when any the above criteria are met. […] Chemoprophylaxis is generally not recommended in group or institutional child care centres and preschools. […] First-generation cephalosporins (e.g., cephalexin) are the preferred agents. […] Penicillin is less effective in eradicating GAS colonization than cephalosporins. […] Chemoprophylaxis for close contacts of severe IGAS cases should follow the definitions above and detailed in the PHAC Guideline.

• #43 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Chemoprophylaxis of close contacts should be administered as soon as possible and preferably within 24 h of case identification, but chemoprophylaxis is still recommended for up to seven days after the last contact with an infectious case. […] Close contacts of all confirmed cases (ie, regardless of whether the case is a severe one) should be alerted to signs and symptoms of invasive group A streptococcal disease, and be advised to seek medical attention immediately should they develop febrile illness or any other clinical manifestations of group A streptococcal infection within 30 days of diagnosis in the index case. […] Chemoprophylaxis is recommended for all children and staff in family or home daycare settings if the above criteria are met. […] The first-generation cephalosporins (eg, cephalexin) are the preferred agents. […] Chemoprophylaxis is not routinely recommended for contacts of cases that are not severe (eg, bacteremia or septic arthritis).

• #44 Invasive group A streptococcal disease: Management and chemoprophylaxis | Canadian Paediatric Society

  https://cps.ca/documents/position/Invasive-group-A-streptococcal-disease

  Chemoprophylaxis is not routinely recommended for contacts of non-severe IGAS cases (e.g., bacteremia without toxic shock; septic arthritis). […] Chemoprophylaxis is recommended for all children and staff in family or home child care settings, when any the above criteria are met. […] Chemoprophylaxis is generally not recommended in group or institutional child care centres and preschools. […] First-generation cephalosporins (e.g., cephalexin) are the preferred agents. […] Penicillin is less effective in eradicating GAS colonization than cephalosporins. […] Chemoprophylaxis for close contacts of severe IGAS cases should follow the definitions above and detailed in the PHAC Guideline.

• #45 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Chemoprophylaxis of close contacts should be administered as soon as possible and preferably within 24 h of case identification, but chemoprophylaxis is still recommended for up to seven days after the last contact with an infectious case. […] Close contacts of all confirmed cases (ie, regardless of whether the case is a severe one) should be alerted to signs and symptoms of invasive group A streptococcal disease, and be advised to seek medical attention immediately should they develop febrile illness or any other clinical manifestations of group A streptococcal infection within 30 days of diagnosis in the index case. […] Chemoprophylaxis is recommended for all children and staff in family or home daycare settings if the above criteria are met. […] The first-generation cephalosporins (eg, cephalexin) are the preferred agents. […] Chemoprophylaxis is not routinely recommended for contacts of cases that are not severe (eg, bacteremia or septic arthritis).

• #46 Invasive group A streptococcal disease: Management and chemoprophylaxis | Canadian Paediatric Society

  https://cps.ca/documents/position/Invasive-group-A-streptococcal-disease

  Chemoprophylaxis is not routinely recommended for contacts of non-severe IGAS cases (e.g., bacteremia without toxic shock; septic arthritis). […] Chemoprophylaxis is recommended for all children and staff in family or home child care settings, when any the above criteria are met. […] Chemoprophylaxis is generally not recommended in group or institutional child care centres and preschools. […] First-generation cephalosporins (e.g., cephalexin) are the preferred agents. […] Penicillin is less effective in eradicating GAS colonization than cephalosporins. […] Chemoprophylaxis for close contacts of severe IGAS cases should follow the definitions above and detailed in the PHAC Guideline.

• #47

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/invasive-group-a-strep.aspx

  Based on this limited evidence, these Guidelines suggest routine provision of antibiotics for chemoprophylaxis by PHUs for birthing parent-neonate pairs only. […] Decisions to provide antibiotics for chemoprophylaxis to any close contacts of a single case should take into account the benefits and risks including: individual risks factors for developing iGAS, the specific context of a case and their close contacts, the risk of side effects, and other potential consequences of providing antibiotics to asymptomatic persons (i.e., elimination of protective flora, or potential to develop antibiotic resistance). […] Antibiotics for chemoprophylaxis should be given to eligible contacts of a single case of iGAS as soon as possible after the contact is identified, preferably within 48 hours of exposure to the original case or, at least, within 48 hours of the case being notified, noting that the utility of administering antibiotics for chemoprophylaxis beyond 10 days of iGAS diagnosis in the initial case is limited.

• #48 Invasive Group A Streptococcal infections (iGAS)

  https://emed.ie/Infections/iGAS.php

  Routine chemoprophylaxis of close contacts of iGAS cases is not recommended. […] However, close contacts should be informed of the symptoms of iGAS infection, and seek immediate medical care if these occur HPSC patient information leaflet. […] Antibiotic chemoprophylaxis should also be given to mother and baby, if either develop iGAS within 28 days after the baby’s birth.

• #49 Invasive Group A Streptococcal infections (iGAS)

  https://emed.ie/Infections/iGAS.php

  Routine chemoprophylaxis of close contacts of iGAS cases is not recommended. […] However, close contacts should be informed of the symptoms of iGAS infection, and seek immediate medical care if these occur HPSC patient information leaflet. […] Antibiotic chemoprophylaxis should also be given to mother and baby, if either develop iGAS within 28 days after the baby’s birth.

• #50

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/invasive-group-a-strep.aspx

  Based on this limited evidence, these Guidelines suggest routine provision of antibiotics for chemoprophylaxis by PHUs for birthing parent-neonate pairs only. […] Decisions to provide antibiotics for chemoprophylaxis to any close contacts of a single case should take into account the benefits and risks including: individual risks factors for developing iGAS, the specific context of a case and their close contacts, the risk of side effects, and other potential consequences of providing antibiotics to asymptomatic persons (i.e., elimination of protective flora, or potential to develop antibiotic resistance). […] Antibiotics for chemoprophylaxis should be given to eligible contacts of a single case of iGAS as soon as possible after the contact is identified, preferably within 48 hours of exposure to the original case or, at least, within 48 hours of the case being notified, noting that the utility of administering antibiotics for chemoprophylaxis beyond 10 days of iGAS diagnosis in the initial case is limited.

