Family doctor warned of ‘low threshold’ for antibiotics in potential streptococcal infection

GPs are advised to “lower the threshold” when prescribing antibiotics to children exhibiting symptoms associated with group A streptococcal infections.

UK public health officials have issued advice across primary care, emergency and pediatric services amid concerns over high levels of infections and six child deaths since September.

GP consultations for scarlet fever and sickness notification, as well as invasive group A streptococcal cases, have increased more sharply than expected for this time of year, although to a lesser extent, UK Health Security Agency warns.

Officials are also investigating an increase in children with lower respiratory group A streptococcal infections, particularly empyema, in the past few weeks.

In an urgent letter to GPs, UKHSA said: We characterize GAS infections, including locations secondary to viral respiratory illness.

Parents of children with viral infections, such as influenza and chickenpox, should be advised about signs suggesting secondary bacterial infections.

“General practitioners should maintain low thresholds for rapid referral to secondary care for children with persistent or worsening symptoms,” he continued.

“The high burden of co-circulating viral infections may contribute to the increased severity and complications from co-infections,” according to the letter.

And GPs should “to assist in differential diagnosis, or if a patient is considered part of an outbreak (to confirm etiology), if allergic to penicillin (to determine antimicrobial susceptibility). , or if you believe you have been in regular contact with a vulnerable individual, you should consider taking a throat swab.”

A total of 4,622 scarlet fever notifications were received in the UK from week 37 to week 46 of the current season (2022-2023), with 851 notifications received in week 46. 37 to 46), UKHSA figures for the last five years show.

There is considerable variation across England, with the highest rates found in the North West.

Laboratory notifications for invasive Group A streptococcal infections are also higher than 509 compared to 248 seen in the last five years. The highest incidences to date have been reported in Yorkshire and Humberside.

In a report published on Friday outlining current disease trends, UKHSA also advised: Recognition and prompt initiation of specific supportive care for patients with iGAS infection can save lives.

Professor Adam Finn, Professor of Pediatrics at the University of Bristol, said: If the infection is detected earlywhich can usually be effectively treated with penicillin.

“Many infections became rare during the recent pandemic restrictions and are now rapidly returning as the mix normalizes. GAS is no exception, with cases rising in recent months.

Dr Michael Head, Senior Fellow of Global Health at the University of Southampton, said that while public health surveillance showed an increase in cases of scarlet fever and invasive group A streptococcal infections, there were more cases than typically seen at this time of year. Full-year case numbers were higher in 2017/18.

“After the past two-and-a-half years of dealing with the pandemic, we may not yet be back to our normal seasonal forecasts, and we are generally observing natural fluctuations in disease patterns.

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