{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:56:06Z","timestamp":1781607366087,"version":"3.54.5"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Shorter-course treatment for group A streptococcal (GAS) pharyngitis may be equivalent to 10 days for clinical cure but effectiveness for pharyngeal GAS eradication is uncertain. The effect on household transmission has not been examined directly. In 2022, a laboratory antimicrobial stewardship initiative drove an abrupt reduction in treatment durations for GAS pharyngitis locally. This study aimed to assess whether this had any negative effect on key treatment outcomes: clinical failure, microbiological failure, immune sequelae, and household GAS transmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Positive throat swab cultures for GAS 2 years prechange until 25 months postchange were matched to antibiotic dispensing data. Logistic models were fitted to examine associations between treatment duration and 30-day repeat antibiotic treatment, repeat GAS-positive throat swab cultures, hospitalization, incident household cases, and 90-day incidence of rheumatic fever.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 851 patients prechange and 1746 postchange were included; 31.3% prechange received \u22647 days\u2019 treatment versus 59.0% postchange (P &amp;lt; .01). There were no significant differences across any outcome measure between periods. When the postchange period was examined specifically, no significant increases occurred for any outcome measure for patients receiving 0, 5, or 7 days of antibiotics versus 10 days, except higher 30-day antibiotic treatment in those initially receiving no antibiotics (15.6% vs 11.4%, P &amp;lt; .01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Shorter-course treatment had no detectable negative effect on GAS pharyngitis outcomes in this population, including patients receiving no antibiotics. Short-course therapy for GAS pharyngitis has been associated with lower pharyngeal eradication; this did not translate to a detectable increase in household transmission in this real-world setting, which to our knowledge is a novel finding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf323","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T07:50:32Z","timestamp":1749109832000},"source":"Crossref","is-referenced-by-count":0,"title":["Effect of a Widespread Reduction in Treatment Duration for Group A Streptococcal Pharyngitis on Outcomes Including Household Transmission"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3920-7151","authenticated-orcid":false,"given":"Max","family":"Bloomfield","sequence":"first","affiliation":[{"name":"Department of Microbiology, Awanui Laboratories Wellington , Wellington ,","place":["New Zealand"]},{"name":"Department of Infection Services, Te Whatu Ora\/Health NZ\u2014Capital, Coast and Hutt Valley , Wellington ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8291-0777","authenticated-orcid":false,"given":"Hamish","family":"Reed","sequence":"additional","affiliation":[{"name":"Resident Medical Officers\u2019 Unit, Te Whatu Ora\/Health NZ\u2014Capital, Coast and Hutt Valley , Wellington ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Todd","sequence":"additional","affiliation":[{"name":"Ora Toa Cannons Creek General Practice , Porirua ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"van der Werff","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Awanui Laboratories Wellington , Wellington ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Balm","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Awanui Laboratories Wellington , Wellington ,","place":["New Zealand"]},{"name":"Department of Infection Services, Te Whatu Ora\/Health NZ\u2014Capital, Coast and Hutt Valley , Wellington ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Blackmore","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Awanui Laboratories Wellington , Wellington ,","place":["New Zealand"]},{"name":"Department of Infection Services, Te Whatu Ora\/Health NZ\u2014Capital, Coast and Hutt Valley , Wellington ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"2026061606321780000_ofaf323-B1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1080\/23744235.2023.2191714","article-title":"Best management of patients with an acute sore throat\u2013a critical analysis of current evidence and a consensus of experts from different countries and traditions","volume":"55","author":"Gunnarsson","year":"2023","journal-title":"Infect Dis"},{"key":"2026061606321780000_ofaf323-B2","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1093\/cid\/cis847","article-title":"Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America","volume":"55","author":"Shulman","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2026061606321780000_ofaf323-B3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1469-0691.2012.03766.x","article-title":"Guideline for the management of acute sore throat: ESCMID Sore Throat Guideline Troup C. 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