Evaluation of short-course therapy with cefixime or rifampin for eradication of pharyngeally carried group a streptococci

The Ontario GAS Study Group

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Therapy to eradicate pharyngeally carried group A streptococci (GAS) has increasingly been used in the management of institutional outbreaks and is now recommended for household contacts of patients with streptococcal toxic shock syndrome. In this randomized, controlled trial, contacts of patients with GAS infections were screened for pharyngeal GAS colonization. Those whose cultures were positive were randomized to receive either cefixime (8 mg/[kgd]; maximum 400 mg) or rifampin (20 mg/kg; maximum, 600 mg) once a day for 4 days. Two to five days following completion of therapy, repeated cultures were negative for 13 (38%) of 34 rifampin recipients and 71 (77%95% CI, 69%–85%) of 97 cefixime recipients. At 10—14 days after treatment, only 53% of cefixime recipients remained culture-negative. Rates of successful clearance improved with increasing age (P <.01); among 17 adults who received cefixime, the success rate was 94%. Four days of therapy with rifampin is not effective for eradication of pharyngeally carried GAS. Four days of therapy with cefixime may be effective for adults, but further studies are needed.

Original languageEnglish (US)
Pages (from-to)1294-1296
Number of pages3
JournalClinical Infectious Diseases
Volume21
Issue number5
DOIs
StatePublished - Nov 1995

Fingerprint

Cefixime
Rifampin
Streptococcus
Therapeutics
Septic Shock
Disease Outbreaks
Randomized Controlled Trials
Infection

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Evaluation of short-course therapy with cefixime or rifampin for eradication of pharyngeally carried group a streptococci. / The Ontario GAS Study Group.

In: Clinical Infectious Diseases, Vol. 21, No. 5, 11.1995, p. 1294-1296.

Research output: Contribution to journalArticle

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abstract = "Therapy to eradicate pharyngeally carried group A streptococci (GAS) has increasingly been used in the management of institutional outbreaks and is now recommended for household contacts of patients with streptococcal toxic shock syndrome. In this randomized, controlled trial, contacts of patients with GAS infections were screened for pharyngeal GAS colonization. Those whose cultures were positive were randomized to receive either cefixime (8 mg/[kgd]; maximum 400 mg) or rifampin (20 mg/kg; maximum, 600 mg) once a day for 4 days. Two to five days following completion of therapy, repeated cultures were negative for 13 (38{\%}) of 34 rifampin recipients and 71 (77{\%}95{\%} CI, 69{\%}–85{\%}) of 97 cefixime recipients. At 10—14 days after treatment, only 53{\%} of cefixime recipients remained culture-negative. Rates of successful clearance improved with increasing age (P <.01); among 17 adults who received cefixime, the success rate was 94{\%}. Four days of therapy with rifampin is not effective for eradication of pharyngeally carried GAS. Four days of therapy with cefixime may be effective for adults, but further studies are needed.",
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