Strep Stuff

[Chemar]

http://firstwatch.jwatch.org/cgi/content/full/2009/227/2

 

 

 

I could not believe here that would suggest that "treatment for chronic strep carriers is not warranted"

http://www.aafp.org/afp/20090301/383-s1.html

 

here is the Physician's First Watch newsletter piece:

 

American Family Physician offers a review of streptococcal pharyngitis diagnosis and treatment.

 

Among the clinical recommendations:

 

• Using clinical decision rules, such as the modified Centor score, to diagnose group A beta-hemolytic streptococcus can reduce unnecessary treatment and cost.
  
• Penicillin is the preferred antibiotic for streptococcal pharyngitis.
  
• Treatment for chronic streptococcus carriers is usually not warranted.
  

The review also presents dosing guidelines for penicillin and other antibiotics for both children and adults.

 

Last week, Physician's First Watch covered the American Heart Association's updated guidelines, which differ from AFP's on the matter of the sensitivity of rapid antigen tests versus throat culture in confirming a diagnosis. AFP's guidelines say the newer assays are over 90% sensitive and that the costs of added testing and follow-up, along with possible overuse of antibiotics, "are valid reasons why back-up cultures are not routinely performed."