Khan Faizan, Bai Zemin, Kelly Shannon, Skidmore Becky, Dickson Catherine, Nunn Alexandra, Rutledge-Taylor Katie, Wells George
Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Open Forum Infect Dis. 2022 May 12;9(8):ofac244. doi: 10.1093/ofid/ofac244. eCollection 2022 Aug.
Among close contacts of patients with invasive group A streptococcal (iGAS) infection, the benefits and harms of chemoprophylaxis are uncertain. We conducted a systematic review of studies that reported on persons who, after being exposed to a case of laboratory-confirmed or probable iGAS, received any antibiotic prophylaxis for the prevention of GAS infection or carriage. Thirty-seven studies including 26 outbreak investigations and 11 case series or reports were included with predominantly descriptive information that suggested that antibiotic prophylaxis may be effective in preventing GAS infection or GAS carriage, with very few serious adverse events. However, current available evidence is scant (with limited information on contacts of iGAS cases) and largely based on studies with weak design and small sample size. Therefore, definitive conclusions on effectiveness of antibiotic prophylaxis cannot be drawn. Well designed prospective studies are required to establish the benefit-harm profile of antibiotic prophylaxis for secondary prevention of GAS disease among close contacts of iGAS cases.
在侵袭性 A 组链球菌（iGAS）感染患者的密切接触者中，化学预防的益处和危害尚不确定。我们对一些研究进行了系统评价，这些研究报告了在接触实验室确诊或疑似 iGAS 病例后接受任何抗生素预防以预防 GAS 感染或携带的人群。纳入了 37 项研究，包括 26 项暴发调查和 11 项病例系列或报告，主要是描述性信息，表明抗生素预防可能有效预防 GAS 感染或 GAS 携带，严重不良事件极少。然而，目前可得的证据不足（关于 iGAS 病例接触者的信息有限），且很大程度上基于设计薄弱和样本量小的研究。因此，无法就抗生素预防的有效性得出明确结论。需要设计良好的前瞻性研究来确定抗生素预防对 iGAS 病例密切接触者中 GAS 疾病二级预防的利弊情况。
