Disease streptococcal

The antibiotic of choice for group B streptococcal disease is penicillin G, although ampicillin is an alternative.43 No resistance to either agent has been reported, and their narrow spectrum of activity makes them ideal choices.43 Resistance has developed with the use of alternative choices for penicillin-allergic patients. A treatment algorithm for group B Streptococcus is shown in Fig. 44—3, and dosing recommendations are shown in Table 44-5. 

Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A. Prevention of perinatal group B streptococcal disease revised guidelines from CDC. Morb Mortal Wkly Rep (MMWR) 2002 51(RR-11 ) 1—22. 

Centers for Disease Control and Prevention. Prevention of perinatal Group B streptococcal disease. Morbidity and Mortality Weekly Report (MMWR) 2002 51(RR11) 1-22. 

Note Do not use tetracyclines for streptococcal disease unless organism has been shown to be susceptible. Tetracyclines are not the drugs of choice in treatment of any type of staphylococcal infection. 

Mohler DN. WaUin DG, Dreyfns EG. Smdies in the home treatment of streptococcal disease. 1. Eailnre of patients to take penicUhn by month. N Engl J Med 1955 252 1116-8. 

Kiessling, L.S. (1989) Tic disorders associated with evidence of invasive group A beta hemolytic streptococcal disease. Dev Med Child Neurol 31 (Suppl 59) 48. 

Increased antenatal administration of ampicillin for the prevention of neonatal group B streptococcal disease may be responsible for the higher incidence of more severe neonatal sepsis with ampicillin-resistant non-group B streptococci, without a change in the overall infection rate (203,204). 

Schrag SJ, Zell ER, Lynfield R, Roome A, Arnold KE, Craig AS, et al. A population-based comparison of strategies to prevent early-onset group B streptococcal disease in neonates. N Engl J Med 2002 347 233-9. 

A combined approach would take into account the prevalence of group A streptococcal disease (which differs by age group and geography) and history of a close contact of a well-documented case, along with clinical criteria, to aid in assessing a patient s risk of the disease. If the diagnosis cannot be excluded at this point. 

Robinson KA, Rothcock G, Phan Q, et al. Risk for severe group A streptococcal disease among patients household contacts. Emerg Infect Dis 2003 9 fotmd at www.medscape.com/viewarticle/45281 print. 

Carapetis J, Robins-Browne R, Martin D, Shelby-James T, Hogg G Increasing severity of invasive group A streptococcal disease in Australia clinical and molecular epidemiological features and identification of a new virulent M-nontypeable clone. Clin Infect Dis 1995 21 1220-1227. 

HsuehP, Wu J, TsaiP, Liu J, ChuangY, Luh K Invasive group A streptococcal disease in Taiwan is not associated with the presence of streptococcal pyrogenic exotoxin genes. Clin Infect Dis 1998 26 584-589. 

Schlievert P, Assimacopoulos A, Cleary P Severe invasive group A streptococcal disease clinical description and mechanisms of pathogenesis. J Lab Clin Med 1996 127 13-22. 

Musser, J. M. and Krause, R. M. (1998). The revival of group A streptococcal diseases, with a commentary on staphylococcal toxic shock syndrome, p. 185-218. In R.M. Krause (ed.), Emerging Infections. Academic Press, San Diego, CA. 

Zimmerman, R. A., Krushak, D. H., Wilson, E., and Douglas, J. D. (1970) Human streptococcal disease syndrome compared with observations in chimpanzees. II. Immunologic responses to induced pharyngitis and effect of treatment. J. Infect. Dis. 122, 280-289. 

SAKAI, M., KUBOTA, R., ATSUTA, s. aud KOBAYASHi, M. (1987) Vaccinatiou of rainbow trout Salmo gairdneri against P-haemolytic streptococcal disease. Nippon Suisan Gak-kaishi 53,1373-1376. 

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