The Experts below are selected from a list of 2346 Experts worldwide ranked by ideXlab platform
Jonathan R Carapetis - One of the best experts on this subject based on the ideXlab platform.
-
acute rheumatic fever and rheumatic heart disease in indigenous populations
Pediatric Clinics of North America, 2009Co-Authors: Andrew C Steer, Jonathan R CarapetisAbstract:Acute rheumatic fever and rheumatic heart disease are diseases of socioeconomic disadvantage. These diseases are common in developing countries and in Indigenous populations in industrialized countries. Clinicians who work with Indigenous populations need to maintain a high index of suspicion for the potential diagnosis of acute rheumatic fever, particularly in patients presenting with joint pain. Inexpensive medicines, such as aspirin, are the mainstay of symptomatic treatment of rheumatic fever; however, antiinflammatory treatment has no effect on the long-term rate of progression or severity of chronic valvular disease. The current focus of global efforts at prevention of rheumatic heart disease is on secondary prevention (regular administration of penicillin to prevent recurrent rheumatic fever), although primary prevention (timely treatment of Streptococcal Pharyngitis to prevent rheumatic fever) is also important in populations in which it is feasible.
-
burden of acute sore throat and group a Streptococcal Pharyngitis in school aged children and their families in australia
Pediatrics, 2007Co-Authors: Margaret Danchin, Susan Rogers, Loraine Kelpie, Gowri Selvaraj, Nigel Curtis, John B Carlin, Terence M Nolan, Jonathan R CarapetisAbstract:OBJECTIVE. The objective of this study was to determine the incidence, transmission, carriage, and risk factors for group A Streptococcal Pharyngitis in school-aged children and their families. METHODS. A 16-month, prospective, family-based cohort study was undertaken from August 2001 through December 2002 in Melbourne, Australia. A total of 202 families (853 people) with at least 1 child aged 3 to 12 years were randomly selected from 3 primary care practices across suburban Melbourne to collect surveillance data for acute group A Streptococcal Pharyngitis, including serology for index and secondary cases and intermittent carriage data. Cohort retention was 97% for 16 months. RESULTS. The incidence of acute sore throat, group A Streptococcal swab–positive Pharyngitis, and serologically confirmed group A Streptococcal Pharyngitis was 33, 13, and 8 per 100 child-years, respectively, for school-aged children (5–12 years) and 60, 20, and 15 per 100 family-years, respectively. Sore throat was less common in adults than children, but adults with sore throat were as likely as children to have group A Streptococcal culture–positive or serologically proven Pharyngitis. In families who had a primary case, 43% had at least 1 secondary case, and in family members who were at risk, 13% contracted a secondary case. The spring, summer, and winter carriage rates for children were 13%, 8%, and 16%, respectively, and for adults the rate was 2% across all seasons. CONCLUSIONS. Group A Streptococcal Pharyngitis is still common, and the peak incidence occurs in school-aged children. However, the incidence in adults is higher than expected, and the number of secondary cases in families may be an important factor when considering the potential benefits of treatment.
-
low rates of Streptococcal Pharyngitis and high rates of pyoderma in australian aboriginal communities where acute rheumatic fever is hyperendemic
Clinical Infectious Diseases, 2006Co-Authors: Malcolm I Mcdonald, Rebecca J Towers, Ross M Andrews, Norma Benger, Bart J. Currie, Jonathan R CarapetisAbstract:Background Acute rheumatic fever is a major cause of heart disease in Aboriginal Australians. The epidemiology differs from that observed in regions with temperate climates; Streptococcal Pharyngitis is reportedly rare, and pyoderma is highly prevalent. A link between pyoderma and acute rheumatic fever has been proposed but is yet to be proven. Group C beta-hemolytic streptococci and group G beta-hemolytic streptococci have also been also implicated in the pathogenesis. Methods Monthly, prospective surveillance of selected households was conducted in 3 remote Aboriginal communities. People were questioned about sore throat and pyoderma; swab specimens were obtained from all throats and any pyoderma lesions. Household population density was determined. Results From data collected during 531 household visits, the childhood incidence of sore throat was calculated to be 8 cases per 100 person-years, with no cases of symptomatic group A beta-hemolytic streptococci Pharyngitis. The median point prevalence for throat carriage was 3.7% for group A beta-hemolytic streptococci, 0.7% for group C beta-hemolytic streptococci, and 5.1% for group G beta-hemolytic streptococci. Group A beta-hemolytic streptococci were recovered from the throats of 19.5% of children at some time during the study. There was no seasonal trend or correlation with overcrowding. Almost 40% of children had pyoderma at least once, and the prevalence was greatest during the dry season. In community 1, the prevalence of pyoderma correlated with household crowding. Group C and G beta-hemolytic streptococci were rarely recovered from pyoderma lesions. Conclusions These data are consistent with the hypothesis that recurrent skin infections immunize against throat colonization and infection. High rates of acute rheumatic fever were not driven by symptomatic group A beta-hemolytic streptococci throat infection. Group G and C beta-hemolytic streptococci were found in the throat but rarely in pyoderma lesions.
