Hyperendemic Streptococcus pyogenes infection despite prophylaxis with penicillin G benzathine

Article Abstract:

Infections with the bacteria Streptococcus pyogenes, responsible for "Strep throat" and other infections, are common among people living in close quarters. During World War II, there were over a million streptococcal infections in the US Navy, and over 21,000 cases of rheumatic fever, a serious complication which can follow these infections. It has now become common to use penicillin G benzathine injections as a preventive (prophylactic) measure for new recruits arriving at camp. Penicillin G benzathine dissolves very slowly, and so the preparation is suited for providing extended protection. However, recent reports within the military have suggested that the use of this prophylactic treatment was failing to prevent streptococcus infection in many recruits, and therefore a study was conducted to evaluate the transmission of infections among recruits and determine why the penicillin G benzathine prophylaxis was ineffective. A total of 736 Marine recruits were prospectively followed for three months. Routine throat swabs were taken every two weeks to monitor colonization with the bacteria and any infections for which the recruit did not seek medical attention. Despite the fact that 93 percent of the recruits had received penicillin G benzathine injections, 37 percent of the 265 sore throats reported by the recruits were due to S. pyogenes infection. Seven percent of the recruits were allergic to penicillin and did not receive injections. These recruits were more likely to be colonized with the bacteria than were their treated comrades. Furthermore, colonization and infection were found to be more likely in the platoons with a greater percentage of allergic recruits who did not receive the prophylactic treatment. After the study data were obtained, the allergic recruits were placed on oral erythromycin, an alternative antibiotic, and the rate of strep throat decreased. The results of the study indicate that a minority of unprotected individuals can provide a reservoir for infection which can then spread even to the people who have been prophylactically treated. For people living in close quarters, such as military recruits, individuals must not be exempted from prophylactic treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Streptococcal infections, Prevention, Streptococcus pyogenes

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The risk of birth defects among children of Persian Gulf war veterans

Article Abstract:

Service in the Persian Gulf War does not appear to have caused any significant reproductive abnormalities or increased the risk of birth defects in children of veterans. This was the conclusion of a study which analyzed all live births at 135 military hospitals in the three years after the war. The rate of birth defects was no higher among the 33,998 babies born to Gulf War veterans than in the general population or in veterans not deployed in the Persian Gulf. There was also no increased risk of infertility among Persian Gulf veterans.

Health aspects, Risk factors, Children, Birth defects, Family, Military personnel, Persian Gulf War veterans, Children of military personnel

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Single-dose azithromycin versus penicillin G benzathine for the treatment of early syphilis

Article Abstract:

The effectiveness of azithromycin for the treatment of syphilis in a developing country is analyzed. Observations reveal that syphilis could be effectively treated with a single dose of oral azithromycin, which might prove successful especially in developing countries where the use of penicillin G benzathine injections poses problems.

New England States, Drug therapy, Syphilis, Dosage and administration, New England, Azithromycin

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