• #51 Preventing Group A Strep Infection | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/prevention/index.html

  There’s no vaccine to prevent group A strep infections. […] However, there are things people can do to protect themselves and others. […] Group A strep prevention activities vary by disease, but generally focus on three important goals: Limit exposure and spread of bacteria, Treat group A strep infections, Use preventive antibiotics when appropriate. […] Take antibiotics, if prescribed. Antibiotics treat the infection and help prevent serious complications, like rheumatic fever. They also prevent the bacteria from spreading to others. […] Preventive antibiotics help protect people with rheumatic fever from getting it again. They may need preventive antibiotics over a period of many years (often until 21 years old). Preventive antibiotics can include daily antibiotics by mouth or a shot into the muscle every few weeks. […] For patients with a serious infection, healthcare providers may give antibiotics to close contacts if they are 65 years or older or have other factors that increase their risk of getting a serious group A strep infection.

• #52 Saginaw County Health Department

  https://saginawpublichealth.org/hot-topics/strep-a/

  Preventive antibiotics help protect people with rheumatic fever from getting it again. They may need preventive antibiotics over a period of many years (often until 21 years old). Preventive antibiotics can include daily antibiotics by mouth or a shot into the muscle every few weeks. […] For patients with a serious infection, healthcare providers may give antibiotics to close contacts if they are 65 years or older or have other factors that increase their risk of getting a serious group A strep infection.

• #53 Will preventive antibiotics stop deadly strep A among schoolchildren? | Strep A | The Guardian

  https://www.theguardian.com/society/2022/dec/07/will-preventive-antibiotics-stop-deadly-strep-a-among-schoolchildren

  With at least nine children confirmed dead from severe strep A infections in England, the government has raised the strategy of preventive antibiotics, where penicillin is given to close contacts to prevent them from falling ill. […] Public health guidelines drawn up more than a decade ago state that close contacts of iGAS cases can receive prophylactic antibiotics for 10 days if there are two or more cases in a household or an institutional setting such as a nursing home or school. […] You give close contacts antibiotics in an attempt to shut down secondary cases. […] If there is an outbreak of iGAS in a school, a local outbreak team will go in, identify close contacts of known cases and offer them a 10-day course of penicillin. […] Penicillin is highly effective against strep A infections.

• #54 Will preventive antibiotics stop deadly strep A among schoolchildren? | Strep A | The Guardian

  https://www.theguardian.com/society/2022/dec/07/will-preventive-antibiotics-stop-deadly-strep-a-among-schoolchildren

  With at least nine children confirmed dead from severe strep A infections in England, the government has raised the strategy of preventive antibiotics, where penicillin is given to close contacts to prevent them from falling ill. […] Public health guidelines drawn up more than a decade ago state that close contacts of iGAS cases can receive prophylactic antibiotics for 10 days if there are two or more cases in a household or an institutional setting such as a nursing home or school. […] You give close contacts antibiotics in an attempt to shut down secondary cases. […] If there is an outbreak of iGAS in a school, a local outbreak team will go in, identify close contacts of known cases and offer them a 10-day course of penicillin. […] Penicillin is highly effective against strep A infections.

• #55 Will preventive antibiotics stop deadly strep A among schoolchildren? | Strep A | The Guardian

  https://www.theguardian.com/society/2022/dec/07/will-preventive-antibiotics-stop-deadly-strep-a-among-schoolchildren

  An analysis of UK data found that 2,000 close contacts would need to receive prophylactic antibiotics to prevent a single subsequent case of iGAS disease. […] Doctors are not worried about strep A developing resistance to penicillin, because the bug seems incapable of withstanding the drug. […] Handing out preventive antibiotics is a short-term intervention, aimed at closing down specific outbreaks.

• #56 Will preventive antibiotics stop deadly strep A among schoolchildren? | Strep A | The Guardian

  https://www.theguardian.com/society/2022/dec/07/will-preventive-antibiotics-stop-deadly-strep-a-among-schoolchildren

  An analysis of UK data found that 2,000 close contacts would need to receive prophylactic antibiotics to prevent a single subsequent case of iGAS disease. […] Doctors are not worried about strep A developing resistance to penicillin, because the bug seems incapable of withstanding the drug. […] Handing out preventive antibiotics is a short-term intervention, aimed at closing down specific outbreaks.

• #57 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Targeted intravenous intrapartum antibiotic prophylaxis has demonstrated efficacy for prevention of GBS early-onset disease (EOD) in neonates born to women with positive antepartum GBS cultures and women who have other risk factors for intrapartum GBS colonization. […] Regardless of planned mode of birth, all pregnant women should undergo antepartum screening for GBS at 36 0/737 6/7 weeks of gestation, unless intrapartum antibiotic prophylaxis for GBS is indicated because of GBS bacteriuria during the pregnancy or because of a history of a previous GBS-infected newborn. […] All women whose vaginalrectal cultures at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis unless a prelabor cesarean birth is performed in the setting of intact membranes.

• #58 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Targeted intravenous intrapartum antibiotic prophylaxis has demonstrated efficacy for prevention of GBS early-onset disease (EOD) in neonates born to women with positive antepartum GBS cultures and women who have other risk factors for intrapartum GBS colonization. […] Regardless of planned mode of birth, all pregnant women should undergo antepartum screening for GBS at 36 0/737 6/7 weeks of gestation, unless intrapartum antibiotic prophylaxis for GBS is indicated because of GBS bacteriuria during the pregnancy or because of a history of a previous GBS-infected newborn. […] All women whose vaginalrectal cultures at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis unless a prelabor cesarean birth is performed in the setting of intact membranes.

• #59 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Targeted intravenous intrapartum antibiotic prophylaxis has demonstrated efficacy for prevention of GBS early-onset disease (EOD) in neonates born to women with positive antepartum GBS cultures and women who have other risk factors for intrapartum GBS colonization. […] Regardless of planned mode of birth, all pregnant women should undergo antepartum screening for GBS at 36 0/737 6/7 weeks of gestation, unless intrapartum antibiotic prophylaxis for GBS is indicated because of GBS bacteriuria during the pregnancy or because of a history of a previous GBS-infected newborn. […] All women whose vaginalrectal cultures at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis unless a prelabor cesarean birth is performed in the setting of intact membranes.

