Antibiotics for tonsillitis in adults and children
The content of the article:
- Symptoms and features of the course of acute and chronic tonsillitis
- Identification of the causative agent of infection
-
Antibiotic treatment for tonsillitis
- Names of drugs for the treatment of acute tonsillitis
- Antibiotics for chronic tonsillitis
- Possible consequences
- Video
Antibiotics for tonsillitis are prescribed for the alleged or confirmed bacterial etiology of the inflammatory process, as well as pronounced signs of intoxication of the body. Appointment of the correct antibiotic therapy regimen is possible only by a doctor, since the number of resistant strains, chronic forms of the disease and complications is growing every year.
The antibiotic regimen must be prescribed by a doctor
Tonsillitis is a widespread infectious disease. Most often, acute inflammation of the tonsils is caused by streptococci, staphylococci, neisseria, corynebacteria, spirochetes, listeria, chlamydia and mycoplasma. At the same time, the share of group A beta-hemolytic streptococcus accounts for up to 30% of cases of angina and exacerbation of chronic tonsillitis.
Most often, infection occurs by airborne droplets.
The infection is transmitted by airborne droplets from patients or carriers of bacteria. Children aged 5-15 and adults under 40 are more likely to get sick. The incidence is higher in contaminated areas. The occurrence of angina is facilitated not only by unfavorable environmental conditions, but also by a lack of vitamins in the diet, general and local hypothermia, concomitant chronic diseases of the respiratory system, gastrointestinal tract, etc.
Symptoms and features of the course of acute and chronic tonsillitis
Sore throat symptoms:
- sharp pain when swallowing;
- an increase in body temperature up to 38–39 ° С;
- headache;
- chills, feeling of weakness, weakness;
- nasal voice;
- bad breath;
- profuse salivation.
With tonsillitis, the palatine tonsils are affected, the surrounding tissues may be involved
With angina, the inflammatory process can spread to the surrounding tissues, leading to pharyngitis and laryngitis. It is also often accompanied by inflammation of the mucous membrane of the nasal cavity and paranasal sinuses, which aggravates nasal breathing.
On examination, the doctor reveals an increase and soreness of the regional lymph nodes. With pharyngoscopy, hyperemia and edema of the mucous membrane of the tonsils is determined, on which fibrinous plaque is often formed.
A blood test reveals leukocytosis, a shift in the leukocyte formula to the left, an acceleration of ESR (erythrocyte sedimentation rate), and the appearance of C-reactive protein.
Chronic tonsillitis is manifested by symptoms of chronic intoxication in the form of general weakness, increased fatigue, irritability. Often there is an increase in body temperature up to 37.0–37.9 ° C in the evenings. Possible vegetative-vascular changes: acrocyanosis, pulse lability, orthostatic hypotension, unpleasant sensations in the heart.
Pharyngoscopy in patients with a chronic form of the disease determines the adhesion of the tonsils with the arches and the presence of scars; caseous plugs are visualized in the lacunae.
Identification of the causative agent of infection
In order to identify the pathogen, a bacteriological study of the discharge of the tonsils is performed to determine antibiotic sensitivity.
In some cases, swabs are taken from the mucous membrane of the tonsils to prescribe adequate treatment.
Without fail, swabs are taken from the mucous membrane of the nose and tonsils for the presence of the causative agent of diphtheria.
To detect beta-hemolytic streptococcus, there is an express test designed for the qualitative detection of the bacteria within 5 minutes. This makes it possible to promptly prescribe treatment for streptococcal angina and avoid complications associated with this form of the disease (rheumatism, vasculitis, acute rheumatic fever, post-streptococcal glomerulonephritis, etc.).
Rapid methods do not exclude a culture study, but only supplement it, since a negative result of an express test cannot fully confirm the absence of streptococcal infection.
Antibiotic treatment for tonsillitis
Can bacterial tonsillitis be cured without antibiotics? This is not only impossible, but also hazardous to health.
The use of antibacterial agents is the basis of conservative therapy for bacterial tonsillitis. A rational approach to the choice of medicines is extremely important. Unreasonable or excessive use of antibiotics contributes to the development of resistance of microorganisms to them.
In case of a severe course of the disease, hospitalization in an infectious diseases hospital is required
Patients with severe angina or complications should be hospitalized in an infectious diseases hospital.
