Do contacts of GAS cases need to receive prophylactic antibiotics?
In Ontario, antibiotic prophylaxis is recommended for household and close contacts of cases of severe GAS infection (necrotizing fasciitis, STSS, or death within 7 days of infection). A household contact is anyone living in the same household as a case within 7 days prior to the case patient becoming ill. Close contacts are persons who share the same sleeping arrangements or who have had direct mucous membrane contact with the oral or nasal secretions of a case within 7 days prior to case patient illness. Prophylaxis consists of 10 days of Cefalexin, Penicillin VK or Erythromycin. Criteria for prophylaxis and antibiotic dosage recommendations can be found in Ontario Ministry of Health guidelines for management of contacts of cases of invasive GAS.