• #60 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  If the prenatal GBS culture result is unknown when labor starts, intrapartum antibiotic prophylaxis is indicated for women who have risk factors for GBS EOD. […] Women with a positive prenatal GBS culture result who undergo a cesarean birth before the onset of labor and with intact membranes do not require GBS antibiotic prophylaxis. […] Intravenous penicillin remains the agent of choice for intrapartum prophylaxis, with intravenous ampicillin as an acceptable alternative. […] For women who are at high risk of anaphylaxis after exposure to penicillin, the laboratory requisitions for ordering antepartum GBS screening cultures (whether on paper or online in electronic medical records) should indicate clearly the presence of penicillin allergy. […] Intravenous vancomycin remains the only pharmacokinetically and microbiologically validated option for intrapartum antibiotic prophylaxis in women who report a high-risk penicillin allergy and whose GBS isolate is not susceptible to clindamycin. […] Obstetric interventions, when necessary, should not be delayed solely to provide 4 hours of antibiotic administration before birth.

• #61 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  If the prenatal GBS culture result is unknown when labor starts, intrapartum antibiotic prophylaxis is indicated for women who have risk factors for GBS EOD. […] Women with a positive prenatal GBS culture result who undergo a cesarean birth before the onset of labor and with intact membranes do not require GBS antibiotic prophylaxis. […] Intravenous penicillin remains the agent of choice for intrapartum prophylaxis, with intravenous ampicillin as an acceptable alternative. […] For women who are at high risk of anaphylaxis after exposure to penicillin, the laboratory requisitions for ordering antepartum GBS screening cultures (whether on paper or online in electronic medical records) should indicate clearly the presence of penicillin allergy. […] Intravenous vancomycin remains the only pharmacokinetically and microbiologically validated option for intrapartum antibiotic prophylaxis in women who report a high-risk penicillin allergy and whose GBS isolate is not susceptible to clindamycin. […] Obstetric interventions, when necessary, should not be delayed solely to provide 4 hours of antibiotic administration before birth.

• #62 Group A streptococcal (GAS) pharyngitis: A practical guide to diagnosis and treatment | Canadian Paediatric Society

  https://cps.ca/documents/position/group-a-streptococcal

  GAS pharyngitis can lead to suppurative complications, including peritonsillar and retropharyngeal abscess, and sepsis. Non-suppurative complications, such as post-streptococcal glomerulonephritis and ARF, are postulated to result from aberrant immune reactions in tissues following immunologically significant GAS infection (i.e., when anti-GAS antibodies are produced). Antibiotic treatment of GAS pharyngitis has been shown to prevent suppurative complications and ARF, but not post-streptococcal glomerulonephritis. […] In settings where the disease burden is high, interventions to improve living conditions, ensure early diagnosis and treatment of GAS pharyngitis through public and health care provider education, and improve access to medical care have been shown to reduce ARF incidence. […] Testing for GAS pharyngitis is recommended for children presenting with moderate to severe sore throat, fever, absence of cough and rhinorrhea, and purulent and/or inflamed tonsils. Microbiological confirmation of GAS pharyngitis using RADT and/or culture is recommended before initiating antimicrobial therapy in low-risk populations. Treatment of first choice for GAS pharyngitis is 10 days of amoxicillin or penicillin.

• #63 Poststreptococcal Illness: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0415/p517.html

  Treatment of group A streptococcal pharyngitis with antibiotics is indicated in patients with a positive rapid antigen detection test or throat culture result. […] Secondary antibiotic prophylaxis is indicated for patients with acute rheumatic fever or poststreptococcal reactive arthritis. […] Early antibiotic treatment in patients with GABHS pharyngitis and positive results on a rapid antigen detection test or throat culture may prevent suppurative complications and rheumatic fever, shorten the clinical course by up to 16 hours, and reduce transmission. […] Treating GABHS within nine days of symptom onset will prevent acute rheumatic fever in two-thirds of patients. […] Most experts recommend monitoring for carditis for several months and prescribing secondary antibiotic prophylaxis for at least one year.

• #64 Primary prevention of acute rheumatic fever

  https://www1.racgp.org.au/ajgp/2021/may/primary-prevention-of-acute-rheumatic-fever

  Acute rheumatic fever (ARF) is an abnormal immune reaction following Streptococcus pyogenes (Strep A) infection of the throat, and likely the skin. Primary prevention is the prompt and appropriate antibiotic treatment of Strep A infection, and it can reduce the risk of developing ARF and subsequent rheumatic heart disease. […] People at increased risk of ARF should be offered empirical antibiotic treatment of Strep A infections to reduce this risk. […] Primary prevention involves the identification of Strep A infections and delivery of appropriate antibiotic treatment to prevent ARF (as distinct from antibiotic treatment to shorten the duration of infection, heal the sores or provide symptomatic relief). The evidence that treatment of Strep A throat infections can prevent ARF is strong, albeit based on historic studies.

• #65 Poststreptococcal Illness: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0415/p517.html

  Treatment of group A streptococcal pharyngitis with antibiotics is indicated in patients with a positive rapid antigen detection test or throat culture result. […] Secondary antibiotic prophylaxis is indicated for patients with acute rheumatic fever or poststreptococcal reactive arthritis. […] Early antibiotic treatment in patients with GABHS pharyngitis and positive results on a rapid antigen detection test or throat culture may prevent suppurative complications and rheumatic fever, shorten the clinical course by up to 16 hours, and reduce transmission. […] Treating GABHS within nine days of symptom onset will prevent acute rheumatic fever in two-thirds of patients. […] Most experts recommend monitoring for carditis for several months and prescribing secondary antibiotic prophylaxis for at least one year.

• #66 Poststreptococcal Illness: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0415/p517.html

  Treatment of group A streptococcal pharyngitis with antibiotics is indicated in patients with a positive rapid antigen detection test or throat culture result. […] Secondary antibiotic prophylaxis is indicated for patients with acute rheumatic fever or poststreptococcal reactive arthritis. […] Early antibiotic treatment in patients with GABHS pharyngitis and positive results on a rapid antigen detection test or throat culture may prevent suppurative complications and rheumatic fever, shorten the clinical course by up to 16 hours, and reduce transmission. […] Treating GABHS within nine days of symptom onset will prevent acute rheumatic fever in two-thirds of patients. […] Most experts recommend monitoring for carditis for several months and prescribing secondary antibiotic prophylaxis for at least one year.

