Imperial College London
Portrait Picture

ProfessorShiraneeSriskandan

Faculty of Medicine, Department of Infectious Disease

Professor of Infectious Diseases
 
 
 
//

Contact

 

s.sriskandan

 
 
//

Assistant

 

Ms Teyanna Gaeta +44 (0)20 3313 1943

 
//

Location

 

8N21ACWBCommonwealth BuildingHammersmith Campus

//

Summary

 

Publications

Citation

BibTex format

@article{McGuire:2023:10.2807/1560-7917.ES.2023.28.15.2200573,
author = {McGuire, E and Li, A and Collin, S and Decraene, V and Cook, M and Padfield, S and Sriskandan, S and van, Beneden C and Lamagni, T and Brown, CS},
doi = {10.2807/1560-7917.ES.2023.28.15.2200573},
journal = {Eurosurveillance},
pages = {1--19},
title = {Time to negative throat culture following initiation of antibiotics for pharyngeal group A Streptococcus: a systematic review and meta-analysis up to October 2021 to inform public health control measures},
url = {http://dx.doi.org/10.2807/1560-7917.ES.2023.28.15.2200573},
volume = {28},
year = {2023}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Public health guidance recommending isolation of individuals with group A streptococcal (GAS) infection or carriage for 12–24h from antibiotic initiation to prevent onward transmission requires a strong evidence base.Aim: To estimate the pooled proportion of individuals who remain GAS culture-positive at set intervals after initiation of antibiotics through a systematic literature review (PROSPERO CRD42021290364) and meta-analysis.Methods: We searched Ovid MEDLINE (1946–), EMBASE (1974–) and Cochrane library. We included interventional or observational studies with ≥10 participants reporting rates of GAS throat culture positivity during antibiotic treatment for culture-confirmed GAS pharyngitis, scarlet fever and asymptomatic pharyngeal GAS carriage. We did not apply age, language or geographical restrictions.Results: Of 5,058 unique records, 43 were included (37 randomised controlled studies, three non-randomised controlled trials and three before-and-after studies). The proportion of individuals remaining culture-positive on day 1, day 2 and days 3–9 were 6.9% (95%CI: 2.7–16.8%), 5.4% (95%CI: 2.1–13.3%) and 2.6% (95%CI: 1.6–4.2%). For penicillins and cephalosporins, day 1 positivity was 6.5% (95% CI: 2.5–16.1%) and 1.6% (95%CI: 0.04–42.9%), respectively. Overall, for 9.1% (95%CI: 7.3–11.3), throat swabs collected after completion of therapy were GAS culture-positive. Only six studies had low risk of bias.Conclusions: Our review provides evidence that antibiotics for pharyngeal GAS achieve a high rate of culture conversion within 24h but highlights the need for further research given methodological limitations of published studies and imprecision of pooled estimates. Further evidence is needed for non-beta-lactam antibiotics and asymptomatic individuals.
AU  - McGuire,E
AU  - Li,A
AU  - Collin,S
AU  - Decraene,V
AU  - Cook,M
AU  - Padfield,S
AU  - Sriskandan,S
AU  - van,Beneden C
AU  - Lamagni,T
AU  - Brown,CS
DO  - 10.2807/1560-7917.ES.2023.28.15.2200573
EP  - 19
PY  - 2023///
SN  - 1025-496X
SP  - 1
TI  - Time to negative throat culture following initiation of antibiotics for pharyngeal group A Streptococcus: a systematic review and meta-analysis up to October 2021 to inform public health control measures
T2  - Eurosurveillance
UR  - http://dx.doi.org/10.2807/1560-7917.ES.2023.28.15.2200573
UR  - https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2023.28.15.2200573
UR  - http://hdl.handle.net/10044/1/103185
VL  - 28
ER  -
Download