A clinical decision rule for streptococcal pharyngitis management: An update

Nasirian, Hosain; TarvijEslami, Saeedeh; Matini, Esfandiar; Bayesh, Seyedehsara; Omaraee, Yasaman

doi:10.4103/0974-2727.199635

Cited by 5 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…China 38,39 (with Hong Kong 8 ), India, 40 Japan, 41 Malaysia 42 and Thailand 43 . Regarding the Middle East, the principal recommendations were found from Iran, 44,45 Israel, 46 Saudi Arabia 47 and Turkey 48 . For South America, recommendations from Argentina 49 and Brazil 6,50 were included, in addition to a Latin American guideline 51 .…”

Section: Resultsmentioning

confidence: 99%

“…34 While the latter two rely on the Centor score (or similar) only, the Dutch guideline considers the distinction of viral and bacterial acute pharyngitis as usually irrelevant, given the low incidence of GAS in the Netherlands. 26 A mixed picture emerges from Asia (except China) and the Middle East, where wealthier countries, such as Japan, 41 Israel 46 and Saudi Arabia, 47 but also Malaysia 42 and a recent recommendation from Iran, 45 include RADT in their guidelines, while the other countries, and an earlier Iranian guideline, 44 recommend treatment according to clinical criteria, with 48,40 or without 43,44 using the Centor score. In China, the Special Administrative Region of Hong Kong recommends RADT, 8 whereas Chinese National guidelines endorse antibiotic treatment based on clinical signs and symptoms only.…”

Section: Recommendations For Antibiotic Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Worldwide comparison of treatment guidelines for sore throat

Coutinho

Duerden

Sessa³

et al. 2021

Int. J. Clin. Pract.

View full text Add to dashboard Cite

Introduction Sore throat (acute pharyngitis) is globally one of the most frequent reasons for seeking healthcare. Its etiology is mostly viral. In 15%‐30% of cases, group A streptococci (GAS) are detected, which may cause acute rheumatic fever. We have done a worldwide systematic review to compare diagnostic and therapeutic guidelines across countries and regions. Previous reviews of sore throat guidelines were limited to specific regions and/or language; this is the first global review. Materials and Methods Searches were performed in MEDLINE, EMBASE and COCHRANE (key words: sore throat, pharyngitis, tonsillitis or pharyngotonsillitis, and management, guidance, guideline or recommendation) and on the web sites of major health authorities and associated institutions from Africa, Asia, Europe, Middle East, North America, Oceania and South America. Results Thirty‐six guidelines were identified from 26 countries. Most common are recommendations relying on the symptom‐ and age‐based Centor or McIsaac scores. However, antibiotic treatment may be based on other symptomatic criteria; in the most extreme approach just sore throat in children. The recommendation of GAS‐specific diagnostic tests is mainly limited to countries where such tests are readily available, although some countries choose not to use them. Penicillins are consistently recommended as first‐line antibiotics. By contrast, guidance for symptomatic treatment is variable and mostly sparse or missing. African countries without sore throat guidelines and Asian countries bypassing them are afflicted by rising antibiotic resistance. Conclusion The availability of sore throat guidelines varies considerably by region and country. Moreover, important divergence is found among the guidelines regarding diagnostic and treatment criteria. This may be explained by the historical background or adoption of external guidelines, rather than local incidences of GAS infections or acute rheumatic fever. Absence of recommendations on symptomatic treatment in many guidelines is concerning, and raises issues about antimicrobial stewardship, as this should be the mainstay of sore throat management, rather than antibiotics.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Recommendations For Antibiotic Treatmentmentioning

confidence: 99%

Worldwide comparison of treatment guidelines for sore throat

Coutinho

Duerden

Sessa³

et al. 2021

Int. J. Clin. Pract.

