For this post I link to and include the show notes from Dr. Maria Ivankovik’s lecture, Should we treat strep throat in children with antibiotics?* which runs from 7:13 to 10:35.
*Link is to EM Quick Hits 17 Adrenal Crisis, Strep Throat, Posterior MI, DKA Just the Facts, Ovarian Torsion Imaging, HINTS Exam, Canadian CT Head Rule, April 2020 from Emergency Medicine Cases
Here are the show notes:
Should we treat strep throat in children with antibiotics?
- The NNT to prevent rheumatic fever for antibiotics in adult patients with strep throat in North America is approximately 1 in 10,000
- The NNH (number needed to harm) is approximately 1 in 15 (anaphylaxis, diarrhea including C.difficile)
- While there is a trend to withhold antibiotics for adults with strep throat, The Canadian Pediatric Society will be publishing guidelines this year likely recommending antibiotic treatment for children with strep throat because of the higher incidence of rheumatic fever compared to adults and in an effort to prevent PANDA (Pediatric Autoimmune Neuropsychiatric Disorder) that is associated with strep throat
- Duration of antibiotic treatment is 10 days to ensure complete eradication of strep