After the peak of cases of scarlet fever e pharyngitis, now we are grappling with a hunt for antibiotics and in particular foramoxicillin. It is the effect of the increase in cases of diseases related to the strepa bacterium responsible – among other pathologies – of pharyngitis, fever, sore throat, but also potentially carditis and rheumatic diseases. The interview granted to Virgil News by the infectious disease specialist Matthew Bassetti, Director of the Infectious Diseases Clinic of the San Martino Hospital in Genoa. According to him “it is a senseless hunt: if you go looking, you will find everything in a child’s throat, there is no need to abuse tampons also because sore throat is not caused only by streptococcus. It may be due to other viruses”.
Because strep tampons are no longer available
If until the time of the pandemic there had been a request for swabs for Covid, now they are looking for those to identify the strep. comment
The search for streptococcus swabs is linked to the increase in circulation of the bacterium, also confirmed by the Ministry of Health: “There is an increase in cases of scarlet fever starting from January 2023, especially in children under 15 years old”, reads a note signed by the Director General of Prevention, Gianni Rezza. Confirmation of the growth in cases had also come from the Italian Society of Pediatrics.
The interview with Matteo Bassetti
“The reason is related to the end of the pandemic and the disappearance of the use of devices such as masks, which facilitated its circulation. But that’s not all: on the one hand, the children’s immune system seems to have become unaccustomed to coming into contact with this bacterium (and with others), on the other, there are more cases also because we are looking for this bacterium more, precisely through swabs, and because there are the tools to identify it while for other microorganisms and viruses we have none”, adds Bassetti.
Why is amoxicillin in short supply?
The other immediate consequence of this situation is that one of the most common antibiotics, also used against streptococcus, namely amoxicillin, is now starting to run short. A condition confirmed by the president of Federfarma Rome, Andrea Cicconetti, who in recent days had spoken of “a critical issue”, explaining that “the situation had already been difficult since January. Yet in March it seemed to have normalized. I am not mistaken in saying that there was a increase in requests by at least 1000% in Lazio. Obviously, however, all this should not be compared with the Covid test phase during the first phase of the pandemic emergency”.
What are the possible risks of strep throat?
“The increase in streptococcus cases does not only concern Italy, but has seen a similar situation in many countries around the world. it is true that it can also give important consequences such as pneumonia, even serious infections of the skin, meningitis or rheumatic diseases, but in most cases there is no need to be alarmed: the invasive forms are very limited”, explains Bassetti. “In the past we have also recorded cases of rheumatic fever, carditis (therefore heart problems) or consequences for the kidneys, but today the situation is different: a child takes more antibiotics during his life and this allows him to be protected from potentially more serious consequences of the action of streptococcus. I often say it’s like the carabinieri, ‘faithful through the ages‘to penicillin’.
And again: “It means that so far it has not become resistant. I hope it stays that way and also for this reason it makes no sense to resort to antibiotics if it’s not necessary, we mustn’t abuse them, as my colleagues and I have been repeating for some time. It is a message addressed both to parents and to some pediatricians who in the past have perhaps prescribed it too lightly”, adds the infectious disease specialist.
Can you be healthy carriers?
The boom in requests for tampons, estimated at one + 2000%, has generated an alarm linked to the possible positivity: “The fact of being positive does not necessarily mean that it is necessary to follow a prophylactic antibiotic therapy – Bassetti further clarifies – If it is found, but it does not give symptoms such as fever or significant sore throat, it nothing needs to be done”. The data indicates that between 5 and 7% of people are healthy carriers: streptococcus can lurk in the nose or mouth even without causing effects: “The goal of antibiotic treatment is to counteract the effects that the bacterium has on the body, but if these are not there, there is no point in following it. Thinking of eradicating it completely is a mistake ”, adds the infectious disease specialist of San Martino in Genoa.
What to do if amoxicillin is missing?
Experts also ensure that no new strains of streptococcus have been identified, nor that there has been a form of resistance to the antibiotics of choice that are used in case of need. Faced with the increased demand for amoxicillin, however, and its scarcity, what should be done? “Don’t be alarmed, because they also exist other treatments such as those with cephalosporins, oral penicillin, sulfonamides, etc. In short, if the first choice therapy is based on amoxicillin for 10 days, in case of lack there are other solutions. The important thing – I repeat – is not to abuse antibiotics when they are not needed, otherwise in 10 years we will no longer have one that works and the risk will be to die again from trivial infections”, concludes Bassetti.