• #67 Primary prevention of acute rheumatic fever

  https://www1.racgp.org.au/ajgp/2021/may/primary-prevention-of-acute-rheumatic-fever

  Prompt treatment with oral penicillin is reported to reduce the attack rate of ARF following Strep A throat infection by approximately 70%, increasing to 80% if a single intramuscular injection of benzathine benzylpenicillin G (BPG) is given. […] There is no empirical evidence that antibiotic treatment of Strep A skin infections has the same effect in reducing ARF risk. However, it is biologically plausible that timely treatment of skin infection would limit the immune response, immune priming and molecular mimicry that underpin the pathophysiology of ARF. […] People who may be at high risk of ARF require primary prevention antibiotic treatment for sore throat. […] First-line treatment is a single immediate dose of intramuscular BPG delivered according to evidence-based guidance to minimise the pain of injection delivery. […] Systemic treatment with oral cotrimoxazole is more appropriate as primary prevention for people at risk of ARF. […] Development of ARF can be prevented by early detection and appropriate antibiotic treatment of sore throats and skin sores for higher-risk groups.

• #68 Primary prevention of acute rheumatic fever

  https://www1.racgp.org.au/ajgp/2021/may/primary-prevention-of-acute-rheumatic-fever

  Prompt treatment with oral penicillin is reported to reduce the attack rate of ARF following Strep A throat infection by approximately 70%, increasing to 80% if a single intramuscular injection of benzathine benzylpenicillin G (BPG) is given. […] There is no empirical evidence that antibiotic treatment of Strep A skin infections has the same effect in reducing ARF risk. However, it is biologically plausible that timely treatment of skin infection would limit the immune response, immune priming and molecular mimicry that underpin the pathophysiology of ARF. […] People who may be at high risk of ARF require primary prevention antibiotic treatment for sore throat. […] First-line treatment is a single immediate dose of intramuscular BPG delivered according to evidence-based guidance to minimise the pain of injection delivery. […] Systemic treatment with oral cotrimoxazole is more appropriate as primary prevention for people at risk of ARF. […] Development of ARF can be prevented by early detection and appropriate antibiotic treatment of sore throats and skin sores for higher-risk groups.

• #69 Group A Streptococcal (GAS) Infection Symptoms, Treatment, Strep A & Vaccines

  https://www.medicinenet.com/streptococcal_infections/article.htm

  Early treatment of deep infections (for example, excision, drainage, and antibiotic treatment of rectal abscesses) helps prevent invasive GAS disease. Besides, appropriate and timely removal of tampons and surgical packing may reduce the incidence of toxic shock syndrome. […] Currently, there is no vaccine commercially available for GAS, but researchers are working on developing vaccines. At least four different major approaches are being researched. There has been some success with a related experimental vaccine against GAS bacterial antigens coupled to cholera toxin subunits. However, the GAS vaccine, by Vaxent, a vaccine company, prepared by recombinant technology, maybe going into human clinical trials. The new experimental vaccines may become available in the future to prevent GAS infections.

• #70 Group A Streptococcal (GAS) Infection Symptoms, Treatment, Strep A & Vaccines

  https://www.medicinenet.com/streptococcal_infections/article.htm

  Early treatment of deep infections (for example, excision, drainage, and antibiotic treatment of rectal abscesses) helps prevent invasive GAS disease. Besides, appropriate and timely removal of tampons and surgical packing may reduce the incidence of toxic shock syndrome. […] Currently, there is no vaccine commercially available for GAS, but researchers are working on developing vaccines. At least four different major approaches are being researched. There has been some success with a related experimental vaccine against GAS bacterial antigens coupled to cholera toxin subunits. However, the GAS vaccine, by Vaxent, a vaccine company, prepared by recombinant technology, maybe going into human clinical trials. The new experimental vaccines may become available in the future to prevent GAS infections.

• #71 Group A Streptococcal (GAS) Infection Symptoms, Treatment, Strep A & Vaccines

  https://www.medicinenet.com/streptococcal_infections/article.htm

  Early treatment of deep infections (for example, excision, drainage, and antibiotic treatment of rectal abscesses) helps prevent invasive GAS disease. Besides, appropriate and timely removal of tampons and surgical packing may reduce the incidence of toxic shock syndrome. […] Currently, there is no vaccine commercially available for GAS, but researchers are working on developing vaccines. At least four different major approaches are being researched. There has been some success with a related experimental vaccine against GAS bacterial antigens coupled to cholera toxin subunits. However, the GAS vaccine, by Vaxent, a vaccine company, prepared by recombinant technology, maybe going into human clinical trials. The new experimental vaccines may become available in the future to prevent GAS infections.

• #72 Invasive group A streptococcal infections: management of household contacts

  https://www.rch.org.au/clinicalguide/guideline_index/Invasive_Group_A_Streptococcal_Infections__management_of_household_contacts/

  Invasive Group A Streptococcal disease (iGAS) is associated with significant morbidity and mortality. […] There is an increased risk of secondary cases of iGAS in household contacts of an index case. […] Inform household contacts about the clinical features of iGAS and provide chemoprophylaxis as soon as possible. […] Some experts and guidelines recommend antibiotic chemoprophylaxis to reduce the risk of iGAS in household contacts, although this has not been studied extensively. […] Regardless of whether chemoprophylaxis is prescribed, all household contacts should be educated about their increased risk of iGAS and the early signs and symptoms of iGAS that require prompt medical evaluation.

