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Management of Pharyngeal Carriers of Group A Streptococcal Organisms-Reply

Franklin R. Cockerill III, MD; Kristine L. MacDonald, MD, MPH; Michael T. Osterholm, PhD, MPH
JAMA. 1997;277(15):1204. doi:10.1001/jama.1997.03540390034031.
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In Reply.  —In our study, we reported that a highly virulent group A streptococcal clone (PFGE-1) caused multiple cases of invasive streptococcal disease in a small community from January through March 1995. Fifty-nine (32%) of 187 children attending the only elementary school in this community carried group A streptococcus organisms in their throats, and in 46 (78%) of the 59 carriers, the PFGE-1 clone was isolated. All 59 children who carried group A streptococcus were offered antimicrobial therapy, and all were treated. No additional cases of invasive disease caused by the PFGE-1 clone occurred in this community at the conclusion of this intervention. However, no follow-up pharyngeal cultures were performed to determine whether the prevalence of the PFGE-1 among these carriers decreased following antimicrobial therapy.Even if one assumes an eradication rate among the PFGE-1 streptococcal carriers in our study similar to that reported by Drs Perry and Maher (83%), other factors


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