Sore throat antibiotics

Acute pharyngitis presents a diagnostic and therapeutic dilemma. The majority of sore throats are caused by a variety of viruses fewer than 20% are bacterial and hence potentially responsive to antibiotic therapy. However, antibiotics are widely prescribed and this reflects the difficulty in discriminating streptococcal from non-streptococcal infections clinically in the absence of microbiological documentation. Nonetheless, Strep, pyogenes is the most important bacterial pathogen and this responds to oral penicillin. However, up to 10 days treatment is required for its eradication fixm the throat. This requirement causes problems with compliance since symptomatic improvement generally occurs within 2-3 days. 

Pharyngitis is an acute throat infection caused by viruses or bacteria. Other conditions, such as gastroesophageal reflux, postnasal drip, or allergies, also can cause sore throat and must be distinguished from infectious causes. Acute pharyngitis is responsible for 1% to 2% of adult physician visits and 6% to 8% of pediatric visits but generally is self-limited without serious sequelae.41,42 Antibiotics are prescribed in 50% to 70% of cases in adults and children because of the inability to... 

Reactions to antithyroid drugs have been described above. A minor rash can often be controlled by antihistamine therapy. Because the more severe reaction of agranulocytosis is often heralded by sore throat or high fever, patients receiving antithyroid drugs must be instructed to discontinue the drug and seek immediate medical attention if these symptoms develop. White cell and differential counts and a throat culture are indicated in such cases, followed by appropriate antibiotic therapy. 

Overuse of antibiotics comes from the desire to treat colds and other illnesses caused by viruses rather than bacteria. Unlike bacteria, viruses do not respond to antibiotics. Yet the symptoms of bacterial and viral infections are similar enough that patients often want antibiotics for both. For example, a study from Harvard University reports that more than a million children a year unnecessarily receive antibiotics for sore throats.53 While 15 to 36 percent of children with sore throats have a bacterial streptococcal infection that antibiotics can treat, 54 percent of the children studied received an antibiotic. Other studies report similar overuse among adults for sinus infections. Although only a small portion of sinus infections result from bacteria, most patients visiting physicians for the problem get a prescription for an antibiotic. 

Jeffrey A Linder, David W. Bates, Grace M. Lee, and Jonathan A. Finkelstein, Antibiotic Treatment of Children with Sore Throats, JAMA 294, no. 18, November 9, 2005, pp. 2,315-2,322. 

Del Mar CB Glasziou PP and Spinks AB (2006) Antibiotics for sore throat. Cochrane Database of Systematic Reviews no. 4, CD000023. 

A systematic review found that antibiotics reduced the proportion of people with symptoms of sore throat at 3 days (47%) compared with placebo (66%) (Del Mar et al., 2006). This represents a shortening in duration of illness by an... 

Approximately a third of patients who attend their GP with a sore throat want or expect a prescription for antibiotics. There is evidence to suggest that prescribing antibiotics increases re-attendance rates for further episodes of sore throat and exposes patients to side-effects. Indiscriminate use of antibiotics also increases antibiotic resistance selection pressure (National Prescribing Centre, 2003). 

The patient s mother should be reassured that the majority of sore throats are caused by viral infection and that symptoms often resolve within 3-7 days without antibiotics. Post-dated prescriptions are a means of providing access to antibiotic therapy following a short period of time during which symptoms may resolve and the patient may choose not to cash in the prescription. Evidence suggests that deploying post-dated prescriptions is associated with comparable cure rates to immediate prescriptions but reduces patients intentions to consult the GP in the future to obtain antibiotics for sore throat. The patient s mother should be reassured that should symptoms persist, the prescription will be honoured on the prescribed date and her child will not suffer any untoward consequences from the delay to starting antibiotics. The risks of adverse effects with... 

Del Mar C B, Glasziou P P, Spinks A B 2001 Antibiotics for sore throat (Cochrane Review). The Cochrane Library 2. Oxford Update Software. 

Thomas M, Del Mar C, Glasziou P 2000 How effective are treatments other than antibiotics for acute sore throat British Journal of General Practice 50 817. 

Have you got anything for my sore throat , a peraon asks the pharmacist. Medicines are loaded with chemicals, often complex and usually in very small quantities. Many of the cures for diseases and ailments depend upon the work of chemists. All of the antibiotics are produced by fermentation, processing natural materials or by chemical synthesis. The intensive search for cures for cancer, AIDS, arthritis, migraines, and many other complaints involves thousands of chemists. 

A 35-year-old woman with acute promyelocytic leukemia was given tretinoin 45 mg/m /day. On day 9 she became febrile (39.5°C) and had a sore throat with pharyngeal erythema and tender lymphadenopathy. The fever persisted despite cephalosporins, vancomycin, and antibiotics for anaerobic cover. On day 20 she developed severe bilateral anterior leg pain and both anterior tibial muscles were tender. Creatine kinase activity was 348 (reference range 38-176) U/1. Tretinoin was withdrawn and she was given intravenous dexamethasone 10 mg/day. Her fever resolved, her pain abated, and her leg muscles felt softer and less tender. Tretinoin was reintroduced and her symptoms returned. 

It is easy to be seduced by surface symptoms and make assumptions about etiology and treatment. If all sore throats were treated with antibiotics, only about 15 to 20 percent would respond because most sore throats are due to viral rather than bacterial infections. Likewise with psychiatric disorders Common symptoms should not automatically lead to conclusions regarding common etiologies. 

Steam inhalation and cough suppressants may relieve upper airway symptoms, sore throat, nonproductive cough, and hoarseness. Appropriate antibiotic therapy should only be instituted following confirmation of infection by positive sputum tests (Gram stain and culture). Intubation should be accomplished prior to the development of laryngeal spasm or edema so that adequate ventilation is established and suction of necrotic and inflammatory debris can be facilitated. Oxygen may be required as well. Early use of positive expiratory pressure (PEEP) or... 

Acute tonsillitis is the inflammation of the tonsils commonly caused by streptococcus bacteria, which results in a sore throat, chills, fever, aching muscles, and pain when swallowing. A throat culture and sensitivity is performed to determine the bacteria causing the infection and the antibiotic to treat the infection. Acute tonsillitis also can be caused by a virus. Saline gargles, lozenges, and increased fluid help soothe the throat. 

Scoparia dulcis Scrophulaiaceae Antiviral, antitumuor chest pains, sore throat, gonorrhoea, otitis, vomiting, cough, snake repellent, anthelmintic, conjunctivitis, rickets, dizziness, constipation, diabetes, diarrhea, antibiotic, fever, respiratory problems, ease childbirth. Alkaloids, tannin, saponin, phlobatanin, terpenes. 17, 21, 25... 

The antibacterial compounds used in sore-throat lozenges are unlikely to be effective against the rhinoviruses that are largely responsible for the common cold. A sore throat complicated by a secondary bacterial infection, such as tonsillitis, would normally be treated with a systemic antibiotic. 

Overprescribing is a large concern that requires consideration. Antibiotics are prescribed in 73% of patients who visit their physician with a complaint of sore throat. This is well above the incidence of group A Streptococcus. For those who receive antibiotics, 68% of prescriptions are described as being nonrecommended treat-... 

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