• #73 Modalities of group A streptococcal prevention and treatment and their economic justification | npj Vaccines

  https://www.nature.com/articles/s41541-023-00649-3

  In this article, we outline the recommended strategies for Strep A treatment and prevention and review the literature for economic evaluations of competing treatment and prevention strategies. […] For the prevention of ARF and RHD, interventions are generally codified into four broad categories: primordial, primary, secondary, and tertiary prevention. Primordial prevention traditionally focuses on preventing infection, and therefore ARF and RHD, by reducing Strep A exposure and transmission through hygiene and social distancing. Primary prevention is treatment of superficial infection and is intended to minimize the risk of ARF. Secondary prevention is antibiotic prophylaxis intended to prevent infection and recurrent ARF in people with a history of ARF or RHD. Tertiary prevention is intended to improve duration or quality of life through medical or surgical management, such as heart valve surgery for people with severe RHD.

• #74 Group A Streptococcal (GAS) Infections Treatment & Management: Approach Considerations, Pharmacologic Therapy, Monitoring

  https://emedicine.medscape.com/article/228936-treatment

  Long-term antibiotic therapy to prevent streptococcal infection is indicated for patients with a history of acute rheumatic fever or rheumatic heart disease. The recommended regimen is 1.2 million international units of benzathine penicillin G injected every 3-4 weeks, 250 mg of oral penicillin V twice daily, or 0.5-1 g of sulfadiazine daily. […] The role of prophylaxis for household contacts of individuals with either acute streptococcal disease or nonsuppurative complications is uncertain. The currently available evidence does not justify routine chemoprophylaxis in close contacts. Some authorities recommend that cultures be obtained from all contacts if a family history of rheumatic fever is noted or when a patient with acute glomerulonephritis is identified. […] Continuous antimicrobial prophylaxis is not recommended except to prevent the recurrence of rheumatic fever in patients who have experienced a previous episode of this disease.

• #75 Modalities of group A streptococcal prevention and treatment and their economic justification | npj Vaccines

  https://www.nature.com/articles/s41541-023-00649-3

  In this article, we outline the recommended strategies for Strep A treatment and prevention and review the literature for economic evaluations of competing treatment and prevention strategies. […] For the prevention of ARF and RHD, interventions are generally codified into four broad categories: primordial, primary, secondary, and tertiary prevention. Primordial prevention traditionally focuses on preventing infection, and therefore ARF and RHD, by reducing Strep A exposure and transmission through hygiene and social distancing. Primary prevention is treatment of superficial infection and is intended to minimize the risk of ARF. Secondary prevention is antibiotic prophylaxis intended to prevent infection and recurrent ARF in people with a history of ARF or RHD. Tertiary prevention is intended to improve duration or quality of life through medical or surgical management, such as heart valve surgery for people with severe RHD.

• #76 Clinical Update – Primary Prevention of ARF | Rheumatic Heart Disease Australia

  https://www.rhdaustralia.org.au/news/clinical-update-primary-prevention-arf

  Guidelines often caution against the overuse of antibiotics for sore throats, however, due to the high impact resulting from ARF and RHD, people who are at increased risk of developing ARF should be treated with antibiotics if they develop a sore throat, irrespective of other clinical features. […] Knowing when to treat sore throats with antibiotics to prevent ARF is an important learning point for all health staff working with populations at high risk of ARF. […] High risk individuals who are already receiving regular benzathine benzylpenicillin injections for ARF still need treatment for sore throats and skin sores. This is necessary because the level of benzathine benzylpenicillin decreases at around day 7 to reach a prevention level, which is lower than the treatment level required for the Strep A infection. […] Updated recommendations for primary prevention of ARF will inform other guidelines as they are updated. For more information about primary prevention of ARF, refer to the 2020 Australian guideline (pages 56-69).

• #77 Antibiotics for PANS/PANDAS | PPN

  https://www.pandasppn.org/antibiotics/

  A follow-up swab a week after finishing antibiotic treatment should be done for those with a documented strep throat infection. Re-treatment is recommended if still positive. Following the initial treatment course, prophylactic antibiotics may be useful for PANDAS (but are less clearly indicated for PANS, since they are effective only in preventing GAS infections). […] Long term prophylactic antibiotics to prevent future strep infections may be appropriate for severely affected children, for those who have received immunotherapy, and for those with multiple strep associated neuropsychiatric exacerbations. […] Continuing prophylaxis until age 18 for severe cases is appropriate, but should be individualized. Physicians considering prophylaxis should consult guidelines for prophylaxis for rheumatic fever.

• #78 Antibiotics for PANS/PANDAS | PPN

  https://www.pandasppn.org/antibiotics/

  A follow-up swab a week after finishing antibiotic treatment should be done for those with a documented strep throat infection. Re-treatment is recommended if still positive. Following the initial treatment course, prophylactic antibiotics may be useful for PANDAS (but are less clearly indicated for PANS, since they are effective only in preventing GAS infections). […] Long term prophylactic antibiotics to prevent future strep infections may be appropriate for severely affected children, for those who have received immunotherapy, and for those with multiple strep associated neuropsychiatric exacerbations. […] Continuing prophylaxis until age 18 for severe cases is appropriate, but should be individualized. Physicians considering prophylaxis should consult guidelines for prophylaxis for rheumatic fever.

• #79 Antibiotics for PANS/PANDAS | PPN

  https://www.pandasppn.org/antibiotics/

  A follow-up swab a week after finishing antibiotic treatment should be done for those with a documented strep throat infection. Re-treatment is recommended if still positive. Following the initial treatment course, prophylactic antibiotics may be useful for PANDAS (but are less clearly indicated for PANS, since they are effective only in preventing GAS infections). […] Long term prophylactic antibiotics to prevent future strep infections may be appropriate for severely affected children, for those who have received immunotherapy, and for those with multiple strep associated neuropsychiatric exacerbations. […] Continuing prophylaxis until age 18 for severe cases is appropriate, but should be individualized. Physicians considering prophylaxis should consult guidelines for prophylaxis for rheumatic fever.

