Acute Streptococcal Tonsillopharyngitis: A Review of Clinical Efficacy and Bacteriological Eradication

Ub, Schaad

doi:10.1177/147323000403200101

Cited by 9 publications

(8 citation statements)

References 30 publications

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“…Bacteriological eradication was less in azithromycin 10 mg/kg/day groups (38-58%) compared to penicillins (81-84%) whereas azithromycin 20 mg/kg/day therapy achieved bacteriological eradication in 95% cases. Authors suggested that a higher dose of azithromycin was more appropriate for management of acute Streptococcal tonsillopharyngitis [21]. Bacteriological eradication is more important from point of view of preventing progression of pharyngitis to acute rheumatic fever.…”

Section: Discussionmentioning

confidence: 99%

Azithromycin in Acute Bacterial Upper Respiratory Tract Infections: An Indian Non-Interventional Study

Donde

Mishra

Kochhar

2012

Indian J Otolaryngol Head Neck Surg

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To assess the effectiveness, safety and tolerability of azithromycin in acute bacterial upper respiratory tract infections (URTIs). In this open-label, prospective, multi-center, non-interventional study in bacterial URTI, the decision to prescribe azithromycin was independent of enrolment. Follow up was 1 week after treatment and if possible, at Week 2. Investigators' assessment of clinical outcome (Success/Failure) at the end of study was the primary endpoint for efficacy analysis. Clinical outcome of 'Success' was defined as the global response of Cure or Improvement. A pharmacoeconomic analysis of management of URTIs was also attempted. Of the 410 patients recruited, all were evaluated for safety and 278 for efficacy. The median treatment duration was 3 days. Following treatment with azithromycin, overall success rate was 98.92% (95% CI 96.88-99.78%; Clopper-Pearson method). The success rate was similar across the subgroups of acute otitis media-100%, bacterial sinusitis-95.83%, and pharyngotonsillitis-99.38%. The success rate was 100% among children and adolescents (age B18 years) and 98.6% among adults (age[18 years). Most of the common signs and symptoms of URTI reported during baseline, significantly improved at the end of the study. Sixteen (3.90%) patients reported treatment emergent adverse events, the most common being diarrhea-5 (1.2%) and flatulence-2 (0.5%). The average cost of treating bacterial URTI was INR 716 per patient. Azithromycin is effective and well tolerated in Indian patients with bacterial URTIs.

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Section: Discussionmentioning

confidence: 99%

Azithromycin in Acute Bacterial Upper Respiratory Tract Infections: An Indian Non-Interventional Study

Donde

Mishra

Kochhar

2012

Indian J Otolaryngol Head Neck Surg

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“…11 The use of BPG injection was considered unethical, dangerous, less efficacious, and even fatal in certain cases; therefore, studies with a direct comparison with azithromycin were not done, but the review of the literature showed azithromycin to be the best drug for GABHS. 12 ARMOR: Azithromycin must be given in a dose of 500 mg one tablet daily for 5 days, followed by one tablet once a week for 1 year for primary prevention, treatment and secondary prophylaxis of RF/RHD, respectively. 13…”

Section: The Miracle Solution Is As Followsmentioning

confidence: 99%

Prophylaxis of Rheumatic Fever/Rheumatic Heart Disease–Penicillin or Azithromycin, Who Wins?

