Treatment of pharyngitis with antibiotics in adults and children
The content of the article:
- Causes of pharyngitis in adults and children
- Pharyngitis symptoms
- Diagnostics
- Pharyngitis treatment
- Video
Antibiotics for pharyngitis in adults and children are prescribed for the treatment of acute pharyngitis of bacterial etiology or for a protracted, severe course of the disease. The problem of the correct selection and rational use of antibacterial drugs is currently one of the most pressing topics in otorhinolaryngology.
A doctor should prescribe antibiotics for the treatment of pharyngitis
Pathogenic microorganisms from the environment, entering the human body against the background of reduced general and local immunity, can invade the pharyngeal mucosa, causing its inflammation - pharyngitis. The prevalence of the disease among the adult population reaches 75%, and in children - 30%.
According to pharmacological and epidemiological studies, in Russia up to 95% of patients who develop sore throats receive antibiotics. This tactic is not always justified. Irrational use of antibacterial drugs leads to the development of resistance of most microorganisms.
Causes of pharyngitis in adults and children
The following factors contribute to the development of acute inflammation of the pharyngeal mucosa:
- hypothermia of the body;
- smoking;
- alcohol intake;
- hot and cold food;
- dust;
- gassed air;
- prolonged mouth breathing.
The causative agent of pharyngitis can be influenza virus
In 40–70% of cases, acute pharyngitis occurs as a result of viruses entering the body that affect the mucous membrane of the upper respiratory tract:
- influenza and parainfluenza viruses;
- rhinoviruses;
- adenoviruses;
- coronaviruses;
- enteroviruses;
- Epstein-Barr virus.
Pathogens of pharyngitis of bacterial etiology can be streptococci
Pharyngitis of bacterial etiology is a separate form of the disease. In this case, the pathogens are staphylococci, streptococci, intracellular microorganisms (chlamydia, mycoplasma).
In case of mycotic lesion of the pharynx, the causative agent is yeast-like fungi of the genus Candida
The cause of mycotic lesions of the pharynx are yeast-like fungi of the genus Candida. A combination of bacterial and fungal flora is possible.
In addition, strep throat can result from mechanical, thermal or chemical damage to the pharynx, as well as be of an allergic nature.
Pharyngitis symptoms
The main complaints of patients with acute pharyngitis are:
- sore throat when swallowing, mainly when swallowing saliva;
- feeling of dryness, perspiration, burning, or discomfort in the throat;
- dry cough.
The feeling of mucus flowing down the back of the throat forces the patient to swallow frequently, which aggravates the sore throat. Most often, pharyngitis proceeds without fever, but body temperature may rise to 37.1–37.9 ° C, especially in children. In case of bacterial damage or severe disease, it can rise above 38.0 ° C.
With the development of acute pharyngitis, a descending inflammation with the occurrence of laryngitis, tracheitis, and bronchitis is possible. In children, the disease often occurs with damage to the mucous membrane of the nasal cavity (rhinitis) and tonsils (tonsillitis).
In chronic pharyngitis, the patient may also complain of pain, discomfort and dry throat, but the symptoms are not so pronounced.
Diagnostics
The diagnosis of pharyngitis plays an important role. When making a diagnosis, the doctor relies on history data, clinical manifestations and research results, such as:
- pharyngoscopy;
- rapid test for streptococcus;
- bacteriological inoculation of the discharge and PCR research (polymerase chain reaction);
- clinical blood test.
If necessary, a PCR study is carried out for diagnostic purposes
Pharyngoscopy is performed, in which diffuse hyperemia of the posterior pharyngeal wall, swelling of tissues and palatine tonsils is determined, plaque is possible.
Bacteriological examination of discharge from the nose and throat is aimed at identifying the pathogen and determining the sensitivity of bacteria to the action of antibacterial drugs.
In the diagnosis of streptococcal pharyngitis, rapid tests are of great importance, which quickly determine the presence of the pathogen.
When an intracellular infection (chlamydia and mycoplasma) is detected by PCR, the principles of antibiotic therapy may change.
A clinical blood test can help in diagnosing the general condition of the body and in the differential diagnosis of a viral or bacterial infection.
Pharyngitis treatment
Treatment of pharyngitis in adults and children includes local and systemic therapy. It is necessary to exclude irritating food from the diet: rough, cold, hot, sour foods and dishes, carbonated drinks. Smoking and alcohol intake should be limited or excluded as much as possible.
In case of exacerbation of the disease, warming procedures are recommended, in particular, a dry bandage around the neck and warm, abundant drink.
At the first signs of an exacerbation or a chronic process, warming procedures are recommended:
- warm plentiful drink;
- hot foot baths;
- dry bandage around the neck.
Can pharyngitis be cured without antibiotics? Systemic antibiotic therapy is justified in acute pharyngitis caused by pyogenic streptococcus or group A beta-hemolytic streptococcus. Antibiotics are also prescribed when pathogenic flora is detected based on the results of inoculation and with a protracted, severe course of the disease.
What antibiotics to drink, the doctor decides, depending on the alleged or established etiological agent. The drug of choice for the treatment of acute bacterial or streptococcal pharyngitis are penicillins: amoxicillin (Flemoxin Solutab), amoxicillin + clavulanate (Amoxiclav), amoxicillin + sulbactam (Trifamox).
An alternative can be the first generation cephalosporins: cefazolin (Zolin), cephalexin (Cefaclor), cefadroxil (Duracef). The names of products containing one active ingredient may vary.
Before prescribing antibiotics for pharyngitis in children, they also rely on the results of an express test for hemolytic streptococcus, assess the severity of the general condition. When choosing an antibiotic, it is necessary to take into account age restrictions and antibiotic therapy, which the child received the previous 2-3 months.
The course of antibiotic treatment for pharyngitis in adults is on average 7-10 days. For the eradication of group A beta-hemolytic streptococcus, the duration of penicillin therapy in children and adults is 10 and 14 days, respectively.
Before prescribing drugs of the penicillin series, a skin test is performed to assess the allergic reaction. In case of allergy to penicillin, the drugs of choice are third generation cephalosporins (Cefixime), macrolides (Azithromycin) or lincosamides (Lincomycin).
Topical treatment for acute pharyngitis includes:
- topical drugs (absorbable tablets, sprays, solutions) that have anti-inflammatory, analgesic, antibacterial, antiviral and immunocorrective effects: Gramicidin, Hexoral, Octenisept, Septolete, Strepsils, Tantum Verde;
- lysozyme-containing agents: Lizobact, Laripront;
- topical immunomodulators: Imudon, Imunoriks, IRS-19, Ribomunil. The drugs are lysates of the main infectious agents of pathological processes in the upper respiratory tract and pharynx. They have anti-inflammatory, anti-edema, antibacterial, antiviral and antifungal effects;
- phytopreparations with local immunostimulating action: Tonsilgon N, Tonsipret, Elekasol, Romazulan;
- topical non-steroidal anti-inflammatory drugs: OKI (ketoprofen), Strepfen (flurbiprofen);
- homeopathic remedies with antiseptic effect: Influcid, Tonsilotren, Faringomed.
Shown are steam inhalation or rinsing the throat with warm infusions of chamomile, calendula, mint or eucalyptus.
For steam inhalation, herbal infusions can be used
In the treatment of the inflammatory process of the pharyngeal mucosa, herbal antiseptics and essential oils are effective, but they are contraindicated in patients who are allergic to plant pollen.
It is recommended to use a nebulizer for direct delivery of the active substance to the upper and lower respiratory tract. This is an inhalation device that converts a solution into an aerosol.
The list of drugs necessary for treatment, and how exactly they are taken, is determined by the doctor. It must be remembered that antibiotics do not work against viruses, do not lower body temperature and do not help prevent bacterial complications. The appointment of these funds for viral pharyngitis leads to the development of unwanted drug reactions and leads to an increase in bacterial resistance.
Unreasonable use of antibiotics disrupts the normal microflora of the body. It is important to comply with the prescribed therapy regimen, you should not prematurely stop taking the drug or reduce the daily dose, even if the condition improves.
Video
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Alina Ervasova Obstetrician-gynecologist, consultant About the author
Education: First Moscow State Medical University. THEM. Sechenov.
Work experience: 4 years of work in private practice.
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