• #80 Antibiotics for PANS/PANDAS | PPN

  https://www.pandasppn.org/antibiotics/

  Typical antibiotics used for prophylaxis include Augmentin (approximately 400mg/day), azithromycin (approximately 250mg/day) or penicillin (250mg po bid). […] Therefore, patients may benefit from antibiotic prophylaxis starting the day before, until 4-7 days after the procedure. The dosing to prevent PANS/PANDAS exacerbation is higher than that used for endocarditis prophylaxis for dental procedures and should be at least equivalent to the dosing for therapeutic strep pharyngitis. […] Azithromycin and penicillin have been utilized in the treatment of PANDAS with observations of improvement in neuropsychiatric symptoms. […] The authors suggest that both antibiotics may be safe and effective in preventing Group A strep infections and in decreasing the number of neuropsychiatric exacerbations in these children without any significant differences between groups. […] Antibiotics have been demonstrated to have benefits to the patient beyond the eradication of pathogens. […] The interplay between the immune system and the Central Nervous System (CNS) makes antimicrobial agents potential therapeutic alternatives for some neuropsychiatric disorders.

• #81 Antibiotics for PANS/PANDAS | PPN

  https://www.pandasppn.org/antibiotics/

  Typical antibiotics used for prophylaxis include Augmentin (approximately 400mg/day), azithromycin (approximately 250mg/day) or penicillin (250mg po bid). […] Therefore, patients may benefit from antibiotic prophylaxis starting the day before, until 4-7 days after the procedure. The dosing to prevent PANS/PANDAS exacerbation is higher than that used for endocarditis prophylaxis for dental procedures and should be at least equivalent to the dosing for therapeutic strep pharyngitis. […] Azithromycin and penicillin have been utilized in the treatment of PANDAS with observations of improvement in neuropsychiatric symptoms. […] The authors suggest that both antibiotics may be safe and effective in preventing Group A strep infections and in decreasing the number of neuropsychiatric exacerbations in these children without any significant differences between groups. […] Antibiotics have been demonstrated to have benefits to the patient beyond the eradication of pathogens. […] The interplay between the immune system and the Central Nervous System (CNS) makes antimicrobial agents potential therapeutic alternatives for some neuropsychiatric disorders.

• #82 Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9424867/

  Among close contacts of patients with invasive group A streptococcal (iGAS) infection, the benefits and harms of chemoprophylaxis are uncertain. […] Therefore, definitive conclusions on effectiveness of antibiotic prophylaxis cannot be drawn. Well designed prospective studies are required to establish the benefit-harm profile of antibiotic prophylaxis for secondary prevention of GAS disease among close contacts of iGAS cases. […] The guidelines recommend that decisions about use of chemoprophylaxis must take into account individual and population risks and benefits, and they conclude that chemoprophylaxis can be offered to close contacts of confirmed severe cases of iGAS (as defined in the guideline). […] Chemoprophylaxis regimens are provided in the guidelines and are generally extrapolated from the treatment guidelines for acute GAS pharyngitis and from clinical trials for the eradication of pharyngeal GAS colonization.

• #83 Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9424867/

  Among close contacts of patients with invasive group A streptococcal (iGAS) infection, the benefits and harms of chemoprophylaxis are uncertain. […] Therefore, definitive conclusions on effectiveness of antibiotic prophylaxis cannot be drawn. Well designed prospective studies are required to establish the benefit-harm profile of antibiotic prophylaxis for secondary prevention of GAS disease among close contacts of iGAS cases. […] The guidelines recommend that decisions about use of chemoprophylaxis must take into account individual and population risks and benefits, and they conclude that chemoprophylaxis can be offered to close contacts of confirmed severe cases of iGAS (as defined in the guideline). […] Chemoprophylaxis regimens are provided in the guidelines and are generally extrapolated from the treatment guidelines for acute GAS pharyngitis and from clinical trials for the eradication of pharyngeal GAS colonization.

• #84 Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9424867/

  To this end, and recognizing the need for evidence synthesis to support guideline recommendations, we conducted a systematic review to (1) determine the effectiveness and safety of chemoprophylaxis for the prevention of GAS infection and GAS carriage in persons exposed to cases of iGAS disease. […] However, the generalizability of the findings from this single study are limited because the population was PEH. […] Although the predominantly descriptive information from outbreak investigations and case series or reports included in our study suggests that antibiotic prophylaxis may be effective in preventing GAS infection or GAS carriage, current available evidence is scant (with limited information on contacts of iGAS cases), largely based on studies with weak design and small sample size, and it does not allow for any definitive conclusions on effectiveness of antibiotic prophylaxis.

• #85 Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9424867/

  Among close contacts of patients with invasive group A streptococcal (iGAS) infection, the benefits and harms of chemoprophylaxis are uncertain. […] Therefore, definitive conclusions on effectiveness of antibiotic prophylaxis cannot be drawn. Well designed prospective studies are required to establish the benefit-harm profile of antibiotic prophylaxis for secondary prevention of GAS disease among close contacts of iGAS cases. […] The guidelines recommend that decisions about use of chemoprophylaxis must take into account individual and population risks and benefits, and they conclude that chemoprophylaxis can be offered to close contacts of confirmed severe cases of iGAS (as defined in the guideline). […] Chemoprophylaxis regimens are provided in the guidelines and are generally extrapolated from the treatment guidelines for acute GAS pharyngitis and from clinical trials for the eradication of pharyngeal GAS colonization.

• #86 Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9424867/

  To this end, and recognizing the need for evidence synthesis to support guideline recommendations, we conducted a systematic review to (1) determine the effectiveness and safety of chemoprophylaxis for the prevention of GAS infection and GAS carriage in persons exposed to cases of iGAS disease. […] However, the generalizability of the findings from this single study are limited because the population was PEH. […] Although the predominantly descriptive information from outbreak investigations and case series or reports included in our study suggests that antibiotic prophylaxis may be effective in preventing GAS infection or GAS carriage, current available evidence is scant (with limited information on contacts of iGAS cases), largely based on studies with weak design and small sample size, and it does not allow for any definitive conclusions on effectiveness of antibiotic prophylaxis.

• #87 Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9424867/

  In conclusion, this systematic review on effectiveness and safety of antibiotic prophylaxis in persons exposed to cases of iGAS disease demonstrates that currently available evidence is limited and largely based on studies with weak design and small sample size. There is insufficient information to confidently conclude whether the benefits of antibiotic prophylaxis outweigh its potential harms.

