Streptococcal Pharyngitis in the General Population. I. A Controlled Study of Streptococcal Pharyngitis and its Complications in the Netherlands

Haverkorn, M. J.; Valkenburg, H. A.; Goslings, W. R. O.

doi:10.1093/infdis/124.4.339

Cited by 27 publications

(7 citation statements)

References 8 publications

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“…These fi ndings, however, have never been confi rmed in other trials with penicillin, [63][64][65] nor have they be confi rmed in consecutive prospective studies. [66][67][68][69] Almost a half-century ago, an editorial claimed:…”

Section: In T Er Nat Iona L Pha Ry Ngi T Is Guidel Inesmentioning

confidence: 99%

Differences Among International Pharyngitis Guidelines: Not Just Academic

Matthys¹,

Meyere²,

Driel³

et al. 2007

The Annals of Family Medicine

158

105

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PURPOSE Many countries have national guidelines for the treatment of pharyngitis. We wanted to compare the recommendations and the reported evidence in national guidelines for the management of acute sore throat in adults.METHODS Guidelines were retrieved via MEDLINE and EMBASE and through a Web-based search for guideline development organizations. The content of the recommendations and the underlying evidence were analyzed with qualitative and bibliometric methods. RESULTSWe included 4 North American and 6 European guidelines. Recommendations differ with regard to the use of a rapid antigen test and throat culture and with the indication for antibiotics. The North American, French, and Finnish guidelines consider diagnosis of group A streptococcus essential, and prevention of acute rheumatic fever remains an important reason to prescribe antibiotics. In 4 of the 6 European guidelines, acute sore throat is considered a self-limiting disease and antibiotics are not recommended. The evidence used to underpin these guidelines was different in North America and Europe. North American guidelines cited more North American references than did European guidelines (87.2% vs 48.0%; ods ratio, 4.6-11.9; P <.001).CONCLUSION Although the evidence for the management of acute sore throat is easily available, national guidelines are different with regard to the choice of evidence and the interpretation for clinical practice. Also a transparent and standardized guideline development method is lacking. These fi ndings are important in the context of appropriate antibiotic use, the problem of growing antimicrobial resistance, and costs for the community.

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Section: In T Er Nat Iona L Pha Ry Ngi T Is Guidel Inesmentioning

confidence: 99%

Differences Among International Pharyngitis Guidelines: Not Just Academic

Matthys¹,

Meyere²,

Driel³

et al. 2007

The Annals of Family Medicine

158

105

View full text Add to dashboard Cite

show abstract

“…Over the past 30 years, there has been a progressive decline in the incidence of acute post-streptococcal glomerulonephritis (APSGN) in developed countries [1][2][3][4][5]; however, among New Zealand children, APSGN is the commonest cause of acute glomerulonephritis. In a recent unpublished study undertaken between January 2006 to April 2007, 111 cases were identified in two children's inpatient facilities in Auckland, New Zealand, resulting in a mean annual admission rate of 30-62 per 100,000 children under the age of 14 years between these two centers.…”

Section: Introductionmentioning

confidence: 99%

Outcome of severe acute post-streptococcal glomerulonephritis in New Zealand children

2009

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Post-streptococcal glomerulonephritis (PSGN) is the commonest cause of severe acute glomerulonephritis in New Zealand children, with the majority (85%) of the patients being of either Pacific Island or Maori ethnicity. We have performed a retrospective study on 27 pediatric patients with acute PSGN. Of these patients, those with crescentic glomerulonephritis (n = 11) had a greater tendency (72.7%) for needing acute dialysis and were left with persistent urinary sediment abnormalities after a mean follow-up of 3.2 years (95% confidence interval 2.1-4.3). The efficacy of immunosuppression in the group with crescentic disease was uncertain. The severity of renal histopathological abnormalities as judged by the total biopsy score did not correlate with either presentation or eventual outcome. Severe childhood acute post-streptococcal glomerulonephritis, although uncommon, results in significant long-term renal morbidity, particularly among Maori and Pacific Island children.

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“…Sore throat is the most common indication for an unscheduled visit with a physician for the school-age child, adolescent, and adult [1,2]. On the other hand, fewer than 20 % of patients with sore throat or pharyngo-tonsillitis seek medical advice [3][4][5][6].…”

Section: Challenges In Treating Sore Throatmentioning

confidence: 99%

Efficacy and Safety of Ambroxol Lozenges in the Treatment of Acute Uncomplicated Sore Throat

Mey

Peil

Kölsch

et al. 2011

Arzneimittelforschung

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Sore throat is the hallmark of acute pharyngitis. Although usually caused by viral infections, it is frequently treated with antibiotics. Such inappropriate use of antibiotics might best be challenged by offering efficacious and safe symptomatic pain relief instead. However, there is need for robust evidence to support such alternatives. Presently, the evidence from randomised, placebo-controlled, double-blind clinical trials (RCT) with the local anaesthetic ambroxol (CAS 23828-92-4) in the treatment of sore throat is being reviewed. This relates to five RCT in 1,772 patients; 1,713 were evaluable with regard to efficacy. Treatment with ambroxol lozenges was statistically significantly superior to placebo in reducing sore throat pain intensity with a high level of consistency of the estimated effect across the different studies. The effect had an early onset and lasted up to at least 3 h after a single first lozenge. The pain relief was associated with a statistically superior regression of pharyngeal redness and inflammation; with ambroxol, the overall efficacy was more frequently rated as at least "good". Treatment with the ambroxol lozenges was well tolerated. There was heterogeneity in reporting adverse events: in one later study with less severe baseline pain intensity there was more frequent reporting of hypoaesthesia of the oral cavity and tongue as an untoward phenomenon. In patients with more severe baseline pain this reflection of the medication's pharmacological action was only rarely reported as untoward. It is concluded that lozenges containing 20 mg ambroxol are a safe and efficacious treatment for acute uncomplicated sore throat of recent onset in adult patients.

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Streptococcal Pharyngitis in the General Population. I. A Controlled Study of Streptococcal Pharyngitis and its Complications in the Netherlands

Cited by 27 publications

References 8 publications

Differences Among International Pharyngitis Guidelines: Not Just Academic

Differences Among International Pharyngitis Guidelines: Not Just Academic

Outcome of severe acute post-streptococcal glomerulonephritis in New Zealand children

Efficacy and Safety of Ambroxol Lozenges in the Treatment of Acute Uncomplicated Sore Throat

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