Antibiotics

Abstract

This study of a college population showed that group A streptococcal pharyngitis accounted for 0.6%–2.5% of total visits to the student health service for the academic years 1977–78, 1978–79, and 1979–80. Streptococcal pharyngitis accounted for 4.0%–13.6% of all throat cultures performed. The prevalence of reported acute rheumatic fever (ARF) in this population was virtually nonexistent.

Review of medical records for 346 cases of streptococcal pharyngitis for academic year 1979–80 revealed that 253 (73%) were treated with oral penicillin V potassium. Nine (4.8%) repeat positive cultures occurred in 188 persons presenting for reculture after completing their course of therapy. All of the repeat positive cases had been treated with oral antibiotics, and almost all responded to a second course of oral treatment. It appeared that oral penicillin was adequate as primary prevention of ARF in this population.

Despite pitfalls of the bacitracin disc method, results of negative cultures prevented unnecessary antibiotic treatment in a population at low risk for ARF. The incidence of penicillin allergy approached 1%, supporting other studies that the risk of penicillin allergy is greater than the risk of ARF.