title: Oral erythromycin prophylaxis against Streptococcus pyogenes infection in penicillin-allergic military recruits: a randomized clinical trial.
abstract: Historically, military recruits have required benzathine penicillin G to prevent epidemics of Streptococcus pyogenes. In this randomized clinical trial, low-dose oral erythromycin was evaluated as an alternative for prophylaxis against group A beta-hemolytic streptococci in penicillin-allergic recruits. US Marine Corps recruits (186) reporting penicillin allergy were randomly given either oral erythromycin (250 mg twice a day) or a vitamin (one tablet daily) for 60 days. Evidence of infection was defined as a two-dilution rise in anti-streptolysin O titer. The erythromycin group had a significantly lower risk of S. pyogenes infection than did the vitamin group (relative risk 0.44; 95% confidence interval, 0.22-0.89). There was no significant difference among the treatment groups in isolation of group A beta-hemolytic streptococci from throat cultures. Low-dose oral erythromycin appears as effective as benzanthine penicillin G in preventing S. pyogenes infection.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore.
authors.forename: J
authors.initials: J
authors.lastname: Fujikawa
authors.forename: J P
authors.initials: JP
authors.lastname: Struewing
authors.forename: K C
authors.initials: KC
authors.lastname: Hyams
authors.forename: E L
authors.initials: EL
authors.lastname: Kaplan
authors.forename: A K
authors.initials: AK
authors.lastname: Tupponce
authors.forename: G C
authors.initials: GC
authors.lastname: Gray
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000989:Antistreptolysin / Q000097:blood; D004342:Drug Hypersensitivity; D004917:Erythromycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008889:Military Personnel; D010349:Patient Compliance; D010406:Penicillins / Q000009:adverse effects; D010614:Pharynx / Q000382:microbiology; D013290:Streptococcal Infections / Q000517:prevention & control*; D013297:Streptococcus pyogenes / Q000187:drug effects*; D014481:United States
chemical_list: D010406:Penicillins; D004917:Erythromycin; D000989:Antistreptolysin