INFLUENCE OF PENICILLINASE-PRODUCING STAPHYLOCOCCI ON THE ERADICATION OF GROUP A STREPTOCOCCI FROM THE UPPER RESPIRATORY TRACT BY PENICILLIN TREATMENT

PEDIATRICS ◽  
1966 ◽  
Vol 37 (3) ◽  
pp. 467-476 ◽  
Author(s):  
Paul G. Quie ◽  
Howard C. Pierce ◽  
Lewis W. Wannamaker
Keyword(s):  
Respiratory Tract ◽  
Respiratory Illness ◽  
Penicillin G ◽  
Group A Streptococci ◽  
Upper Respiratory Tract ◽  
Benzathine Penicillin G ◽  
Group A ◽  
Upper Respiratory ◽  
Penicillin Treatment

Penicillinase-producing strains of S. aureus were isolated from the upper respiratory tract of 28% of a group of children presenting with signs or symptoms of respiratory illness and group A streptococci on cultures from the pharynx or anterior nares. Although group A streptococci were found in 10% of the children 14 to 30 days after penicillin treatment, no correlation was found between the presence of penicillinase-producing S. aureus initially or at follow-up and re-isolation of group A streptococci. There was no suggestion from these studies that antibiotic therapy aimed at penicillin-resistant staphylococci would be of any greater value than intramuscular benzathine penicillin G for the treatment of patients with group A streptococci in the upper respiratory tract.

Significance of Quantitative Salivary Cultures for Group A and Non-group A β-Hemolytic Streptococci in Patients with Pharyngitis and in Their Family Contacts

PEDIATRICS ◽  
1979 ◽  
Vol 64 (6) ◽  
pp. 904-912
Author(s):  
Edward L. Kaplan ◽  
Robert Couser ◽  
Barbara Ballard Huwe ◽  
Carolyn Mckay ◽  
Lewis W. Wannamaker
Keyword(s):  
Antibody Response ◽  
Respiratory Tract ◽  
Group A Streptococci ◽  
Upper Respiratory Tract ◽  
C Reactive Protein ◽  
Throat Culture ◽  
Reactive Protein ◽  
Group A ◽  
Bona Fide ◽  
Upper Respiratory

One hundred ninety-six individuals, 86 with clinically overt pharyngotonsillitis and 110 of their clinically negative contacts were studied to evaluate the sensitivity and the specificity of quantitative saliva cultures for group A β-hemolytic streptococci. We also compared this technique with semiquantitative throat cultures as a means of isolating group A streptococci and of differentiating the streptococcal carrier state from patients with bona fide streptococcal upper respiratory tract infection as defmed by the presence of an antibody response. The data indicate that the throat culture is a more reliable means of identifying group A β-hemolytic streptococci in the upper respiratory tract than is the saliva culture. The converse is true for non-group A β-hemolytic streptococci; the saliva culture is a much better means for isolating these organisms. In individuals positive by both techniques we found good correlation between the degree of positivity of the saliva culture and the degree of positivity of the throat culture. Furthermore, while there was a definite trend for individuals with strongly positive cultures to demonstrate more often an antibody rise in either antistreptolysin O and/or antideoxynibonuclease B—indicating bona fide infection—this relationship was not sufficiently constant to provide a clear differentiation. This study also indicates that discordance (one positive, one negative) of simultaneous duplicate semiquantitative throat cultures is much more common among individuals who do not show an antibody response ("carriers") than among those with an antibody response (bona fide infection). This study confirms our previous observations suggesting that the presence of C-reactive protein in the serum of patients with a positive culture for group A streptococci and clinical signs and symptoms of pharyngitis is often an indication of true streptococcal upper respiratory tract infection, and that even with a positive saliva culture at the initial visit, a negative C-reactive protein is only infrequently (25%) associated with an antibody response.

Comparison of Erythromycin Ethyl Succinate, Stearate and Estolate Treatments of Group A Streptococcal Infections of the Upper Respiratory Tract

1975 ◽  
Vol 14 (12) ◽  
pp. 1098-1110 ◽  
Author(s):  
R. S. Janicki ◽  
J. C. Garnham ◽  
M. C. Worland ◽  
W. E. Grundy ◽  
J. R. Thomas
Keyword(s):  
Respiratory Tract ◽  
Oral Treatment ◽  
Upper Respiratory Tract ◽  
Streptococcal Infections ◽  
Acute Group ◽  
Clinical Responses ◽  
Group A ◽  
Upper Respiratory ◽  
Initiation Of Therapy

The microbiologic and clinical responses of acute Group A beta-hemolytic streptococcal infections of the upper respiratory tract to oral treatment with erythromycin ethyl succinate, stearate, and estolate were studied in 303 patients. Streptococcal M and T typing was done on all positive cultures. The overall cure rate was 95.4 per cent, with no statistically significant differences in clearing organisms from the pharynx. Of the 285 cured patients who completed the prescribed follow-up period, 11 had recurrences between the 12th and 31st day after initiation of therapy, and five developed new infections. No cases of rheumatic fever or glomerulonephritis were encountered during a follow-up study. Eight gastrointestinal reactions and one transient rash occurred. Results with these forms of erythromycin compare favorably with published results for similar infections treated with oral penicillins.

