title: [Controversies on antibiotics for common group A streptococcus infections].
abstract: Management of common group A streptococcus (GAS) infections remains controversial. French recommendations advocate systematic treatment of streptococcal tonsillitis after confirmation by rapid diagnostic test. Oral amoxicillin twice daily for 6 days is the first-line treatment. Antibiotic prophylaxis is restricted to at-risk patients after contact with invasive GAS case. These recommendations take into consideration the prevention of complications, even if they are rare, the reduction of infectiousness and the reduction of the duration of symptoms. Different recommendations have been issued in other countries, particularly in Europe and are based on different considerations. These differences do not originate in the absence of demonstrative scientific studies but rather in societal considerations, themselves guided by the history of each different health system (and also judicial system). This is probably necessary to obtain physicians and public support. The French attitude reflects these considerations. However, its lack of enforcement needs to question about its origins.
authors.affiliation: Service de pédiatrie, hôpital Armand-Trousseau, université Pierre-et-Marie-Curie - Paris 6, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France; ACTIV (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France; Groupe de pathologie infectieuse pédiatrique (GPIP) de la Société française de pédiatrie, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France. Electronic address: emmanuel.grimprel@trs.aphp.fr.
authors.forename: E
authors.initials: E
authors.lastname: Grimprel
authors.affiliation: Unité court séjour, petits nourrissons, service de néonatologie, CHI de Créteil, 40, avenue de Verdun, 94010 Créteil, France; ACTIV (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France; Centre de recherche clinique (CRC) et Centre hospitalier intercommunal (CHI), 40, avenue de Verdun, 94010 Créteil, France; Groupe de pathologie infectieuse pédiatrique (GPIP) de la Société française de pédiatrie, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France.
authors.forename: R
authors.initials: R
authors.lastname: Cohen
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D003657:Decision Making; D005602:France; D006801:Humans; D017410:Practice Guidelines as Topic; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy*; D013297:Streptococcus pyogenes
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin