Impact of Antibiotic Treatment of Group A Streptococcal Blistering Distal Dactylitis in Children (TAPPS)

Camille JUNG

Status: Completed

Conditions: Blistering Distal Dactylitis

Treatments: Procedure: Negative rapid GAS test; Procedure: Positive rapid GAS test

Study type: Interventional

Funder types: Other

Identifiers

NCT02624882

TAPPS

Details and patient eligibility

About

Single-center prospective study to assess the clinical course of group A streptococcal blistering distal dactylitis in children after antibiotic treatment.

Full description

Blistering distal dactylitis are very common in children. About 60% are caused by Staphylococcus aureus and some are caused by Group A Streptococcus (GAS) or Streptococcus pyogenes. While these forms have been known for fifty years, few publications are interested in it. Some studies have confirmed that a single antibiotic treatment against the SGA allows the healing of these dactylitis but few surgical teams have adopted this strategy. As all streptococcal infections, they face the risk of acute complications (septicemia, streptococcal toxic shock, etc.) or late (post-streptococcal glomerulonephritis, acute rheumatic fever, etc.). The involvement of the SGA in these dactylitis is easy to demonstrate through the use of rapid GAS test already widely used in other GAS infections (tonsillitis, scarlet fever, streptococcal perianal infections).

This study aims to assess the clinical course of positive GAS test blistering distal dactylitis in children after antibiotic treatment.

Enrollment: 177 patients

Sex: All

Ages: 1 day to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Children 0-18 years
• Distal blistering dactylitis collected or not collected
• Positive rapid Group A Streptococcus test
• Informed consent signed by the parents

Exclusion criteria

• Subungual or pulp Whitlow
• Children not affiliated to the social security scheme
• Refusal by the parents to participate in the study

Trial design

Primary purpose: Diagnostic

Allocation: Non-Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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177 participants in 2 patient groups

Positive rapid Group A Streptococcus (GAS) test

Experimental group

Description:

In case of positive rapid GAS test, patients will be treated by antibiotics: amoxicillin 50mg/kg/d during 10 days or cefpodoxime 8mg/kg/d during 10 days in case of betalactamine allergy

Treatment:

Procedure: Positive rapid GAS test

Negative rapid GAS test

Active Comparator group

Description:

If case of negative rapid GAS test, usual care: local antiseptic or surgical intervention

Treatment:

Procedure: Negative rapid GAS test