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Choosing Wisely: Effectiveness and Safety of Antibiotic Prophylaxis in Close Contacts of Invasive Group A
Marina G Birck1,2, Cristiano S Moura1, Kevin L Winthrop3
1Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
Abstract:
Antibiotic prophylaxis is often recommended for close contacts of index cases of invasive Streptococcus pyogenes infections. Using MarketScan data (2010-2019), we found no difference in infection rates between those who received and those who did not receive antibiotics but a 3-fold increased risk of adverse events in those who did receive antibiotics.
Insights
Antibiotic prophylaxis for invasive Streptococcus pyogenes infections in close contacts did not reduce infection rates. However, antibiotic use was linked to a 3-fold higher risk of adverse events, questioning its routine use.
Area of Science:
- Infectious Diseases
- Pharmacology
- Public Health
Background:
- Invasive Streptococcus pyogenes infections pose significant public health risks.
- Antibiotic prophylaxis is a common strategy for close contacts of infected individuals.
Purpose of the Study:
- To evaluate the effectiveness and safety of antibiotic prophylaxis in close contacts of invasive Streptococcus pyogenes cases.
- To determine if antibiotic prophylaxis impacts subsequent infection rates and adverse event occurrences.
Main Methods:
- Retrospective analysis of MarketScan data from 2010-2019.
- Comparison of infection rates and adverse events between prophylaxis recipients and non-recipients.
Main Results:
- No significant difference in infection rates was observed between the antibiotic prophylaxis group and the no-prophylaxis group.
- A threefold increased risk of adverse events was associated with receiving antibiotic prophylaxis.
Conclusions:
- Antibiotic prophylaxis for close contacts of invasive Streptococcus pyogenes infections does not appear to reduce infection rates.
- The use of antibiotic prophylaxis in this context is associated with a higher incidence of adverse events, suggesting a need to reconsider its widespread application.
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