Purulent sore throat treatment: how to treat throat in adults quickly and effectively
The content of the article:
- Causes and mechanisms of development of pathology
- Symptoms and diagnosis of the disease
-
How to treat purulent sore throat
How to treat the throat?
- Video
Treatment of purulent sore throat is an urgent issue in modern otorhinolaryngology, which is associated with a high risk of severe complications and an increase in the number of bacteria resistant to antibiotics.
To prescribe therapy for purulent sore throat, you should consult a doctor
Angina, or acute tonsillitis, is an infectious-allergic disease, manifested by acute inflammation of the tonsils. Angina is also called exacerbation of chronic tonsillitis.
Inflammatory changes in the tonsils can be catarrhal, purulent, or fibrinous.
Causes and mechanisms of development of pathology
Inflammation of the lymphoid tissue of the tonsils can be caused by viruses, bacteria or fungi. The development of purulent sore throat is associated with pathogenic or conditionally pathogenic flora: staphylococci, streptococci, haemophilus influenzae, anaerobes.
In most cases, bacteria lead to the development of purulent sore throat, namely, pyogenic streptococcus
The most significant causative agent is group A beta-hemolytic streptococcus, or pyogenic streptococcus. It is found in angina up to 80% of cases. The bacterium is a gram-positive immobile microorganism that produces toxins: hemolysin, streptolysin, streptokinase, deoxyribonuclease, hyaluronidase.
The penetration of the pathogen into the mucous membrane of the tonsils can occur by airborne droplets or alimentary.
The causative agent of the disease is usually transmitted by airborne droplets
Factors predisposing to the occurrence of angina may be: weakening of the body's natural defense mechanisms, concomitant pathology of the ENT organs, which complicates nasal breathing, as well as chronic inflammatory processes in the oral cavity.
A certain role is played by seasonal fluctuations in environmental conditions, the use of monotonous protein foods with a lack of vitamins, pathology of the central and autonomic nervous system, trauma to the tonsils.
After the introduction of an infectious agent into the mucous membrane of the tonsils, a complex inflammatory process is triggered, as a result of which antibodies are produced, which can serve as a prerequisite for the occurrence of various complications that have an infectious-allergic nature.
Pathomorphological changes in acute tonsillitis are characterized by a pronounced expansion of small blood and lymphatic vessels in the parenchyma of the tonsils, thrombosis of small veins, and stasis in the lymphatic capillaries. A large amount of serous secretion is exuded into the intercellular space.
The epithelial cover of the tonsils is densely infiltrated with lymphocytes and leukocytes. In the follicles leukocyte infiltrates appear, necrosis appears. In the gaps, there are accumulations of purulent discharge, which consists of leukocytes, lymphocytes, desquamated epithelium and fibrin.
If the drainage of the lacunae is disturbed, necrotic processes in the follicles, merging, form an abscess inside the amygdala. Thus, an abscess is formed, which can be emptied into the oral cavity.
Symptoms and diagnosis of the disease
Symptoms of purulent sore throat:
- acute onset of the disease;
- severe sore throat;
- fever;
- intoxication against the background of hyperthermia: chills, headache, pain in muscles and joints;
- bright hyperemia of the tonsils;
- plaque and purulent exudate in the lacunae of the tonsils;
- soreness and enlargement of the cervical lymph nodes;
- dyspeptic symptoms: nausea, vomiting, abdominal pain (in rare cases).
The main symptoms of purulent sore throat include an acute onset of the disease and severe sore throat.
What to do with purulent sore throat? If there are signs of a disease, it is recommended to consult a specialist: therapist, otorhinolaryngologist or infectious disease specialist. The doctor examines and determines the necessary laboratory and instrumental research methods. As a rule, pharyngoscopy, bacteriological culture, clinical blood test, general urine analysis are prescribed. According to the indications, an ECG (electrocardiography) is performed.
With purulent sore throat during pharyngoscopy, edema and bright hyperemia of the tonsils are determined, under the mucous membrane there are multiple festering yellow follicles, which can be seen in the photo of the throat taken during the procedure.
Purulent tonsillitis is characterized by a purulent plaque on the tonsils and bright hyperemia of the surrounding tissues
During the study, the specialist takes material for cultural research. The discharge from the surface of the tonsils is collected for inoculation on nutrient media. A smear is taken on an empty stomach or not earlier than 2-3 hours after eating and drinking. Through this analysis, the species identification of bacteria is carried out and the sensitivity to antibiotics is determined.
To identify pyogenic streptococcus, an express analysis is performed
Express diagnostics, which are based on the identification of streptococcal antigen in smears, have become widespread. The method is distinguished by high specificity (95-100%), quick results (5-10 minutes) and cost-effectiveness.
