Reducing Broad-Spectrum Antibiotic Treatment of Simple Group A Streptococcal Infections to Reduce Harm to the Microbiome.

Tyrone J Sumibcay,Jannet J Lee-Jayaram,Loren G Yamamoto

doi:10.7759/cureus.15629

Tyrone J Sumibcay, Jannet J Lee-Jayaram + Show 1 more

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https://doi.org/10.7759/cureus.15629

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Abstract

BackgroundBroad-spectrum antibiotics disrupt the human microbiome resulting in a greater risk of harmful, long-term conditions that impact human health. Group A streptococcal (GAS) infections can be treated with penicillin.Objective We examined the treatment of simple GAS infections to assess the use of broad-spectrum antibiotics.Methods Smart relational database extraction queries from January 1, 2016 to July 10, 2019 (3.6 years) of patients less than 22 years old in a 4-hospital system electronic medical record (EMR).Results We found 1778 non-ED outpatients and 873 ED patients with simple GAS infections who were not allergic to penicillin. A total of 75% and 44% of non-ED and ED patients were treated with broad-spectrum antibiotics, respectively (p < 0.001). Older patients were treated with penicillin alone more frequently than younger age groups (p < 0.001).Conclusion These findings highlight opportunities for clinicians to reduce the utilization of broad-spectrum antibiotics for the treatment of simple GAS infections to reduce harm to the microbiome.

Highlights

IntroductionDisruption of the human microbiome, caused by a reduction in the diversity of its microorganisms that occurs with antibiotic treatment, can play a role in the development of harmful, long-term conditions that impact human health
We found 1778 non-ED outpatients and 873 ED patients with simple Group A streptococcal (GAS) infections who were not allergic to penicillin
A total of 75% and 44% of non-ED and ED patients were treated with broad-spectrum antibiotics, respectively (p < 0.001)

Summary

Introduction

Disruption of the human microbiome, caused by a reduction in the diversity of its microorganisms that occurs with antibiotic treatment, can play a role in the development of harmful, long-term conditions that impact human health. Antibiotic treatment of Group A streptococcal (GAS) infections, serves as an area where harm to the microbiome can be reduced since it can be treated with the narrow-spectrum antibiotic, penicillin, with 100% sensitivity. The purpose of this study is to characterize the antibiotics used to treat simple streptococcal throat infections and scarlet fever in children and to assess the degree of unnecessary broad-spectrum antibiotic use for these conditions. Broad-spectrum antibiotics disrupt the human microbiome resulting in a greater risk of harmful, long-term conditions that impact human health. Group A streptococcal (GAS) infections can be treated with penicillin

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Discussion

Conclusion