Francesco Di Pierro - One of the best experts on this subject based on the ideXlab platform.
-
clinical evaluation of the oral probiotic streptococcus salivarius k12 in the prevention of recurrent Pharyngitis and or tonsillitis caused by streptococcus pyogenes in adults
Expert Opinion on Biological Therapy, 2013Co-Authors: Francesco Di Pierro, Teresa Adami, Giuliana Rapacioli, Nadia Giardini, Christian StreitbergerAbstract:Background: Streptococcus salivarius K12 has been shown to inhibit the growth of Streptococcus pyogenes due to bacteriocins release. Because of its ability to colonize the oral cavity, we have tested the strain K12 for its efficacy in preventing Streptococcal Pharyngitis and/or tonsillitis in adults. Methods: Forty adults with a diagnosis of recurrent oral Streptococcal Pharyngitis were enrolled in the study. Twenty of these subjects took for 90 days a tablet containing Streptococcus salivarius K12 (Bactoblis®). The other 20 subjects served as untreated controls. A 6-month follow-up was included to evaluate any persistent protective role. Results: The 20 adults who completed the 90-day course of Bactoblis® showed a reduction in their episodes of Streptococcal pharyngeal infection (about 80%). The 90 days treatment was also associated with an approximately 60% reduction in the incidence of reported Pharyngitis in the 6-month period following use of the product. The product was well tolerated by the subject...
-
preliminary pediatric clinical evaluation of the oral probiotic streptococcus salivarius k12 in preventing recurrent Pharyngitis and or tonsillitis caused by streptococcus pyogenes and recurrent acute otitis media
International Journal of General Medicine, 2012Co-Authors: Francesco Di Pierro, Guido Donato, Federico Fomia, Teresa Adami, Domenico Careddu, Claudia Cassandro, Roberto AlberaAbstract:Background The oral probiotic Streptococcus salivarius K12 has been shown clearly to antagonize the growth of Streptococcus pyogenes, the most important bacterial cause of pharyngeal infections in humans, by releasing two bacteriocins named salivaricin A2 and salivaricin B. Unpublished observations indicate that it can also antagonize the growth of other bacteria involved in acute otitis media. Because of its ability to colonize the oral cavity and its safety profile, we have tested its efficacy in reducing the incidence of Streptococcal Pharyngitis and/or tonsillitis and episodes of acute otitis media.
Edward L Kaplan - One of the best experts on this subject based on the ideXlab platform.
-
clinical practice guideline for the diagnosis and management of group a Streptococcal Pharyngitis 2012 update by the infectious diseases society of america
Clinical Infectious Diseases, 2012Co-Authors: Stanford T Shulman, Edward L Kaplan, Herbert W Clegg, Alan L Bisno, Michael A Gerber, Judith M Martin, Chris A Van Beneden, Robert H LurieAbstract:The guideline is intended for use by healthcare providers who care for adult and pediatric patients with group A Streptococcal Pharyngitis. The guideline updates the 2002 Infectious Diseases Society of America guideline and discusses diagnosis and management, and recommendations are provided regarding antibiotic choices and dosing. Penicillin or amoxicillin remain the treatments of choice, and recommendations are made for the penicillin-allergic patient, which now include clindamycin.
