Primary prevention
Your Organizational Guidance
ebpracticenet urges you to prioritize the following organizational guidance:
Acute KeelpijnPublished by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2017Mal de gorge aiguPublished by: Groupe de Travail Développement de recommmandations de première ligneLast published: 2017The only indication for prophylactic antibiotics is in patients with a history of rheumatic heart disease. To prevent the spread of Group A Streptococcus (GAS) infection, good hand hygiene and respiratory etiquette are recommended.[4] In countries with low vaccination rates, diphtheria and measles are possible causes of acute pharyngitis. Measles can be prevented by immunization with a live virus vaccine and, therefore, encouraging uptake of the MMR (measles, mumps, and rubella) vaccine is a crucial prevention strategy.[23]
Corynebacterium diphtheriae is a cause of pharyngitis and is of particular concern for travelers to areas where vaccination programs are not well established or have failed.[8] Therefore, children should be vaccinated for diptheria as part of the routine immunization schedule. Travelers to areas with endemic diphtheria should have their vaccination status reviewed and updated if necessary prior to departing.[24]
Consult your local immunization protocols for more information on vaccine schedules.
Secondary prevention
The only situation where antibiotic prophylaxis is provided for group A Streptococcus (GAS) is in individuals with a history of rheumatic fever in order to prevent rheumatic heart disease. The World Health Organization recommends intramuscular benzathine penicillin G over many years to prevent further infection and damage to heart valves.[77]
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