Anti-streptolysin O (ASLO) values usually go up one week after the streptococcal infection reach its peak in three to six weeks, then fall back3. According to Machado et al. (2001)5 ASLO's normal ranges vary according with the individual's age, the season of the year, geographic location and prevalence of streptococcal infections in the population. Infants and pre-school-aged children have lower ASLO values when compared with school-aged children because of their lower exposure to streptococcal antigens.
S. pyogenes is considered universally sensitive to penicillin. The first choice antimicrobial agents are4: phenoxymethylpenicillin (Oral V Penicillin V) or 10 days of amoxicillin, or even a single intramuscular injection of G-Benzathine Penicillin.
Failure in the treatment with V penicillin can happen in up to 35% of the cases, especially in children younger than six years. According to Cohen (2004)6 reasons for treatment failure are: incorrect dosage use or drug use for less than 10 days, new child contact with the individual infected by S. pyogenes, penicillin degrading by the beta-lactamases produced by the oropharyngeal flora, or eradication of the oropharyngeal protecting flora (Streptococcus salivarius and other alpha-hemolytic streptococci). When one suspects of penicillin degrading, beta-lactamase inhibitors must be used (amoxicillin/clavulanate, or amoxicillin and sulbactam).
Anti-streptolysin O (ASLO) values usually go up one week after the streptococcal infection reach its peak in three to six weeks, then fall back3. According to Machado et al. (2001)5 ASLO's normal ranges vary according with the individual's age, the season of the year, geographic location and prevalence of streptococcal infections in the population. Infants and pre-school-aged children have lower ASLO values when compared with school-aged children because of their lower exposure to streptococcal antigens.S. pyogenes is considered universally sensitive to penicillin. The first choice antimicrobial agents are4: phenoxymethylpenicillin (Oral V Penicillin V) or 10 days of amoxicillin, or even a single intramuscular injection of G-Benzathine Penicillin.Failure in the treatment with V penicillin can happen in up to 35% of the cases, especially in children younger than six years. According to Cohen (2004)6 reasons for treatment failure are: incorrect dosage use or drug use for less than 10 days, new child contact with the individual infected by S. pyogenes, penicillin degrading by the beta-lactamases produced by the oropharyngeal flora, or eradication of the oropharyngeal protecting flora (Streptococcus salivarius and other alpha-hemolytic streptococci). When one suspects of penicillin degrading, beta-lactamase inhibitors must be used (amoxicillin/clavulanate, or amoxicillin and sulbactam).
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