A pilot study of penicillin prophylaxis for neuropsychiatric exacerbations triggered by streptococcal infections.

摘要: Abstract Background: Some children with obsessive-compulsive disorder (OCD) and tic disorders appear to have symptom exacerbations triggered by group A beta-hemolytic streptococcal infections in a manner that is similar rheumatic fever its neurologic variant, Sydenham’s chorea. Because penicillin prophylaxis has proven be effective preventing recurrences of fever, it was postulated might also prevent streptococcal-triggered neuropsychiatric Pediatric Autoimmune Neuropsychiatric Disorders Associated Streptococcal (PANDAS). These are identified five clinical characteristics: presence OCD or disorder, prepubertal onset, episodic course, abnormalities (i.e., choreiform movements) exacerbations. Methods: Thirty-seven PANDAS were enrolled an 8 month, double-blind, balanced cross-over study. Patients randomized receive either 4 months the active compound (twice daily oral 250 mg V) followed placebo, placebo V. Tic, OCD, other psychiatric symptoms monitored monthly. Throat cultures antibody titers obtained. Results: There equal number both phases no significant change seen severity between two phases. Conclusions: failure achieve acceptable level prophylaxis, conclusions can drawn from this study regarding efficacy Future studies should employ more prophylactic agent, include larger sample size.