A clinical blood test is carried out for the purpose of differential diagnosis of bacterial and viral pathology, exclusion of infectious mononucleosis and blood diseases. With purulent angina, leukocytosis is observed, a pronounced shift of the leukocyte formula to the left due to an increase in the number of neutrophils and an increase in ESR (erythrocyte sedimentation rate).
A general urinalysis is necessary to rule out kidney complications such as glomerulonephritis or pyelonephritis.
How to treat purulent sore throat
Treatment of purulent sore throat in adults is carried out using local and general therapy, which is based on antibacterial drugs.
Antibiotics for purulent sore throat in adults are prescribed in order to eradicate the infectious pathogen and reduce the risk of rheumatic fever.
The widespread and not always justified use of antibacterial drugs has led to a significant increase in the number of antibiotic-resistant bacteria. The choice of the drug should be carried out strictly by the doctor. Self-treatment can lead not only to the resistance of the flora, but also to a number of complications, side reactions or the transition of an acute process to a chronic one.
Pyogenic streptococcus retained sensitivity to beta-lactam antibiotics. In some regions of the world, macrolide resistance exceeds 30%.
Amoxiclav is one of the drugs of choice for the treatment of angina
The drugs of choice for purulent sore throat are:
- Amoxicillin;
- Amoxicillin / clavulanate (Amoxiclav);
- Ceftriaxone.
Amoxicillin has a high bactericidal activity against group A beta-hemolytic streptococcus. A narrow targeted spectrum of action, good tolerance, minimal effect on the normal microflora of the gastrointestinal tract and low price are the main advantages of this drug.
But Amoxicillin is not always effective enough. This is due to the persistence of Staphylococcus aureus and Haemophilus influenzae on the mucous membrane of the upper respiratory tract, which, by producing the enzyme beta-lactamase, destroy the antibacterial substance of the drug. Therefore, in the treatment of acute purulent tonsillitis, they often resort to the appointment of protected penicillins, to which Amoxiclav belongs.
Amoxiclav, in addition to semi-synthetic penicillin (amoxicillin), contains a beta-lactamase inhibitor - clavulanic acid. By itself, clavulanic acid does not have an antibacterial effect, but it prevents the inactivation of amoxicillin, thereby expanding the spectrum of its activity.
The spectrum of action of cephalosporins is wider, which negatively affects the intestinal microflora. This once again proves the importance of prior consultation with a specialist before starting to take this or that antibacterial drug.
In patients with hypersensitivity to penicillins, cross-allergic reactions with cephalosporin antibiotics are possible.
With a purulent form of tonsillitis, Sumamed is often prescribed
Alternative medications are:
- Azithromycin (Sumamed);
- Cefotaxime;
- Lincomycin;
- Clarithromycin.
Macrolides are prescribed to persons with allergic manifestations to penicillins or other beta-lactam antibiotics.
Sumamed is a broad-spectrum bacteriostatic antibiotic from the macrolide-azalide group. Azithromycin, which is the active substance of the drug, suppresses protein synthesis of the microbial cell, slows down the growth and reproduction of bacteria. Sumamed activity extends to gram-positive, gram-negative, anaerobic and intracellular microorganisms.
How long antibiotic therapy lasts and which drug is best to take is decided individually, depending on the severity of the condition.
After receiving the results of bacteriological culture, due to the increase in the proportion of antibiotic-resistant strains, it may be necessary to correct the initial therapy.
With timely and adequate treatment, purulent angina lasts for 7-10 days.
The dynamic observation of a doctor also plays an important role for the timely diagnosis of possible complications.
To normalize the intestinal microflora or prevent dysbiosis after antibiotic therapy, drugs containing lacto- and bifidobacteria (Acipol) are prescribed.
In order to lower body temperature, non-steroidal anti-inflammatory drugs (Paracetamol) are used. Also, if you have a fever, it is advisable to drink plenty of fluids to rehydrate.
How to treat the throat?
Local therapy is recommended in the form of gargles, inhalations, tablets and lozenges.
Positive reviews confirm the effectiveness of the Tantum Verde spray. The medicine has anti-inflammatory, analgesic and antiseptic effects.
Antibiotic therapy should be combined with topical treatments such as Tantum Verde spray
Local antimicrobial agents play an important role. The drug Grammidin neo contains antibacterial and antiseptic components - gramicidin C and cetylpyridinium chloride. And Grammidin neo with anesthetic additionally contains oxybuprocaine, which helps to relieve pain and discomfort in the throat.
A broad-spectrum local antimicrobial agent is Streptocid, which can be applied to the affected tonsils in the form of an ointment. Sulfanilamide in the composition of the drug acts against gram-positive, gram-negative, anaerobic bacteria and allows you to get rid of purulent sore throat in the shortest possible time.
Among folk remedies, in addition to the main treatment at home, a compress of vodka is often made on the neck area. Before carrying out the procedure, it is necessary to consult a doctor, since in some cases the use of this method is contraindicated.
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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