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Recurrent GAS in High-Risk Populations — RACP Paediatrics MCQ

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ModerateCommunity & Indigenous HealthRecurrent GAS in High-Risk PopulationsRACP Paediatrics

A 6-year-old Aboriginal child in a remote community has recurrent group A streptococcal pharyngitis. He has had 3 episodes in 6 months. Given the high rates of acute rheumatic fever in this population, what is the recommended management?

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Correct answer: B — Consider secondary prophylaxis with IM benzathine penicillin if recurrent confirmed GAS pharyngitis in a high-risk population

In moderate-to-high-risk populations for ARF (Aboriginal and Torres Strait Islander, Maori, Pacific Islander), recurrent GAS pharyngitis may warrant consideration of secondary prophylaxis, even without confirmed ARF, due to the cumulative risk. Early and aggressive treatment of each GAS episode is essential. Community-level strategies (housing, overcrowding) are also critical.

Reference: RHDAustralia – 2024 – Australian Guideline for ARF