Recurrence rate of streptococcal pharyngitis related to hygienic measures

Abstract

Objective - To test the hypothesis that treatment failures of streptococcal pharyngotonsillitis may be caused by reinfection by the patients' own streptococci remaining on a toothbrush or in the bedclothes. Design - To elucidate the role of streptococcal contamination of the environment, hygienic measures regarding change of toothbrush and bed linen and washing of toys were given to half of the patients/families. Throat specimens were taken from all the patients before treatment with phenoxymethylpenicillin for 5 days, and the patients were followed-up for 1 month. At a home visit after 6-10 days, throat specimens were taken from the patients and all permanent residents of the home. Environmental samples were taken from pillowcases, floors, toothbrushes, dummies, and toys. Setting - Six health care centres. Subjects - 114 patients of all ages suffering from group A streptococcal pharyngotonsillitis, and 289 family members. Measurements and main results - 54 patients/families received hygiene instructions. The total number of recurrences was 40 (35%). There was no difference in treatment failure rate between patients/families that had taken or not taken hygienic measures. Conclusions - Hygienic measures have no decisive influence on the risk of recurrence of streptococcal pharyngotonsillitis.