From the Guidelines
Obtaining a strep culture after starting Augmentin is not recommended as it is unlikely to provide useful information for clinical decision-making. The provided evidence from the 2012 clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis by the Infectious Diseases Society of America 1 supports the idea that once antibiotic therapy has begun, the bacterial load in the throat decreases rapidly. This guideline discusses various treatment regimens for chronic carriers of Group A Streptococci, including Amoxicillin–clavulanic acid, but it does not suggest the need for a strep culture after starting antibiotics.
Key points to consider include:
- The difficulty in differentiating a GAS carrier with an intercurrent viral infection from a patient with acute streptococcal pharyngitis, as noted in the guideline 1.
- The recommendation that for a single episode of pharyngitis associated with laboratory confirmation of GAS that occurs shortly after completion of a course of appropriate antimicrobial therapy, treatment with any of the agents listed is appropriate, without the need for additional throat swab specimens for culture after the second course of therapy unless the patient remains or becomes symptomatic 1.
- The guideline's discussion on distinguishing persistent carriage from recurrent episodes of acute GAS pharyngitis, which may involve clinical assessment and response to antibiotic therapy rather than relying on cultures after antibiotic initiation 1.
Given this information, the focus should be on clinical assessment and symptom improvement rather than on obtaining a strep culture after starting Augmentin, as the culture's sensitivity is significantly reduced after antibiotic therapy has begun.
From the Research
Strep Culture After Starting Augmentin
- The provided studies do not directly address the usefulness of strep culture after starting Augmentin 2, 3, 4, 5, 6.
- However, it can be inferred that the effectiveness of Augmentin (amoxicillin/clavulanate) in treating streptococcal pharyngitis may reduce the need for subsequent strep culture 4, 6.
- According to the studies, throat culture is considered the diagnostic standard for streptococcal pharyngitis, but its usefulness after starting antibiotic treatment like Augmentin is not explicitly stated 2, 3, 5.
- The studies focus on the diagnosis and treatment of streptococcal pharyngitis, including the use of antibiotics like Augmentin, but do not provide clear guidance on the role of strep culture after initiating treatment 2, 3, 4, 5, 6.
Diagnostic Methods and Treatment Guidelines
- The studies discuss various diagnostic methods for streptococcal pharyngitis, including clinical scoring systems, rapid antigen detection tests, throat culture, and nucleic acid amplification tests 2, 3, 5.
- Treatment guidelines recommend using antibiotics with narrow spectrums of activity, such as penicillin or amoxicillin, for streptococcal pharyngitis 2, 3, 5.
- Augmentin (amoxicillin/clavulanate) is considered an effective treatment option for streptococcal pharyngitis, especially in cases where penicillin is not suitable 4, 6.
Antibiotic Treatment and Resistance
- The studies highlight the importance of using antibiotics judiciously to minimize the development of resistance 2, 3, 4, 5, 6.
- Augmentin (amoxicillin/clavulanate) has a favorable pharmacokinetic/pharmacodynamic profile, which contributes to its high bacteriological and clinical efficacy in treating respiratory tract infections, including streptococcal pharyngitis 4.