Monitoring
Follow-up and repeat testing of asymptomatic patients after completion
of antibiotic course is not typically necessary. If
with no improvement or with worsening of symptoms despite adherence to treatment
or with reactions to previously prescribed antibiotics, further evaluation is
indicated and change in antibiotics may be considered.
Follow-up cultures or RADT are indicated in:
- Patients who remain asymptomatic
- Patients whose symptoms recur
- Patients with history of rheumatic fever
- Patients who develop acute pharyngitis during outbreaks of either rheumatic fever or post-streptococcal glomerulonephritis, or during outbreaks of GABS in close or partially closed communities
- Continual spread of infection within a family
Persistence of group A Streptococcus carriage in the face of an intercurrent viral infection, a new group A Streptoccus pharyngeal infection obtained from contacts, and non-compliance with treatment regimen should be considered if recurrent episodes occur.