-
treatment of Streptococcal Pharyngitis with once daily compared with twice daily amoxicillin a noninferiority trial
Pediatric Infectious Disease Journal, 2006Co-Authors: Herbert W Clegg, Dwight R Johnson, Oliver F Roddey, Edward S Martin, Raymond L Swetenburg, Edward L Kaplan, Amy G. Ryan, Steven D. Dallas, James H Norton, Elizabeth W KoonceAbstract:Background:Two relatively small previous studies comparing once-daily amoxicillin with conventional therapy for group A Streptococcal (GAS) Pharyngitis reported similar rates of bacteriologic success for each treatment group. The purpose of this study was to further evaluate once-daily amoxicillin f
-
practice guidelines for the diagnosis and management of group a Streptococcal Pharyngitis
Clinical Infectious Diseases, 2002Co-Authors: Alan L Bisno, Edward L Kaplan, Richard H Schwartz, Michael A Gerber, Jack M GwaltneyAbstract:Alan L. Bisno, Michael A. Gerber, Jack M. Gwaltney, Jr., Edward L. Kaplan, and Richard H. Schwartz Department of Medicine, University of Miami School of Medicine and Veterans Affairs Medical Center, Miami, Florida; 2 Cincinnati Children’s Hospital Medical Center and University of Cincinnati School of Medicine, Ohio; University of Virginia School of Medicine, Charlottesville, Inova Fairfax Hospital for Children, Falls Church, Virginia; and Department of Pediatrics, University of Minnesota Medical School, Minneapolis
-
Streptococcal infections clinical aspects microbiology and molecular pathogenesis
2000Co-Authors: Dennis L Stevens, Edward L KaplanAbstract:Introduction 1: Floyd Denny: History of Streptococcal Infections 2: Dennis Stevens: Group A Streptococci: Virulence Factors, Pathogenesis and the Spectrum of Clinical Infection 3: Joseph Ferretti and Patrick Cleary: Group A Streptococcal Genetics 4: Patrick Schlievert, Roggiani, Aris P. Assimacopoulos: Exotoxins of Group A Streptococci 5: Stan Shulman, Robert R. Tanz, Michael Gerber: Streptococcal Pharyngitis 6: Elia Ayoub, Malak Kotb, Madelaine Cunningham: Rheumatic Fever Pathogenesis 7: Edward Kaplan, Milton Markowitz: Rheumatic Fever 8: Dennis Stevens, Bascom Anthony: Impetigo 9: Stig Holm: Post Streptococcal Glomerulonephritis 10: Dennis Stevens: Life Threatening Streptococcal Infections: bacteremia, Streptococcal toxic shock syndrome, and necrotizing fasciitis 11: Vicor Nizet, Craig Rubens, Patricia Ferrieri: Group B Streptococcal Genetics and Pathogenesis 12: Carol Baker: Group B Streptococcal Infections 13: Alan Bisno, Jose Miltoy Gaviria: Group C & G Streptococcal 14: Judy Daly: The Non-Hemolytic Streptococci 15: Diana Martin: Laboratory Evaluation of Streptococci 16: Walter Wilson: Viridans and Fastidious Strep Infections 17: Larry J. Strausbaugh, Micheal Gilmore: Enterococcal Infections 18: Barry Gray: Streptococcus pneumoniae Infections 19: Mark C. Hertzberg: Streptococcus in dental disease 20: Vincent Fischetti: Protection against Group A Streptococcal Infection 21: Jim Dale: Type Specific, Multi-valent Group A Streptococcal M protein Vaccines 22: Mike Wessels, Dennis Kasper: Group B Streptococcal Vaccines 23: David Briles: Vaccine Strategies in Streptococcus pneumoniae.
-
efficacy of cefuroxime axetil suspension compared with that of penicillin v suspension in children with group a Streptococcal Pharyngitis
Antimicrobial Agents and Chemotherapy, 1993Co-Authors: W M Gooch, Edward L Kaplan, Gerson H Aronovitz, Michael E Pichichero, Samuel Mclinn, A Kumar, M J OssiAbstract:The bacteriological and clinical efficacies of cefuroxime axetil suspension (20 mg/kg of body weight per day in two divided doses) were compared with those of penicillin V suspension (50 mg/kg/day in three divided doses) in a multicenter, randomized, evaluator-blinded study. Children aged 2 to 13 years with clinical signs and symptoms of acute Pharyngitis and a positive throat culture for group A beta-hemolytic streptococci (GABHS) were eligible. Patients were assessed and samples from the throat for culture were obtained at the time of diagnosis, 3 to 7 days after the initiation of treatment, and 4 to 8 days and 19 to 25 days after the completion of 10 days of therapy. Of the 385 evaluable patients, GABHS were eradicated from 244 of 259 (94.2%) cefuroxime-treated patients and 106 of 126 (84.1%) penicillin-treated patients (P = 0.001). Complete resolution of the signs and symptoms present at the time of diagnosis was achieved in 238 of 259 (91.9%) cefuroxime-treated patients and 102 of 126 (81.0%) penicillin-treated patients (P = 0.001). Potential drug-related adverse events were reported in 7.0 and 3.2% of the cefuroxime- and penicillin-treated patients, respectively (P = 0.078). In the present study, cefuroxime axetil suspension given twice daily resulted in significantly greater bacteriological and clinical efficacies than those of penicillin V suspension given three times daily to pediatric patients with acute Pharyngitis and a positive throat culture for GABHS.
