GROUP-A BETA-HEMOLYTIC STREPTOCOCCI IN RHEUMATIC PATIENTS RECEIVING LONG-ACTING PENICILLIN

Objective: To detect group A b hemolytic streptococci (GAbHS) in the t hroat of rheumatic patients receiving long acting penicillin (LAP) for 2ry prophylaxis using different schedules and to compare the results of ordinary throat culture versus latex agglutination for the rapid de tection of streptococci. Patients and methods: Setting. Pediatric card iology and general pediatrics clinics, Ain Shams University Cairo, Egy pt. A prospective study on 200 rheumatic children and 100 controls: al l cases complained of sore throat. Rheumatic groups were: GI(n = 60) r eceiving LAP (Benzathine penicillin) every 3 weeks, GII (n=60) receivi ng LAP every 4 weeks, GIII (n=40) on oral penicillin (Phenoxymethyl pe nicillin), GIV (n=40) in rheumatic activity. Two throat swabs were tak en from each case one for ordinary culture and the other for latex agg lutination.Results: Latex agglutination test for rapid detection of gr oup A streptocacci had a 100% sensitivity and specificity. The biweekl y LAP regimen significantly (P<0.01) eradicated throat streptococci th an the 4 weeks and oral regimens A highly significant difference (P<0. 001) was found between the biweekly regimen and the control group as r egard the presence of GAbHS. Streptococci were the cause of pharyngiti s in 20% of controls. Conclusion: The latex agglutination test is a ra pid, sensitive and specific tool for the detection of GAbHS, LAP is st ill the corner stone for 2ry prophylaxis in rheumatic fever. The biwee kly schedule is superior to both the 4 weeks and the oral regimens in eradicating GAbHS.