Pediatric Pharmacology and Therapeutics

Aim: Th is school study compares the eff ect on the pharyngeal GAS prevalence of 30 days BlisK12 probiotic for all consenting pupils, after 10 days antibiotic treatment of GAS positive pupils, compared with antibiotics alone.

 

Background: Acute Rheumatic fever (ARF) is prevalent for indigenous Bay of Plenty, New Zealand, Maori and Pacific children and young adults with an incidence similar to that seen for NZ Europeans in the 1930s. Group A streptococcal infection (mainly pharyngeal in New Zealand) precedes ARF. School programmes treating students GAS sore throats with antibiotics halved ARF. We evaluated BlisK12 probiotic containing Streptococcus salivarius, (producing two anti-streptococcal lantobiotics) impact on GAS prevalence.

 

Method: Consenting pupils with GAS positive throat swabs in two school cohorts 1 and 2 without school ARF programmes were treated with 10 days antibiotics. All pupils in Cohort 1 were then off ered BlisK12 Probiotic for 30 days. Cohort 2 school pupils only had antibiotics for GAS positive throat swabs. Th e outcomes were compared in both cohorts with throat swabs a month later. Th ose initially negative who became positive were noted and those initially positive also followed, separating probiotic effects preventing the carriage from clearance.

 

Results: BlisK12 is associated with a greater decline in GAS prevalence than antibiotics alone. BlisK12 prevented carriage rather than increased antibiotic effi cacy prolonging GAS clearance; Antibiotics unexpectedly were more effective without BlisK12.

 

Conclusion: BlisK12 Probiotic is eff ective at preventing GAS pharyngeal carriage; BlisK12 probiotic for GAS negative students might augment school ARF prevention, evaluated with two winter terms’ school sweeps assessing GAS pharyngealprevalen.