In the absence of the results of bacteriological research, the doctor chooses an empirically optimal drug, taking into account the spectrum of the most likely causative agents of the disease.
Names of drugs for the treatment of acute tonsillitis
The choice of medicines always remains with the specialist, since only a doctor can tell which medicines are best to take for one form or another of tonsillitis.
To make a diagnosis and choose a drug, you must consult with an ENT doctor
Antibacterial drugs should be prescribed when there is a reasonable indication. Early initiation of antibiotic use significantly reduces the duration and severity of symptoms.
Prophylactic antibacterial, antifungal and antiviral medications should be avoided. It is necessary to comply with the treatment regimen prescribed by the doctor: drug, daily dose, frequency of administration, duration of use. At the end of treatment, repeated microbiological examination is indicated.
In acute tonsillitis, the drugs of choice are antibiotics from the penicillin group, for example, Amoxicillin, which is administered orally in 500 mg tablets 3 times a day, or Phenoxymethylpenicillin 500 mg 3 times a day. The course of treatment is 10 days.
In children with angina, it is necessary to refrain from prescribing aminopenicillins if infectious mononucleosis is suspected, since with it Ampicillin and Amoxicillin can cause a skin rash.
Alternative drugs for the treatment of sore throat have a broader spectrum of antimicrobial activity and can affect the normal flora of the body. List of alternative medicines:
- Cephalexin;
- Benzathine benzylpenicillin;
- Josamycin;
- Azithromycin;
- Clarithromycin.
For recurrent A-streptococcal tonsillitis, the drug of choice is Amoxicillin / clavulanate. Alternative remedies:
- Cefuroxime axetil;
- Cefixime;
- Lincomycin;
- Clindamycin.
The duration of therapy is 10 days. Self-reduction in the timing of taking the drug is unacceptable, as this leads to a recurrence of the process, contributes to the emergence of resistant strains of microorganisms and the development of complications. Therefore, antibiotics should be drunk according to the scheme prescribed by the specialist.
Antibiotics for chronic tonsillitis
Treatment of chronic tonsillitis with antibiotics is carried out only during an exacerbation of the disease. Drugs of choice are: Amoxicillin / clavulanate, Cefuroxime. The duration of treatment is 10-14 days.
Against the background of antibiotic therapy, it is recommended to take probiotics or eubiotics (Linex, Acipol) to prevent or treat intestinal dysbiosis.
The risk of developing invasive mycosis or local candidiasis (oral mucosa, urinary tract, genital organs) while taking antimicrobial agents is quite low. But after assessing the risk factors, the doctor can prescribe antifungal drugs - Fluconazole, Nystatin.
Possible consequences
Among the adverse reactions when taking antibiotics, the most dangerous are:
- allergic reactions;
- chondro- and arthrotoxicity;
- hepatotoxic effect;
- pseudomembranous colitis (the risk is higher with fluoroquinolones and lincosamides);
- antibiotic-associated diarrhea.
With untimely started or inadequate treatment, complications may develop, in particular - paratonsillar abscess
If in the first days active treatment of angina is not started, then on the fifth day a paratonsillar abscess may form, which is a limited abscess in the peri-rectal tissue. It is also possible to develop lymphadenitis, purulent otitis media, sinusitis. In rare cases, with reduced reactivity of the body, an abscess can form even during therapy.
An initial assessment of the effectiveness of antibiotics should be carried out on the third day after the start of their intake. In this case, you need to focus on the symptoms of intoxication and the severity of inflammation: normalization of body temperature, reduction or disappearance of pain in the throat, as well as swelling and hyperemia of the tonsils. In the absence of clinical improvement in the patient's condition, the doctor can adjust the treatment.
Unmotivated delay in working capacity, weakness, an unstable increase in body temperature to subfebrile digits (37.1-38.0 ° C), joint pain, palpitations that persist after suffering tonsillitis in combination with a moderate increase in ESR (erythrocyte sedimentation rate) and an increase in anti-streptococcal antibodies in the blood indicates the onset of acute rheumatic fever. At the same time, due to the erased clinical picture of the disease, patients often prefer to be treated at home on their own without antibacterial agents, which aggravates the pathological process.
Antibiotics are among the drugs that are most likely to be effective. Optimization of their use in the treatment of acute and chronic inflammatory diseases inhibits antibiotic resistance.
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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