Not at present. Watch for more guidance.
Not at present. Watch for more guidance.
No antibiotics for contacts except for invasive GAS (not for strep throat or scarlet fever).
Advise caution as in any infection. No guidelines yet – watch this space.
Prescribe 10 days and if pharmacy have 5 days they will issue an ‘owing’ ticket and provide further supply when more is available. There are supplies coming through.
Notify scarlet fever and invasive group A Strep ONLY. You do not need to notify for strep throat.
Yes. Please see prescribing guidance for children.
Unable to comment – please seek local info from UHL. As a general rule a brief letter (just a few lines) is usually a basic minimum for referrals and will in most cases assure the child is seen by the Paeds team and not just UCC (unless they have a paeds specialist there – winter pressures).
Increased demand and distribution concerns. No problems reported with manufacturing.
Yes.
Please see prescribing guidance for children. BD dose for PenV is just the same total daily dose divided by two.
Yes. While not ideal, it is still safe and and effective to do this. Please see prescribing guidance for children.
No treatment needed
Yes. While not ideal, it is still safe and effective to do this. Please see prescribing guidance for children.
Please use Centor or Fever pain score in prescribing guidance for children.
COVID – yes. Use Centor or fever pain to determine swabbing for Strep A.
Controversial re: risk/benefit. Please await formal guidance.
Discussion around efficacy and sensitivity of tests. A positive rapid/POC test is a rule in (treat as a definite positive), a negative test is NOT a rule-out (do not assume it is a true negative).
Positive swabs should have 10 days of treatment.
No. Please see prescribing guidance for children.
Lab M,C & S – very sensitive. POC/rapid tests – less sensitive.
Not yet – work in progress.
School age children (generally under 12, but can be young adults)
Can stop immediately.
Post Covid mixing, susceptible population, first ‘proper’ Xmas, thought NOT likely to be a different serovar/variant of strep.
5 days is due to supply issues. Ideal is still 10 days.
OneBromley are trying to arrange for local pharmacies to email their local PCN with regular updates of supply situation.
Urine dip if obvious haematuria. BP if positive.
Treat for 10 days if no swab taken and meets criteria.
Pragmatism – yes. Or suspend in water in a syringe and give measured dose of suspension.
The usual referral guidelines apply. Please call hospital and bleep Paeds Registrar if concerned enough to make paeds referral. Please also pen a few lines for referral.
All iGAS are very sick – they are all admitted.
Please give 10 day prescription if unable to review.
Lab M,C & S – very sensitive. POC/rapid tests – less sensitive. A positive rapid/POC test is a rule in (treat as a definite positive), a negative test is NOT a rule-out (do not assume it is a true negative)
No – please see FeverPAIN or Centor criteria.
Standard BNF and CKS dosing. Please see prescribing guidance for children.
A political question – we are dealing with the clinical response
Pragmatism – if unable to review at 5 days then prescribe 10 days.
Advised no antibiotics are indicated.
Please treat as per fever pain and Centor criteria.
OneBromley are trying to arrange for local pharmacies to email their local PCN with regular updates of supply situation.
Indeterminate sensitivity of POC/rapid tests – we do not recommend rapid testing and prefer lab testing.
Please see fever pain and mentor calculations in prescribing guidance for children.
Precise cause/aetiology of reduced incidence of rheumatic fever is complex. Please give 10 days of antibiotics unless able to review at 5 days.
No defined pattern emerged yet – still small numbers.
No defined pattern emerged yet – watch for more guidance.
Almost always have strep throat first. Then develop complications of streptococcal infection.