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Recurrent group A streptococcal tonsillopharyngitis

M E Pichichero¹, J L Green, A B Francis

¹Elmwood Pediatric Group, Rochester, NY 14642, USA. mepo@uhura.cc.rochester.edu

The Pediatric Infectious Disease Journal

|October 21, 1998

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Recurrent group A beta-hemolytic streptococcal tonsillopharyngitis is increasing, particularly in young children. Penicillin treatment shows higher recurrence rates compared to alternative antibiotics.

Area of Science:

Pediatric infectious diseases
Epidemiology of bacterial infections

Background:

Recurrent tonsillopharyngitis caused by group A beta-hemolytic streptococcus (GABHS) presents a persistent challenge in pediatric care.
Understanding the trends and treatment outcomes of GABHS infections is crucial for effective management.

Purpose of the Study:

To investigate the epidemiology and treatment patterns of recurrent GABHS tonsillopharyngitis in pediatric private practice.
To analyze changes in recurrence rates over time and identify risk factors.

Main Methods:

Retrospective chart review of 2140 GABHS episodes from 1975 to 1996.
Diagnosis confirmed by clinical symptoms and laboratory tests (throat culture or rapid antigen detection test).

Main Results:

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Recurrence rates within 30 days post-treatment increased significantly from 1975-1979 (9%) to 1995-1996 (25.9%).
Younger children (1-8 years) experienced higher recurrence rates (21.3%) than adolescents (5%).
Penicillin treatment was associated with higher recurrence rates compared to cephalosporins or macrolides.

Conclusions:

GABHS recurrences have become more frequent in the 1990s compared to the 1970s.
Age is a significant factor, with younger children being more susceptible to recurrent infections.
Alternative antibiotic therapies may be more effective in preventing GABHS recurrences than penicillin.