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19 Cards in this Set
- Front
- Back
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Diagnosis of GAS Pharyngitis?
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RADT: rapid antigen detection test and/or culture.
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If RADT is negative, what should be done.
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Throat culture should done in children > 3 and adolescents. 24 hours incubation if negative 48hours
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If RADT is positive should culture be done?
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No. RADT test is highly specific.
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Are clinical features useful in diagnosis of GAS pharyngitis?
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Clinical features do not reliably discriminate between GAS and viral pharyngitis except when overt viral features like rhinorrhea, cough, oral ulcers and/or horsiness are present. (viral)
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Age groups with less risk of GAS Pharyngitis?
Age group mostly seen in? |
adults and children < 3
5-15 |
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Treatment of GAS Pharyngitis? Why is one preferred over the other? For how long?
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Eradicate organism from throat: Penicillin or amoxicillin. Amoxicillin taste better, equally effective, once daily dosing available. X10 days.
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Treatment of GAS Pharyngitis in the penicillin allergic patient?
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First generation cephalosporin (if not anaphylactic to Penicillin), Clindamycin 1% Resistence, Clarithromycin 8%R or all for 10 days except Azithromycin 8%R 5 days (5 days not as effective at eradicating GAS
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Most common Bacterial cause of Acute pharyngitis?
Most common cause of pharyngitis? |
GAS 5-15% Adults, 20-30% Children.
Viruses |
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GAS related post infection disorders ?
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Acute Rheumatic Fever, carditis, post streptococcal glomerulonephritis.
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Percent of patients with sore throats that receive patients versus patients who likely have GAS pharyngitis.
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70%
20-30% |
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most common months for GAS Pharyngitis
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November to May, Winter to early spring.
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Incidence of penicillin-resistance to GAS?
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None documented
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Should short course cephalosporins be used?
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Not endorsed at this time. They have a broader spectrum the penicillin and are more expensive.
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Antibiotic choice for patient unlikely to comply for 10 days?
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IM benzathine penicillin G.
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Antibiotics that should not be used for gas?
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Tetracyclines-resistance. Bactrim doesn’t eradicate GAS in pharyngitis. Older quinolines, cipro, limited activity against GAS. New quinolines, levo and moxi, active in vitro but expensive and too broad spectrum.
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Adjunctive Therapy?
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Acetaminophen works, but not as effective as ibuprofen. Corticosteroids decrease duration and severity of signs and sx, by about 5 hours, but not recommended. Asprin avoid in children.
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Should asymptomatic GAS carriers be treated with antibiotics?
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Not usually. They typically do not spread the disease nor develop it. They usually develop viral infections.
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If necessary to treat GAS Carriers, which antibiotics should you use?
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Not usually. If treatment is necessary, use Clindamycin, penicillin and rifampin, amoxicillin clavulanic acid or Benzanthine penicillin + rifampin. Failures with amoxicillin and penicillin.
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Is GAS contagious?
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Yes. If patient goes on to develop symptoms, up to one third of persons in a semi close community may develop symptomatic pharyngitis during an outbreak. Carriers are unlikely to spread the infection.
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