• #88 Group A Streptococcal (GAS) Infection Symptoms, Treatment, Strep A & Vaccines

  https://www.medicinenet.com/streptococcal_infections/article.htm

  Early treatment of deep infections (for example, excision, drainage, and antibiotic treatment of rectal abscesses) helps prevent invasive GAS disease. Besides, appropriate and timely removal of tampons and surgical packing may reduce the incidence of toxic shock syndrome. […] Currently, there is no vaccine commercially available for GAS, but researchers are working on developing vaccines. At least four different major approaches are being researched. There has been some success with a related experimental vaccine against GAS bacterial antigens coupled to cholera toxin subunits. However, the GAS vaccine, by Vaxent, a vaccine company, prepared by recombinant technology, maybe going into human clinical trials. The new experimental vaccines may become available in the future to prevent GAS infections.

• #89 Group A Streptococcal (GAS) Infections Treatment & Management: Approach Considerations, Pharmacologic Therapy, Monitoring

  https://emedicine.medscape.com/article/228936-treatment

  An alternative approach to prophylaxis is to treat all household contacts in the setting of acute PSGN in an effort to eradicate household transmission of nephritogenic strains. For invasive GAS infections (eg, necrotizing fasciitis, TSS), no data are available on which to base assessment of risk to household contacts. However, because of the devastating nature of these infections and the observation that invasive disease may be due to clonal outbreaks of more virulent strains, empiric antibiotic therapy of household contacts seems warranted. […] A streptococcal vaccine could be a promising tool for disease prevention, but an effective vaccine would have to provide protection from multiple serotypes.

• #90 Group A Streptococcal (GAS) Infections Treatment & Management: Approach Considerations, Pharmacologic Therapy, Monitoring

  https://emedicine.medscape.com/article/228936-treatment

  An alternative approach to prophylaxis is to treat all household contacts in the setting of acute PSGN in an effort to eradicate household transmission of nephritogenic strains. For invasive GAS infections (eg, necrotizing fasciitis, TSS), no data are available on which to base assessment of risk to household contacts. However, because of the devastating nature of these infections and the observation that invasive disease may be due to clonal outbreaks of more virulent strains, empiric antibiotic therapy of household contacts seems warranted. […] A streptococcal vaccine could be a promising tool for disease prevention, but an effective vaccine would have to provide protection from multiple serotypes.

• #91 Group A Streptococcal (GAS) Infection Symptoms, Treatment, Strep A & Vaccines

  https://www.medicinenet.com/streptococcal_infections/article.htm

  Early treatment of deep infections (for example, excision, drainage, and antibiotic treatment of rectal abscesses) helps prevent invasive GAS disease. Besides, appropriate and timely removal of tampons and surgical packing may reduce the incidence of toxic shock syndrome. […] Currently, there is no vaccine commercially available for GAS, but researchers are working on developing vaccines. At least four different major approaches are being researched. There has been some success with a related experimental vaccine against GAS bacterial antigens coupled to cholera toxin subunits. However, the GAS vaccine, by Vaxent, a vaccine company, prepared by recombinant technology, maybe going into human clinical trials. The new experimental vaccines may become available in the future to prevent GAS infections.

• #92 Group A Streptococcal (GAS) Infection Symptoms, Treatment, Strep A & Vaccines

  https://www.medicinenet.com/streptococcal_infections/article.htm

  Early treatment of deep infections (for example, excision, drainage, and antibiotic treatment of rectal abscesses) helps prevent invasive GAS disease. Besides, appropriate and timely removal of tampons and surgical packing may reduce the incidence of toxic shock syndrome. […] Currently, there is no vaccine commercially available for GAS, but researchers are working on developing vaccines. At least four different major approaches are being researched. There has been some success with a related experimental vaccine against GAS bacterial antigens coupled to cholera toxin subunits. However, the GAS vaccine, by Vaxent, a vaccine company, prepared by recombinant technology, maybe going into human clinical trials. The new experimental vaccines may become available in the future to prevent GAS infections.

• #93 Group A Streptococcal (GAS) Infection Symptoms, Treatment, Strep A & Vaccines

  https://www.medicinenet.com/streptococcal_infections/article.htm

  Early treatment of deep infections (for example, excision, drainage, and antibiotic treatment of rectal abscesses) helps prevent invasive GAS disease. Besides, appropriate and timely removal of tampons and surgical packing may reduce the incidence of toxic shock syndrome. […] Currently, there is no vaccine commercially available for GAS, but researchers are working on developing vaccines. At least four different major approaches are being researched. There has been some success with a related experimental vaccine against GAS bacterial antigens coupled to cholera toxin subunits. However, the GAS vaccine, by Vaxent, a vaccine company, prepared by recombinant technology, maybe going into human clinical trials. The new experimental vaccines may become available in the future to prevent GAS infections.

• #94 Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9424867/

  In conclusion, this systematic review on effectiveness and safety of antibiotic prophylaxis in persons exposed to cases of iGAS disease demonstrates that currently available evidence is limited and largely based on studies with weak design and small sample size. There is insufficient information to confidently conclude whether the benefits of antibiotic prophylaxis outweigh its potential harms.

• #95 Modalities of group A streptococcal prevention and treatment and their economic justification | npj Vaccines

  https://www.nature.com/articles/s41541-023-00649-3

  Economic modelling can support decision making on these issues by outlining the costs and benefits of different Strep A control strategies. […] This review compiles evaluations of Strep A treatment or prevention strategies that included an economic analysis. […] Supporting decision makers with clear, economic justification for strategies to prevent the burden of Strep A infection is hindered by a range of issues. […] The absence of studies addressing key issues in Strep A control was revealing. For example, there were no economic evaluations for primordial prevention of infection by addressing environmental or social factors or hygiene infrastructure or behaviours. […] This review highlights a range of issues in economic analysis for Strep A treatment and prevention modalities. […] Studies included in this review illustrate the urgent need for a range of better-quality primary data in economic analyses of Strep A prevention and treatment modalities.

• #96 Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9424867/

  Among close contacts of patients with invasive group A streptococcal (iGAS) infection, the benefits and harms of chemoprophylaxis are uncertain. […] Therefore, definitive conclusions on effectiveness of antibiotic prophylaxis cannot be drawn. Well designed prospective studies are required to establish the benefit-harm profile of antibiotic prophylaxis for secondary prevention of GAS disease among close contacts of iGAS cases. […] The guidelines recommend that decisions about use of chemoprophylaxis must take into account individual and population risks and benefits, and they conclude that chemoprophylaxis can be offered to close contacts of confirmed severe cases of iGAS (as defined in the guideline). […] Chemoprophylaxis regimens are provided in the guidelines and are generally extrapolated from the treatment guidelines for acute GAS pharyngitis and from clinical trials for the eradication of pharyngeal GAS colonization.

