From the Guidelines
For patients diagnosed with 2+ Beta Hemolytic Streptococci, Group C, antimicrobial therapy should be initiated to mitigate the clinical course of the infection, despite the lack of convincing evidence from controlled studies on clinical response to such therapy. When considering treatment options, it's essential to note that Group C streptococci can cause acute pharyngitis with clinical features similar to those of GAS pharyngitis, as stated in the study by 1. The primary reason to identify Group C streptococcus as the cause of acute pharyngitis is to initiate antimicrobial therapy. Some key points to consider in the treatment of Group C streptococcal infections include:
- The clinical presentation, which can be similar to Group A streptococcal infections
- The importance of initiating antimicrobial therapy, as noted in the study by 1
- The lack of evidence linking Group C streptococcal pharyngitis to acute rheumatic fever, which distinguishes it from Group A streptococcal infections, as mentioned in the study by 1 Given the information available and the need to prioritize morbidity, mortality, and quality of life, penicillin V 500 mg orally twice daily for 10 days could be considered for uncomplicated pharyngitis, although the specific recommendation may vary based on the most recent clinical guidelines and patient-specific factors. It's also worth noting that for patients with penicillin allergy, alternative antibiotics such as azithromycin or clindamycin may be used, but the choice of antibiotic should be guided by the most recent and highest quality evidence available, such as the study by 1.
From the Research
Characteristics of 2+ Beta Hemolytic Streptococci, Group C
- Beta-hemolytic streptococci, including Group C, are defined by their ability to cause beta-hemolysis on blood agar plates 2
- Group C beta-hemolytic streptococci can cause a variety of infections, including skin and soft-tissue infections, pneumonitis, sinusitis, septicemia, endocarditis, osteomyelitis, and meningitis 3, 4
- These infections can be severe and sometimes fatal, especially in patients with underlying medical conditions 3
Transmission and Epidemiology
- Most human infections caused by Group C streptococci are transmitted from person to person 3
- However, some species, such as Streptococcus equi subsp. zooepidemicus, can be transmitted through animal contact or contaminated food products 3
Treatment and Antibiotic Resistance
- Penicillin is the antimicrobial agent of choice for infections due to Group C streptococci 3, 4
- However, treatment failure can occur, and some strains may be resistant to other antibiotic classes, including tetracyclines, macrolides, and clindamycin 3
- The use of clindamycin in combination with benzylpenicillin has been shown to be beneficial in some cases of beta-hemolytic streptococcal infections 2