Lu Diane, Strauss Barbara, Simkus Kristen, Tepper Martin, Gagnon François, Johnson Noémie, Girard Eric, Barnes Kirsten
Directorate of Force Health Protection, Canadian Forces Medical Group Headquarters, Ottawa, ON.
41 Centre des Services de santé des Forces canadiennes, Richelain, QC.
Can Commun Dis Rep. 2020 Sep 3;46(9):264-271. doi: 10.14745/ccdr,v46i09a03.
Between December 2016 and March 2018, two outbreaks of Group A (GAS) infection occurred at the Canadian Forces Leadership and Recruit School. A voluntary mass antibiotic prophylaxis (MAP) program was implemented in March 2018, to interrupt an ongoing GAS outbreak, and to prevent future outbreaks.
Instructors and recruits were offered a one-time intramuscular injection of 1.2 million units penicillin G benzathine (PGB). Individuals with a penicillin allergy were offered azithromycin; 500 mg orally once weekly for four consecutive weeks. Instructors and recruits were also asked to complete a voluntary and anonymous survey one week after receipt of MAP, to detect MAP-related adverse events.
MAP was offered to 2,749 individuals; 2,707 of whom agreed to receive it (98.5% uptake). The majority of personnel experienced adverse events in the days following MAP; 92.3% of personnel who received PGB reported localized pain at the injection site, and 70.2% of personnel who received azithromycin reported gastrointestinal symptoms. However, only five cases of serious adverse events were reported, and less than 1% of recruits could not complete their basic military training course because of MAP-related adverse events.
The MAP program implemented in March 2018 was the first of its kind in the Canadian Armed Forces, and the largest single use of PGB in a defined group in Canada. It resulted in very few serious adverse events and with minimal impact on military recruits' successful completion of recruit training.
2016年12月至2018年3月期间，加拿大部队领导力与新兵学校发生了两起A组链球菌（GAS）感染疫情。2018年3月实施了一项自愿性大规模抗生素预防（MAP）计划，以中断正在发生的GAS疫情，并预防未来的疫情爆发。
向教官和新兵提供一次肌肉注射120万单位苄星青霉素G（PGB）。对青霉素过敏的个体提供阿奇霉素；每周口服500毫克，连续四周。还要求教官和新兵在接受MAP一周后完成一项自愿且匿名的调查，以检测与MAP相关的不良事件。
向2749人提供了MAP；其中2707人同意接受（接受率为98.5%）。大多数人员在接受MAP后的几天内出现了不良事件；接受PGB的人员中有92.3%报告注射部位局部疼痛，接受阿奇霉素的人员中有70.2%报告出现胃肠道症状。然而，仅报告了5例严重不良事件，因与MAP相关的不良事件而无法完成基础军事训练课程的新兵不到1%。
2018年3月实施的MAP计划是加拿大武装部队中的首例此类计划，也是加拿大特定群体中单次使用PGB量最大的一次。该计划导致的严重不良事件极少，对新兵成功完成新兵训练的影响最小。