View full text Add to dashboard Cite

show abstract

“…If left untreated, it may cause post streptococcal glomerulonephritis and acute rheumatic fever (ARF) that is currently uncommon in most developed countries, but it remains the leading cause of acquired heart disease, rheumatic mitral stenosis in developing and low-income group countries [20][21][22]. Antibiotics and anti-inflammatory drugs always constitute first-line of treatments but increasing microbial resistance to antibiotics [23], GAS is becoming a major health threat to children, even in developed countries [24,25].…”

Section: Discussionmentioning

confidence: 99%

Instant Antibacterial and Anti-Inflammatory Osmotic Polymeric Film to Treat Sore Throat in Children

Shrivastava¹

2021

JCRR

View full text Add to dashboard Cite

Background: Pharyngitis, a common viral throat infection in children, involving inflammation, widespread local bacterial contamination and tissue destruction. When clinical signs appear, the disease already became multifactorial. In the absence of any multitarget treatment, we conceived a new generation of topical, osmotic, anti-inflammatory, throat surface cleaning polymeric film, capable of detaching and draining throat surface contaminants nearly instantly. Material and methods: A glycerol and polymer containing osmotic film was prepared. Osmotic film attracts hypotonic liquid from the throat tissue, which detach and drain throat surface contaminants and create a favorable environment for cell growth and healing. Specific pro-inflammatory cytokine and virus glycoprotein binding polymers were incorporated in the film to suppress the inflammation. An observational, randomized, placebo-controlled study was performed after the approval of ethical committee on 30 children aged between (3-15), presenting symptoms of acute pharyngitis. After randomization, test product (n=20) and saline control (n=10) solutions were applied as 3-4 throat sprays 4-5 times / day for 15-days. Change in all the key pharyngitis symptom (difficulty swallowing, throat inflammation, irritation, redness, and bacterial deposit) were evaluated employing two-tailed Student’s test for followed by the post hoc Bonferroni’s test for comparisons of multiple groups Results: Only a few specific polymers were able to bind with viral proteins and/or cytokines in adequate filmogen concentrations. Throat surface cleaning and cytokine neutralization strongly decrease all the pharyngitis symptoms and need for antibiotic therapy compared to controls (p<0.05 from day 3 onwards). No adverse effects were noted in any of the groups. Conclusion: Clinical results showed excellent efficacy and safety of osmotically active polymeric film. Polymeric drugs may represent an excellent multitarget treatment approach to minimize the use of antibiotics and chemical drugs in the future.

show abstract

“…Streptococcal throat infection (strep throat) is caused by group A beta-hemolytic Streptococcus pyogenes [7]. This bacterial cause of pharyngitis is frequently associated with post-streptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease [7,8]. Although a few case reports have been published on the possible association between strep pharyngitis and intracranial infections [9][10][11], the role of microbial infection in ACM is not clear.…”

Section: Introductionmentioning

confidence: 99%

Arnold-Chiari Malformation Type I Evident After a Streptococcal Throat Infection in a Young Female: A Rare Case

Shahab¹,

Nazir²,

Nazir³

2023

Cureus

View full text Add to dashboard Cite

Arnold-Chiari malformation (ACM) is a rare neurological developmental disorder that presents at birth. No such cases have been reported in support of microbial infections causing Chiari malformation, yet there is evidence of how microorganisms can lead to brain abscess, brain empyema, and meningoencephalitis. We present a 23-year-old young woman with progressive back and leg pain after a streptococcal throat infection, followed by a single episode of syncope. Radiographs of the spine revealed a mild reversal of cervical spine curvature and minimal levocurvature of the lumbar spine. Magnetic resonance imaging of the brain showed herniation of the cerebral tonsils into the foramen magnum, which suggested the diagnosis of ACM type I. Neurosurgery was recommended for posterior fossa decompression, but the patient was reluctant to undergo the procedure. This is a rare case of ACM symptomology that became evident only after a streptococcal throat infection in a young adult female.

show abstract

A clinical decision rule for streptococcal pharyngitis management: An update

Cited by 5 publications

References 20 publications

Worldwide comparison of treatment guidelines for sore throat

Worldwide comparison of treatment guidelines for sore throat

Instant Antibacterial and Anti-Inflammatory Osmotic Polymeric Film to Treat Sore Throat in Children

Arnold-Chiari Malformation Type I Evident After a Streptococcal Throat Infection in a Young Female: A Rare Case

Contact Info

Product

Resources

About