Objectives.— The Centers for Disease Control and Prevention (CDC) convened a Working
Group in October 1995 to summarize the data regarding the risk of invasive
group A streptococcal (GAS) disease among household contacts of an index patient
and the potential efficacy of chemoprophylaxis. This statement on chemoprophylaxis
for prevention of subsequent cases among household contacts is intended for
use by public health professionals and clinicians.
Participants.— The CDC invited representatives of the American Academy of Pediatrics,
the Council of State and Territorial Epidemiologists, the Hospital Infection
Control Practice Advisory Committee, the Infectious Diseases Society of America,
and experts from academia to participate.
Evidence.— Data on the transmission of GAS and risk factors for severe infection
were considered. Population-based surveillance data were used to estimate
the risk of invasive GAS disease among household contacts of a case patient.
The potential efficacy of chemoprophylaxis was considered using estimates
of the efficacy of various regimens in eradicating pharyngeal carriage.
Consensus Process.— This document summarizes the data considered by the Working Group to
develop its position. The consensus achieved by group discussion at the meeting
was incorporated in a draft document, which was reviewed by all members and
revised to include suggested changes.
Conclusions.— The Working Group concluded that no definite recommendations can be
made at this time regarding chemoprophylaxis for household contacts of persons
with invasive GAS infection. More data are needed to assess the risk of subsequent
cases and to determine an optimal regimen for chemoprophylaxis. Until such
data are available, physicians and health departments should base decisions
regarding chemoprophylaxis on their assessment of the risk associated with
each individual case.