From the Guidelines
The recommended treatment for Streptococcus anginosus infections is a combination of antimicrobial therapy, such as penicillin or ceftriaxone, with gentamicin for 2 weeks, and surgical drainage when abscesses are present. This approach is based on the guidelines for the management of infective endocarditis, which suggest that IE due to group A, B, C, or G streptococci, including Streptococcus anginosus group, requires antibiotic treatment similar to that of oral streptococci, except that short-term therapy is not recommended 1. Some key points to consider in the treatment of Streptococcus anginosus infections include:
- The use of penicillin or ceftriaxone as the primary antibiotic, with gentamicin added for 2 weeks 1
- The importance of surgical drainage in cases of deep-seated abscesses, which are common with S. anginosus group infections
- The need for individualized treatment duration based on clinical response, with possible transition to oral antibiotics after clinical improvement
- The consideration of alternative antibiotics, such as vancomycin or teicoplanin, in patients allergic to beta-lactams 1 It is essential to note that S. anginosus group organisms have a unique propensity for abscess formation due to their production of hydrolytic enzymes that facilitate tissue invasion, which explains why both antimicrobial therapy and surgical intervention are often required for successful treatment.
From the FDA Drug Label
Serious infections, such as pneumonia and endocarditis, due to susceptible strains of streptococci (including S (maximum dose of 12 to 20 million units/day) (penicillin-susceptible strains)
The recommended treatment for Streptococcus anginosus infections is penicillin G (IV) at a dose of 12 to 20 million units/day for serious infections such as pneumonia and endocarditis, as long as the strain is penicillin-susceptible 2.
From the Research
Treatment of Streptococcus anginosus Infections
The recommended treatment for Streptococcus anginosus infections typically involves a combination of antibiotics and surgical intervention, depending on the severity and location of the infection.
- Antibiotics: The use of beta-lactam antibiotics, such as penicillin G and cephalosporins, is commonly recommended for the treatment of S. anginosus infections 3, 4.
- Surgical intervention: Surgical procedures, such as drainage of abscesses, may be necessary in addition to antibiotic treatment to achieve full recovery 5, 4, 6.
- Supportive care: Supportive care, such as management of underlying conditions and close monitoring of the patient's condition, is also important in the treatment of S. anginosus infections.
Specific Treatment Approaches
- For intra-abdominal abscesses, treatment with antibiotics and surgery is recommended 5.
- For central nervous system infections, such as brain abscesses, prompt surgical intervention and timely initiation of antibiotics are critical for optimal outcomes 6.
- For disseminated infections, treatment with beta-lactam antibiotics and surgical procedures may be necessary, and underlying conditions should be managed 4.