• #97 Modalities of group A streptococcal prevention and treatment and their economic justification | npj Vaccines

  https://www.nature.com/articles/s41541-023-00649-3

  Economic modelling can support decision making on these issues by outlining the costs and benefits of different Strep A control strategies. […] This review compiles evaluations of Strep A treatment or prevention strategies that included an economic analysis. […] Supporting decision makers with clear, economic justification for strategies to prevent the burden of Strep A infection is hindered by a range of issues. […] The absence of studies addressing key issues in Strep A control was revealing. For example, there were no economic evaluations for primordial prevention of infection by addressing environmental or social factors or hygiene infrastructure or behaviours. […] This review highlights a range of issues in economic analysis for Strep A treatment and prevention modalities. […] Studies included in this review illustrate the urgent need for a range of better-quality primary data in economic analyses of Strep A prevention and treatment modalities.

• #98 Modalities of group A streptococcal prevention and treatment and their economic justification | npj Vaccines

  https://www.nature.com/articles/s41541-023-00649-3

  Economic modelling can support decision making on these issues by outlining the costs and benefits of different Strep A control strategies. […] This review compiles evaluations of Strep A treatment or prevention strategies that included an economic analysis. […] Supporting decision makers with clear, economic justification for strategies to prevent the burden of Strep A infection is hindered by a range of issues. […] The absence of studies addressing key issues in Strep A control was revealing. For example, there were no economic evaluations for primordial prevention of infection by addressing environmental or social factors or hygiene infrastructure or behaviours. […] This review highlights a range of issues in economic analysis for Strep A treatment and prevention modalities. […] Studies included in this review illustrate the urgent need for a range of better-quality primary data in economic analyses of Strep A prevention and treatment modalities.

• #99 Preventing Group A Strep Infection | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/prevention/index.html

  There’s no vaccine to prevent group A strep infections. […] However, there are things people can do to protect themselves and others. […] Group A strep prevention activities vary by disease, but generally focus on three important goals: Limit exposure and spread of bacteria, Treat group A strep infections, Use preventive antibiotics when appropriate. […] Take antibiotics, if prescribed. Antibiotics treat the infection and help prevent serious complications, like rheumatic fever. They also prevent the bacteria from spreading to others. […] Preventive antibiotics help protect people with rheumatic fever from getting it again. They may need preventive antibiotics over a period of many years (often until 21 years old). Preventive antibiotics can include daily antibiotics by mouth or a shot into the muscle every few weeks. […] For patients with a serious infection, healthcare providers may give antibiotics to close contacts if they are 65 years or older or have other factors that increase their risk of getting a serious group A strep infection.

• #100 Invasive group A streptococcal disease: Management and chemoprophylaxis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2912623/

  Given the potentially devastating consequences of severe invasive group A streptococcal disease, attention has been directed toward the role of chemoprophylaxis and the optimization of management strategies. […] The present document summarizes key components of the recommendations for use by Canadian physicians. […] In 2006, Canadian guidelines were developed to address the prevention and control of invasive disease due to group A streptococcus (GAS). […] With respect to the role of chemoprophylaxis, the Canadian guidelines suggest the following: Chemoprophylaxis should only be offered to close contacts of a confirmed case of severe GAS, and to close contacts who have been exposed to the case during the period from seven days before the onset of symptoms in the case to 24 h after the initiation of antimicrobial therapy in the case.

• #101 Group A Streptococcal (GAS) Infection Symptoms, Treatment, Strep A & Vaccines

  https://www.medicinenet.com/streptococcal_infections/article.htm

  Early treatment of deep infections (for example, excision, drainage, and antibiotic treatment of rectal abscesses) helps prevent invasive GAS disease. Besides, appropriate and timely removal of tampons and surgical packing may reduce the incidence of toxic shock syndrome. […] Currently, there is no vaccine commercially available for GAS, but researchers are working on developing vaccines. At least four different major approaches are being researched. There has been some success with a related experimental vaccine against GAS bacterial antigens coupled to cholera toxin subunits. However, the GAS vaccine, by Vaxent, a vaccine company, prepared by recombinant technology, maybe going into human clinical trials. The new experimental vaccines may become available in the future to prevent GAS infections.

• #102

  https://www.nbcnews.com/health/health-news/invasive-strep-infections-doubled-us-cdc-study-finds-rcna199759

  The study calls for accelerated efforts to prevent and control infections. […] Doctors said the rise in group A strep infections also points to the need for a vaccine, especially given the rise in antibiotic resistance.

• #103 Invasive group A streptococcal infections: management of household contacts

  https://www.rch.org.au/clinicalguide/guideline_index/Invasive_Group_A_Streptococcal_Infections__management_of_household_contacts/

  Invasive Group A Streptococcal disease (iGAS) is associated with significant morbidity and mortality. […] There is an increased risk of secondary cases of iGAS in household contacts of an index case. […] Inform household contacts about the clinical features of iGAS and provide chemoprophylaxis as soon as possible. […] Some experts and guidelines recommend antibiotic chemoprophylaxis to reduce the risk of iGAS in household contacts, although this has not been studied extensively. […] Regardless of whether chemoprophylaxis is prescribed, all household contacts should be educated about their increased risk of iGAS and the early signs and symptoms of iGAS that require prompt medical evaluation.

• #104 What doctors wish patients knew about strep throat | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-strep-throat

  If your child is having difficulty swallowing and maintaining adequate hydration or they’re complaining that it hurts a lot to drink fluids, that might be a sign that their throat is in a significant amount of pain that we want to make sure to get checked out. […] It’s important for families to realize the complications to watch out for when it comes to strep throat or improperly treated strep throat. […] These include complications such as abscesses or more serious infection in your tonsils or close to your tonsils. […] Rheumatic fever is also a complication to watch out for.

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