Lalchandani

Lalchandani²,

Ahmad

et al. 2021

IJCDW

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For eradication of rheumatic fever (RF)/rheumatic heart disease (RHD), we must have a simplified diagnosis, and a treatment which is painless, easily available and safe; prophylaxis must be painless, safe, easily available, readily administered, and comprising a weekly oral single dose.Arati's regime for management of RF/RHD (ARMOR) consists of diagnosis and management of RF/RHD in today's context in a very easy and simplified way.ARMOR criteria: Arthritis or arthralgia with typical features suggestive of RF, carditis or cardiac involvement, typical of RF or RHD, and echocardiographic evidence of rheumatic heart valve involvement should essentially be the criteria to diagnose RF and RHD with high specificity and sensitivity.With regard to treatment of RF/RHD, we need a drug which is highly efficacious against Group A Beta Hemolytic Streptococcus (GABHS), which is the causative agent for primary prevention and treatment and secondary prophylaxis.The best drug discovered, to date, for GABHS is azithromycin.ARMOR for primary prevention, treatment and secondary prophylaxis of RF/RHD is as follows:Azithromycin must be given in a dose of 500 mg 1 tablet daily for 5 days, followed by 1 tablet once a week for 1 year.Penicillin for treatment and prophylaxis must be given up due to its lack of availability, side effects, risk of anaphylaxis, parenteral preparation, hazards of administration, need for sensitivity test each time, etc. and replaced by azithromycin.

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“…This failure probably stems from the fact that about 20% of children with GABHS is infected with bacteria which contain M protein, a virulence factor located on the surface of the bacterial wall that confers resistance to commonly used antibiotics [12]. Newer beta-lactamase-resistant antibiotics did not prevent this treatment failure [13, 14]. …”

Section: Introductionmentioning

confidence: 99%

“…Review of the literature from 1945 to 1999, which includes 10,484 cases of GABHS sore throat, found that antibiotic treatment reduced the occurrence of acute otitis media, a common complication of this disease, by a mere 25%, compared to the placebo group and sinusitis by only 50% [13]. Rheumatic fever, a nonsuppurative complication, was reduced by less than 33%, compared to placebo [8, 10, 11, 15].…”

Section: Introductionmentioning

confidence: 99%

Streptococcal Pharyngitis: A Prospective Study of Compliance and Complications

Sarrell

Giveon

2012

ISRN Pediatrics

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Background. Uncertainty exists concerning the necessity of 10-day antibiotic treatment of group A beta hemolytic streptococcus (GABHS) pharyngitis. Objective. To assess the incidence of GABHS recurrence and suppurative and nonsuppurative complications in relation to compliance. Methods. (Design). Prospective cohort observational study. (Subjects). 2,000 children aged 6 months to 18 years with sore throat and positive GABHS culture. (Main Outcome Measures). Recurrence of symptomatic culture positive GABHS pharyngitis, incidence of suppurative, and long-term, regional, nonsuppurative complications of GABHS pharyngitis, over a ten year period. Results. 213 (11%) of the children received no treatment. Most children received antibiotics for only 4–6 days (in correlation with the duration of fever, which in most cases lasted up to 3 days). Three hundred and six (15.3%) children had clinically diagnosed recurrent tonsillopharyngitis; 236 (12.3%) had positive GABHS findings within 10 to 14 days and thirty-four (1.7%) within 21–30 days after the index positive GABHS culture. The remaining 1.3% had no positive culture despite the clinical findings. Almost all recurrences [236 (11.6%)] occurred within 14 days and 156 (7.6%) in the fully treated group. The presence of fever during the first 3 days of the disease was the most significant predictor for recurrence. Other predictors were the age younger than 6 years and the presence of cervical lymphadenitis. No increase in the incidence of nonsuppurative or suppurative complications was noted during the 10-year follow-up period, compared to the past incidence of those complications in Israel. Conclusions. Our data suggests that the majority of children discontinue antibiotics for GABHS tonsillopharyngitis a day or two after the fever subsides. The incidence of complications in our study was not affected by this poor compliance.

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Acute Streptococcal Tonsillopharyngitis: A Review of Clinical Efficacy and Bacteriological Eradication

Cited by 9 publications

References 30 publications

Azithromycin in Acute Bacterial Upper Respiratory Tract Infections: An Indian Non-Interventional Study

Azithromycin in Acute Bacterial Upper Respiratory Tract Infections: An Indian Non-Interventional Study

Prophylaxis of Rheumatic Fever/Rheumatic Heart Disease–Penicillin or Azithromycin, Who Wins?

Streptococcal Pharyngitis: A Prospective Study of Compliance and Complications

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