Different antibiotic treatments for group A streptococcal pharyngitis

Driel, Mieke van; Sutter, An IM De; Keber, Natalija; Habraken, Hilde; Christiaens, Thierry

doi:10.1002/14651858.cd004406.pub2

Cited by 35 publications

(29 citation statements)

References 74 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The highest levels of evidence within this category comes from a Cochrane review (level 1 evidence) conducted in 2013 examining the role of antibiotics in the presence of GABHS . The review included seventeen trials in its analysis (5352 total participants); 16 compared penicillin with other antibiotic agents (six with cephalosporins, six with macrolides, three with carbacephem and one with sulphonamides), with the final one comparing clindamycin with ampicillin.…”

Section: Resultsmentioning

confidence: 99%

Controversies in the management of acute tonsillitis: an evidence‐based review

Bird

Biggs

King

2014

Clinical Otolaryngology

View full text Add to dashboard Cite

Management of acute tonsillitis within a secondary care setting largely consists of anecdotal or relatively low-quality evidence. Thus, much evidence from management comes from expert opinion or practice within a primary care setting. Management across the UK can also vary greatly. An evidence-based review of best practice has been presented here, but further evidence will be required in the future examining the significance of corticosteroids and antibiotic administration in this patient cohort specifically, ensuring practice is evidence based and clinically relevant.

show abstract

Section: Resultsmentioning

confidence: 99%

Controversies in the management of acute tonsillitis: an evidence‐based review

Bird

Biggs

King

2014

Clinical Otolaryngology

View full text Add to dashboard Cite

show abstract

“…Reasons are the continuing susceptibility of GAS toward penicillin, its efficiency, safety, and the comparably low costs of penicillin treatment. 3,4,5 However, penicillin-related treatment failure has been reported repeatedly in cases of streptococcal pharyngitis. 6,7 Factors that have been discussed to be responsible for this phenomenon include the coexistence of β-lactamase–producing bacteria, 8 biofilm formation by GAS, 9 and internalization of GAS into epithelial host cells.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of Growth and Gene Expression by PNA-peptide Conjugates in Streptococcus pyogenes

Patenge

Pappesch

Krawack

et al. 2013

Molecular Therapy - Nucleic Acids

View full text Add to dashboard Cite

While Streptococcus pyogenes is consistently susceptible toward penicillin, therapeutic failure of penicillin treatment has been reported repeatedly and a considerable number of patients exhibit allergic reactions to this substance. At the same time, streptococcal resistance to alternative antibiotics, e.g., macrolides, has increased. Taken together, these facts demand the development of novel therapeutic strategies. In this study, S. pyogenes growth was inhibited by application of peptide-conjugated antisense-peptide nucleic acids (PNAs) specific for the essential gyrase A gene (gyrA). Thereby, HIV-1 Tat peptide-coupled PNAs were more efficient inhibitors of streptococcal growth as compared with (KFF)3K-coupled PNAs. Peptide-anti-gyrA PNAs decreased the abundance of gyrA transcripts in S. pyogenes. Growth inhibition by antisense interference was enhanced by combination of peptide-coupled PNAs with protein-level inhibitors. Antimicrobial synergy could be detected with levofloxacin and novobiocin, targeting the gyrase enzyme, and with spectinomycin, impeding ribosomal function. The prospective application of carrier peptide-coupled antisense PNAs in S. pyogenes covers the use as an antimicrobial agent and the employment as a knock-down strategy for the investigation of virulence factor function.

show abstract

“…34 These results from our limited number of GAS isolates indicate that narrow-spectrum penicillin should remain the mainstay of treatment for GAS pharyngitis in Thailand, as elsewhere. 11,39 It is thus a concern that none of the 53 patients with sore throat and fever who received antibiotics had received penicillin (almost all received amoxicillin). This finding is not limited to this study but was also seen in all primary care units in the same district of Chiang Rai in a previous review of antibiotic use in primary care and is consistent with the Thai antibiotic guidelines, which give the option of treatment with penicillin V or amoxicillin for GAS pharyngitis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Group A Streptococcus in Primary Care Patients and the Utility of C-Reactive Protein and Clinical Scores for Its Identification in Thailand

Greer

Althaus

Ling

et al. 2020

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Pharyngitis is usually caused by a viral infection for which antibiotics are often unnecessarily prescribed, adding to the burden of antimicrobial resistance. Identifying who needs antibiotics is challenging; microbiological confirmation and clinical scores are used but have limitations. In a cross-sectional study nested within a randomized controlled trial, we estimated the prevalence and antibiotic susceptibility profiles of group A Streptococcus (GAS) in patients presenting to primary care with a sore throat and fever in northern Thailand. We then evaluated the use of C-reactive protein (CRP) and clinical scores (Centor and FeverPAIN) to identify the presence of GAS. One hundred sixty-nine patients were enrolled, of whom 35 (20.7%) had β-hemolytic Streptococci (BHS) isolated from throat swab culture, and 11 (6.5%) had GAS. All GAS isolates were sensitive to penicillin G. The median CRP of those without BHS isolation was 10 mg/L (interquartile range [IQR] £ 8-18), compared with 18 mg/L (IQR 9-71, P = 0.0302) for those with GAS and 14 mg/L (IQR £ 8-38, P = 0.0516) for those with any BHS isolated. However, there were no significant relationships between CRP > 8 mg/L (P = 0.112), Centor ³ 3 (P = 0.212), and FeverPAIN ³ 4 (P = 1.000), and the diagnosis of GAS compared with no BHS isolation. Identifying who requires antibiotics for pharyngitis remains challenging and necessitates further larger studies. C-reactive protein testing alone, although imperfect, can reduce prescribing compared with routine care. Targeted CRP testing through clinical scoring may be the most cost-effective approach to ruling out GAS infection.

show abstract

Different antibiotic treatments for group A streptococcal pharyngitis

Cited by 35 publications

References 74 publications

Controversies in the management of acute tonsillitis: an evidence‐based review

Controversies in the management of acute tonsillitis: an evidence‐based review

Inhibition of Growth and Gene Expression by PNA-peptide Conjugates in Streptococcus pyogenes

Prevalence of Group A Streptococcus in Primary Care Patients and the Utility of C-Reactive Protein and Clinical Scores for Its Identification in Thailand

Contact Info

Product

Resources

About