Updated guideline for the management of upper respiratory tract infections in South Africa: 2008

Abstract

Output: Penicillin remains the drug of choice for tonsillopharyngitis. Single-dose parenteral administration of benzathine penicillin is effective, but many favour oral administration twice daily for 10 days. Amoxycillin remains the drug of choice for both AOM and ABS. A dose of 90 mg/kg/day is recommended in general, which should be effective for pneumococci with high-level penicillin resistance (this is particularly likely in children ≤2 years of age, in day-care attendees, in cases with prior AOM within the past six months, and in children who have received antibiotics within the last three months). Alternative antibiotic choices are given in the guideline with recommendations for their specific indications. These antibiotics include amoxycillin-clavulanate, some cephalosporins, the macrolide/azalide and ketolide groups of agents and the respiratory fluoroquinolones. Conclusion:The guideline should assist rational antibiotic prescribing for URTIs. However, it should be continuously updated when new information becomes available from randomised controlled trials and surveillance studies of local antibiotic susceptibility patterns.

Grommets - an update on common indications for tympanostomy tube placement

“…3 The advantages of topical rather than systemic antibiotics are multiple and include higher tissue levels, reduced adverse effects and less likelihood of the development of antimicrobial resistance. 13 Only eardrops specifically approved for use with tympanostomy tubes should be used because nonapproved drugs, including over-the-counter preparations, are ototoxic and may induce pain or infection, or even damage hearing.…”