Beta Hemolytic Strep Drug Treatment

The beta-hemolytic streptococci include the organism (beta strep group A) responsible for strep throat, scarlet fever and necrotizing fasciitis. Beta strep group B is seen in cases of neonatal meningitis and sepsis. Other beta strep groups include C, F and G.

Drug of choice

For group A strep and the other beta-hemolytic streptococci, penicillin is the drug of choice. Penicillin resistance has not been encountered with the beta-hemolytic streptococci.

Penicillin allergies

For people who have allergies to penicillin, alternative treatments like erythromycin or azithromycin (macrolides) can be used to treat strep throat. However, due to possible antibiotic resistance, susceptibility testing is required to detect resistance.

Systemic infections

For more serious systemic infections like endocarditis from group B strep, penicillin used in conjunction with gentamicin is optimal treatment. For people with a systemic infection and a penicillin allergy, vancomycin should be used.

Laboratory testing

Performing antibiotic susceptibility testing to guide therapy for treating beta-hemolytic strep is not required unless a macrolide is used. Acceptable methods of testing include disk diffusion and broth dilution.

Other considerations

For toxic shock syndrome caused by beta-hemolytic strep group A, intravenous immunoglobulin is the appropriate treatment. For cases of necrotizing fasciitis (flesh-eating bacteria) caused by beta-hemolytic strep group A, intravenous antibiotics are required as well as debridement of dead tissue.

References

• "Johns Hopkins ABX Guide for the Diagnosis and Treatment of Infectious Diseases", John Bartlett, M.D., 2005