Impact of single dose azithromycin on group A streptococci in the upper respiratory tract and skin of Aboriginal children

2002 ◽  
Vol 21 (5) ◽  
pp. 375-380 ◽  
Author(s):  
TANIA M. SHELBY-JAMES ◽  
AMANDA J. LEACH ◽  
JONATHAN R. CARAPETIS ◽  
BART J. CURRIE ◽  
JOHN D. MATHEWS
Keyword(s):  
Single Dose ◽  
Respiratory Tract ◽  
Group A Streptococci ◽  
Upper Respiratory Tract ◽  
Group A ◽  
Upper Respiratory ◽  
Aboriginal Children

scholarly journals Inhibitory substances produced byStreptococcus salivariusand colonization of the upper respiratory tract with group A streptococci

1989 ◽  
Vol 102 (3) ◽  
pp. 401-412 ◽  
Author(s):  
W. Charles Huskins ◽  
Edward L. Kaplan
Keyword(s):  
Respiratory Tract ◽  
Therapy Group ◽  
Group A Streptococci ◽  
Upper Respiratory Tract ◽  
Viridans Streptococci ◽  
Total Percentage ◽  
Group I ◽  
Group A ◽  
Upper Respiratory ◽  
Group Ii

SUMMARYIt has been proposed that inhibitory substances produced by viridans streptococci colonizing the upper respiratory tract aid in cradication of established group A streptococcal colonization of that site. We studied the prevalence of inhibitory-substance producing strains ofStreptococcus salivariusin throat cultures from three groups of children: 16 children with persistently positive throat cultures for group A streptococci despite receiving recommended therapeutic courses of antibiotics (group I). 26 children from whom group A streptococci were eradicated from the upper respirator tract by antibiotic therapy (group II). and 18 children who never harboured group A streptococci in their upper respiratory tract during the study period (group Ill). An vitro deferred antagonism method was employed to detect inhibitory substances: 5233 strains ofS. salivariuswere examined. Strains ofS. salivariusproducing inhibitory substances were isolated from 76−88% of the children in each group on at least one occasion.However, only a small percentage of subjects in each group harboured strains producing these substances in every throat culture. The mean total percentage ofS. salivariusstrains producing inhibitory substances was 21·8% in children in group 1·22.4 % in children in group II. and 16.4% in children in group III: these percentages were not statistically different (P > 0·1). In this study, we could not confirm a significant role for inhibitory substances produced byS. salivariusin the eradication of group A streptococci from the upper respiratory tract of colonized individuals.

Effects of procalcitonin testing on antibiotic use and clinical outcomes in patients with upper respiratory tract infections. An individual patient data meta-analysis

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Jonas Odermatt ◽  
Natalie Friedli ◽  
Alexander Kutz ◽  
Matthias Briel ◽  
Heiner C. Bucher ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Therapy ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Antibiotic Exposure ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Restricted Activity ◽  
Tract Infections

AbstractBackground:Several trials found procalcitonin (PCT) helpful for guiding antibiotic treatment in patients with lower respiratory tract infections and sepsis. We aimed to perform an individual patient data meta-analysis on the effects of PCT guided antibiotic therapy in upper respiratory tract infections (URTI).Methods:A comprehensive search of the literature was conducted using PubMed (MEDLINE) and Cochrane Library to identify relevant studies published until September 2016. We reanalysed individual data of adult URTI patients with a clinical diagnosis of URTI. Data of two trials were used based on PRISMA-IPD guidelines. Safety outcomes were (1) treatment failure defined as death, hospitalization, ARI-specific complications, recurrent or worsening infection at 28 days follow-up; and (2) restricted activity within a 14-day follow-up. Secondary endpoints were initiation of antibiotic therapy, and total days of antibiotic exposure.Results:In total, 644 patients with a follow up of 28 days had a final diagnosis of URTI and were thus included in this analysis. There was no difference in treatment failure (33.1% vs. 34.0%, OR 1.0, 95% CI 0.7–1.4; p=0.896) and days with restricted activity between groups (8.0 vs. 8.0 days, regression coefficient 0.2 (95% CI –0.4 to 0.9), p=0.465). However, PCT guided antibiotic therapy resulted in lower antibiotic prescription (17.8% vs. 51.0%, OR 0.2, 95% CI 0.1–0.3; p<0.001) and in a 2.4 day (95% CI –2.9 to –1.9; p<0.001) shorter antibiotic exposure compared to control patients.Conclusions:PCT guided antibiotic therapy in the primary care setting was associated with reduced antibiotic exposure in URTI patients without compromising outcomes.

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