Stanford T Shulman - One of the best experts on this subject based on the ideXlab platform.
-
clinical practice guideline for the diagnosis and management of group a Streptococcal Pharyngitis 2012 update by the infectious diseases society of america
Clinical Infectious Diseases, 2012Co-Authors: Stanford T Shulman, Edward L Kaplan, Herbert W Clegg, Alan L Bisno, Michael A Gerber, Judith M Martin, Chris A Van Beneden, Robert H LurieAbstract:The guideline is intended for use by healthcare providers who care for adult and pediatric patients with group A Streptococcal Pharyngitis. The guideline updates the 2002 Infectious Diseases Society of America guideline and discusses diagnosis and management, and recommendations are provided regarding antibiotic choices and dosing. Penicillin or amoxicillin remain the treatments of choice, and recommendations are made for the penicillin-allergic patient, which now include clindamycin.
-
macrolide treatment failure in Streptococcal Pharyngitis resulting in acute rheumatic fever
Pediatrics, 2012Co-Authors: Latania K Logan, James B Mcauley, Stanford T ShulmanAbstract:Macrolide resistance (MR) in group A Streptococcus (GAS) has been well documented in several countries and has become clinically significant since the large increases in macrolide usage during the 1970s. Macrolides are recommended as an alternative therapy for GAS Pharyngitis, the most common cause of bacterial Pharyngitis. Macrolide resistance has been associated with certain emm types, a sequence-based typing system of the hypervariable region of the GAS M-protein gene. Clinical failure of macrolide treatment of GAS infections can be associated with complications including acute rheumatic fever and rheumatic heart disease, the leading cause of acquired heart disease in children worldwide. Here we report 2 pediatric cases of MR and/or treatment failure in the treatment of GAS Pharyngitis with the subsequent development of acute rheumatic fever. We also review the literature on worldwide MR rates, molecular classifications, and emm types, primarily associated with GAS pharyngeal isolates between the years of 2000 and 2010. The use of macrolides in the management of GAS Pharyngitis should be limited to patients with significant penicillin allergy.
-
treatment of acute Streptococcal Pharyngitis and prevention of rheumatic fever a statement for health professionals
Pediatrics, 1995Co-Authors: Adnan S Dajani, Patricia Ferrieri, Kathryn A Taubert, Georges Peter, Stanford T ShulmanAbstract:Primary prevention of acute rheumatic fever is accomplished by proper identification and adequate antibiotic treatment of group A beta-hemolytic Streptococcal (GAS) tonsilloPharyngitis. Diagnosis of GAS Pharyngitis is best accomplished by a throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) remains the treatment of choice, because it is cost effective, has a narrow spectrum of activity, has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. Various macrolides, oral cephalosporins, and other beta-lactam agents are acceptable alternatives, particularly in penicillin-allergic individuals. The individual who has had an attack of rheumatic fever is at very high risk of developing recurrences after subsequent GAS Pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The duration of prophylaxis depends on the number of previous attacks, the time lapsed since the last attack, the risk of exposure to Streptococcal infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or erythromycin are acceptable alternatives in penicillin-allergic individuals. This report is an update of a 1988 statement by this committee. It expands on the previous statement, includes more recent therapeutic modalities, and makes more specific recommendations for the duration of secondary prophylaxis.
Adnan S Dajani - One of the best experts on this subject based on the ideXlab platform.
-
treatment of acute Streptococcal Pharyngitis and prevention of rheumatic fever a statement for health professionals
Pediatrics, 1995Co-Authors: Adnan S Dajani, Patricia Ferrieri, Kathryn A Taubert, Georges Peter, Stanford T ShulmanAbstract:Primary prevention of acute rheumatic fever is accomplished by proper identification and adequate antibiotic treatment of group A beta-hemolytic Streptococcal (GAS) tonsilloPharyngitis. Diagnosis of GAS Pharyngitis is best accomplished by a throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) remains the treatment of choice, because it is cost effective, has a narrow spectrum of activity, has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. Various macrolides, oral cephalosporins, and other beta-lactam agents are acceptable alternatives, particularly in penicillin-allergic individuals. The individual who has had an attack of rheumatic fever is at very high risk of developing recurrences after subsequent GAS Pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The duration of prophylaxis depends on the number of previous attacks, the time lapsed since the last attack, the risk of exposure to Streptococcal infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or erythromycin are acceptable alternatives in penicillin-allergic individuals. This report is an update of a 1988 statement by this committee. It expands on the previous statement, includes more recent therapeutic modalities, and makes more specific recommendations for the duration of secondary prophylaxis.
