SO for years I have been puzzled why folks swab for strep in kids less than 2. When I read the Red Book it says testing for Strep in kids 2-3 is marginally indicated. They say typically 3 and up. According to what I have been told Rheumatic Fever doesn't occur in kids < 2, and is rare anyway and so if the reason we swab for strep is to prevent RF by early intervention, then why waste the money in kids < 2?If it's to limit the symptoms, avoid spreading contagion especially to daycare classmates, and or to allow parents to return to work sooner, why don't we screen for other causes of treatable bacterial infections like Eikenella, or arcanybacterium or mycoplasma? Studies done looking at the treatment with Penicillin and cephalosporins excluded kids under 3 ( Pediatric Annals May 1998 . the entire issue is dedicated to Group A Strep Infections. ). SO how do we know that treating kids <2 is actually worthwhile? SO do you see patients who have been diagnosed with "Strep" pharyngitis that are < 2? Do you swab and treat kids < 2 if positive?
Martin Herman, M.D.
Pediatric Emergency Medicine
Sacred Heart Children's Hospital
FSU @ Sacred Heart, Division of Pediatrics
5153 N. 9th Ave, 6th Floor Nemours Bldg
Pensacola, FL 32504
Ph: 850 416 7658(office)
Ph: 901 219 9202 ( cell)
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