Streptococcal infections pharyngeal

Streptococcal infections Pharyngitis, rheumatic fever, otitis media and even for subacute bacterial endocarditis. Staphylococcal infections Penicillinase resistant penicillin can be used. Meningococcal infections Meningitis other infections caused by meningococci. 

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, tonsiiiitis 30 mg/kg/day in single or 2 divided doses. For -hemolytic streptococcal infections, continue treatment for at least 10 days. 

Pharyngitis is caused by a virus (viral pharyngitis) or by bacteria (bacteria pharyngitis) such as the beta-hemolytic streptococci. Patients know this as strep throat. A throat culture is taken to mle out beta-hemolytic streptococcal infection. Sometimes patients experience acute pharyngitis along with other upper respiratory tract disease such as a cold, rhinitis, or acute sinusitis. 

The goals of therapy for streptococcal pharyngitis are to eradicate infection, reduce symptoms and infectivity, and prevent complications. 

The goals of therapy for streptococcal pharyngitis are to eradicate infection in order to prevent complications, shorten the disease course, and reduce infectivity and spread to close contacts. Sequelae that can be prevented by antibiotic use are peritonsillar or retropharyngeal abscess, cervical lymphadenitis, and rheumatic fever. There is no evidence that antibiotic use has an impact on the incidence of poststreptococcal glomerulonephritis. 

Assess the patient s signs and symptoms. Are they consistent with streptococcal pharyngitis Are symptoms of viral infection present ... 

Bisno AL, Gerber MA, Gwaltney JM Jr, et al. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Diseases Society of America. Clin Infect Dis 2002 35(2) 113-125. 

Sulfouamides have a broad spectrum of antimicrobial activity, including Staphylococcus aureus, nonenterococcal types of Streptococcus, Listeria monocytogenes, Nocardia, Neisseria, Haemophilius influenzae, enteric Gram-negative types of E. coli, Proteus mirabilis, and a few forms of anaerobic bacteria. Above all, sulfonamides are used for treating uncomplicated infections of the urinary tract, infections caused by Nocardia asteroids, streptococcal pharyngitis, menigococcal diseases, toxoplasmosis, and others. 

Streptococcal pharyngitis, skin and skin structure infections, uncomplicated cystitis In patients older than 15 years of age 500 mg every 12 hours. 

Monohydrate 25 to 50 mg/kg/day in divided doses. For streptococcal pharyngitis in patients older than 1 year of age and for skin and skin structure infections, divide total daily dose and give every 12 hours. In severe infections, double the dose. 

Skin and skin-structure infections, group A beta-hemolytic streptococcal pharyngitis, tonsillitis PO 1 2g in 2 divided doses. 

Allen et al., 1995). To increase confidence that an affected child belongs in the PANDAS subgroup, there must be at least two symptom exacerbations occurring subsequently to documented GABHS infections, and one or more periods of partial or complete quiescence of symptoms in the absence of streptococcal pharyngitis. 

Kaplan, E.L. (1971) Diagnosis of streptococcal pharyngitis differentiation of active infection from carrier state in the symptomatic child. J Infect Dis 123 490-501. 

Oral bioavailability is 57%, and tissue and intracallular penetration is generally good. Telithromycin is metabolized in the liver and eliminated by a combination of biliary and urinary routes of excretion. It is administered as a once-daily dose of 800 mg, which results in peak serum concentrations of approximately 2 g/mL. Telithromycin is indicated for treatment of respiratory tract infections, including community-acquired bacterial pneumonia, acute exacerbations of chronic bronchitis, sinusitis, and streptococcal pharyngitis. Telithromycin is a reversible inhibitor of the CYP3A4 enzyme system. 

Phase II/III clinical trials in the USA have yielded data on 1928 children aged 6 months to 15 years who took azithromycin for infections that included acute otitis media n — 1150) and streptococcal pharyngitis n — 754) (2). Most took a 5-day course of azithromycin (5-12 mg/kg/day). There were adverse effects in 190 patients (9.9%) diarrhea (3.1%), vomiting (2.5%), abdominal pain (1.9%), loose stools (1%), and rash (2.5%). In three comparisons with co-amoxiclav, the overall incidence of adverse effects was significantly lower with azithromycin (7.7 versus 29%), with withdrawal rates of 0.3 versus 3.6%. However, the incidence of adverse effects was significantly greater with azithromycin than with penicilhn V in comparisons in patients with streptococcal pharyngitis (13 versus 6.7%). In conclusion, it appears that the safety and tolerability of azithromycin is similar in children and adults. 

Clarithromycin has been compared with amoxicillin suspension in the treatment of children with lower respiratory tract infections. No significant differences were seen between the groups with respect to clinical cure rates and incidence and severity of adverse events, which generally were mild [35], Five days of treatment with clarithromycin suspension was superior to 10 days of penicillin suspension in eradicating Streptococcus pyogenes in children with streptococcal pharyngitis [36]. 

Double-blind, randomized, multicenter clinical studies showed dirithromycin to be equally effective as erythromycin base in clinical (92-94% vs. 94-95%) and bacteriological (79-84% vs. 86-88%) responses for 10-day treatment of streptococcal pharyngitis and tonsillitis [116, 117]. Dirithromycin also exhibited comparable efficacies as penicillin V and miokamycin in the treatment of such infections [118, 119]. Very few clinical trials were published on the use of this macrolide in treating acute or chronic sinusitis. 

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