Incidence of streptococcal carriers in private pediatric practice

Objective: To determine the incidence of group A beta-hemolytic streptococc us (GABHS) carriers in children who are well, in children seen with presume d and documented viral illnesses with sore throat, and in children after tr eatment of acute GABHS tonsillopharyngitis with 10 days of oral penicillin V potassium, oral cephalosporins, or macrolides. Methods: Prospective collection of clinical and microbiologic data from Oct ober 1996 to June 1997 in a private pediatric practice were obtained from c hildren who were asymptomatic and well, from children with both presumed la nd documented) viral sore throats, and from children who had completed a fu ll antibiotic treatment course for acute GABHS throat infections. Results: The incidence of GABHS carriers was 2.5% among well children (n = 227), 4.4% among children with upper respiratory tract infections including sore throat of presumed viral etiology (n = 296), and 6.9% among children with upper respiratory tract infections including sore throat from whom vir uses were isolated (n = 87). Following 10 days' treatment of acute GABHS to nsillopharyngitis, 81 (11.3%) of 718 children treated with penicillin, 22 ( 4.3%) of 508 children treated with an oral cephalosporin, and 10 (7.1%) of 140 children treated with a macrolide were GABHS carriers (P<.001). Conclusions: A small percentage of children seen in private pediatric pract ices who ale well or who have apparent viral upper respiratory tract infect ions with sore throat are GABHS carriers. Penicillin treatment of acute GAB HS tonsillopharyngitis results in a higher GABHS carriage rate than occurs following treatment with cephalosporins and macrolides.