Time to negative throat culture following initiation of antibiotics for pharyngeal group A
Disease Transmission
Group A Strep Infection
Infectious
Infectious Disease Outbreaks
Streptococcal
Streptococcus pyogenes
Journal
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
ISSN: 1560-7917
Titre abrégé: Euro Surveill
Pays: Sweden
ID NLM: 100887452
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
medline:
17
4
2023
entrez:
13
4
2023
pubmed:
14
4
2023
Statut:
ppublish
Résumé
BackgroundPublic health guidance recommending isolation of individuals with group A streptococcal (GAS) infection or carriage for 12-24 h from antibiotic initiation to prevent onward transmission requires a strong evidence base.AimTo estimate the pooled proportion of individuals who remain GAS culture-positive at set intervals after initiation of antibiotics through a systematic literature review (PROSPERO CRD42021290364) and meta-analysis.MethodsWe searched Ovid MEDLINE (1946-), EMBASE (1974-) and Cochrane library. We included interventional or observational studies with ≥ 10 participants reporting rates of GAS throat culture positivity during antibiotic treatment for culture-confirmed GAS pharyngitis, scarlet fever and asymptomatic pharyngeal GAS carriage. We did not apply age, language or geographical restrictions.ResultsOf 5,058 unique records, 43 were included (37 randomised controlled studies, three non-randomised controlled trials and three before-and-after studies). The proportion of individuals remaining culture-positive on day 1, day 2 and days 3-9 were 6.9% (95% CI: 2.7-16.8%), 5.4% (95% CI: 2.1-13.3%) and 2.6% (95% CI: 1.6-4.2%). For penicillins and cephalosporins, day 1 positivity was 6.5% (95% CI: 2.5-16.1%) and 1.6% (95% CI: 0.04-42.9%), respectively. Overall, for 9.1% (95% CI: 7.3-11.3), throat swabs collected after completion of therapy were GAS culture-positive. Only six studies had low risk of bias.ConclusionsOur review provides evidence that antibiotics for pharyngeal GAS achieve a high rate of culture conversion within 24 h but highlights the need for further research given methodological limitations of published studies and imprecision of pooled estimates. Further evidence is needed for non-beta-lactam antibiotics and asymptomatic individuals.
Identifiants
pubmed: 37052678
doi: 10.2807/1560-7917.ES.2023.28.15.2200573
pmc: PMC10103550
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
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