-
cefpodoxime proxetil vs penicillin v in pediatric Streptococcal Pharyngitis tonsillitis
Pediatric Infectious Disease Journal, 1993Co-Authors: Adnan S Dajani, Susan L Kessler, Robert Mendelson, Donald L Uden, Wesley Mark ToddAbstract:This multicenter, randomized, parallel treatment, observer-blinded study was designed to evaluate the safety and efficacy of cefpodoxime proxetil (5 mg/kg twice daily for 10 days) compared with penicillin V (13.4 mg/kg three times daily for 10 days) for treatment of Group A Streptococcal Pharyngitis and tonsillitis in pediatric patients. Clinical and microbiologic results were evaluated before therapy, during therapy (Study Days 3 to 5), at the end of therapy (Study Days 14 to 18) and at long term follow-up (Study Days 30 to 32). Both drugs were well-tolerated in 578 patients evaluable for safety. Mild gastrointestinal complaints were noted in 6.7% of 386 cefpodoxime-treated patients and in 5.2% of 192 penicillin-treated patients. In 413 patients evaluable for efficacy, both treatment regimens resulted in comparably favorable clinical outcome; cure rates were 83.8% for 275 cefpodoxime-treated patients and 77.5% for 138 penicillin-treated patients. However, eradication of S. pyogenes at end of therapy was significantly higher with cefpodoxime (93.1%) than with penicillin (81.2%) (P < 0.01). Cefpodoxime proxetil provides an effective alternative to penicillin V for the treatment of Streptococcal Pharyngitis and tonsillitis.
-
guidelines for the diagnosis of rheumatic fever jones criteria updated 1992 special writing group of the committee on rheumatic fever endocarditis and kawasaki disease of the council on cardiovascular disease in the young american heart association
Circulation, 1993Co-Authors: Adnan S Dajani, Alan L Bisno, F Z Bierman, Floyd W Denny, David T Durack, Patricia Ferrieri, Michael D Freed, Michael A Gerber, Elia Ayoub, E L KaplanAbstract:The Jones criteria for guidance in the diagnosis of acute rheumatic fever were first published by T. Duckett Jones, MD, in 1944 and have been revised over the years by the American Heart Association. The current guidelines are an update of these criteria. For the first time, the guidelines are designed to establish the initial attack of acute rheumatic fever. Major manifestations, minor manifestations, and supporting evidence of antecedent group A Streptococcal infection are discussed. These updated guidelines expand on the available tools to diagnose Streptococcal Pharyngitis and clarify the available antibody tests for detecting antecedent group A Streptococcal infection. At the present time echocardiography without accompanying auscultatory findings is insufficient to be the sole criterion for valvulitis in acute rheumatic fever. Finally, this article addresses overdiagnosis of rheumatic fever and lists exceptions to the Jones criteria, including recurrent attacks in individuals with a history of rheumatic fever.
-
guidelines for the diagnosis of rheumatic fever jones criteria 1992 update
JAMA, 1992Co-Authors: Adnan S Dajani, Elia M Ayoub, Alan L Bisno, F Z Bierman, Floyd W Denny, David T Durack, Patricia Ferrieri, Michael D Freed, Michael A Gerber, Edward L KaplanAbstract:The Jones Criteria for guidance in the diagnosis of acute rheumatic fever were first published by T. Duckett Jones, MD, in 1944 and have been revised over the years by the American Heart Association. The current guidelines are an update of these criteria. For the first time, the guidelines are designed to establish the initial attack of acute rheumatic fever. Major manifestations, minor manifestations, and supporting evidence of antecedent group A Streptococcal infection are discussed. These updated guidelines expand on the available tools to diagnose Streptococcal Pharyngitis and clarify the available antibody tests for detecting antecedent group A Streptococcal infection. At the present time echocardiography without accompanying auscultatory findings is insufficient to be the sole criterion for valvulitis in acute rheumatic fever. Finally, this article addresses overdiagnosis of rheumatic fever and lists exceptions to the Jones Criteria, including recurrent attacks in individuals with a history of rheumatic fever. (JAMA. 1992;268:2069-2073)
