Prevalence and Epidemiology of Group A Beta Hemolytic Streptococcus (GABHS) Among School-Age Children with Tonsillopharyngitis in Northern Palestine, A Cross-Sectional Study

Tonsillopharyngitis is a common diagnosis in children, and viral pathogens mainly cause it. Group A B-Hemolytic Streptococcus GABHS is the most common bacterial cause, and it is often overestimated as a causative agent because diagnosis usually relies on clinical judgment, leading to the overuse of broad-spectrum antibiotics. The study aims to investigate the prevalence of GABHS in children clinically suspected of having tonsillopharyngitis and to identify the associated risk factors and antibiotic profiles. In this non-interventional cross-sectional study, 321 throat swab samples from children aged 5-15, clinically diagnosed with tonsillopharyngitis at 3 major healthcare centers in North Palestine from September 2022 to January 2023, were tested using throat swab cultures on blood agar and rapid antigen test for Streptococcus. A structured questionnaire was used to collect data from patients, their families, and treating physicians. A total of (99/321-30.8%) tested positive by the Rapid Antigen Test, with (75/321- 23.4%) confirmed through culture. A higher number of siblings and a history of recurrent infections were identified as significant risk factors for a positive throat swab culture. Penicillin was identified as the most effective antibiotic with a sensitivity rate of 97.3%, followed by Amoxicillin-Clavulanic Acid with a sensitivity rate of 96%, while Azithromycin was the least effective antibiotic. Among patients with tonsillopharyngitis, the prevalence of GABHS was determined to be 23.4%. If antibiotic therapy is warranted, Penicillin and Amoxicillin/Clavulanic Acid are the recommended drugs of choice