title: Invasive group A streptococcal disease: should close contacts routinely receive antibiotic prophylaxis?
abstract: Group A streptococci (Streptococcus pyogenes) causes a wide range of illnesses from non-invasive disease--eg, pharyngitis--to more severe invasive infections--eg, necrotising fasciitis and toxic shock-like syndrome. There remains uncertainty about the risk of secondary cases of invasive disease occurring among close contacts of an index case and how best to manage that risk. We do not consider that currently available evidence justifies the routine administration of chemoprophylaxis to close contacts. We suggest that the appropriate response should be to routinely inform all household contacts of a patient with invasive group A streptococcal disease about the clinical manifestations of invasive disease and to seek immediate medical attention if they develop such symptoms.
authors.affiliation: Health Protection Agency, Centre for Infections, London, UK. alan.smith@hpa.org.uk
authors.forename: A
authors.initials: A
authors.lastname: Smith
authors.forename: T L
authors.initials: TL
authors.lastname: Lamagni
authors.forename: I
authors.initials: I
authors.lastname: Oliver
authors.forename: A
authors.initials: A
authors.lastname: Efstratiou
authors.forename: R C
authors.initials: RC
authors.lastname: George
authors.forename: J M
authors.initials: JM
authors.lastname: Stuart
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D013297:Streptococcus pyogenes / Q000145:classification / Q000472:pathogenicity
chemical_list: D000900:Anti-Bacterial Agents