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Orishchak, Diana. "Acute Inflammatory Diseases of the Pharynx – the Role and Possibilities of Local Therapy." Family Medicine. European Practices, no. 1 (February 28, 2023): 51–56. https://doi.org/10.30841/2786-720X.1.2023.
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Acute inflammatory diseases of the pharynx (tonsillitis, pharyngitis, etc.) are the most common reasons for visits to the family doctor and otorhinolaryngologist at any time of the year. In 95 % of cases, these diseases are caused by a viral infection (adenoviruses, influenza virus A and B, parainfluenza virus, herpes virus, enteroviruses, Coxsackie viruses), less often by group A Streptococcus. <strong>The objective:</strong> to analyze the clinical effectiveness of the local non-steroidal drug flurbiprofen in the treatment of acute viral pharyngitis and acute streptococcal tonsillitis in adults. <strong>Materials and methods.</strong> The study included 64 patients 18–36 years old (35 persons with viral pharyngitis and 29 – with streptococcal tonsillitis). The patients were divided into two groups: I (main) group – 40 patients (21 patients with acute viral pharyngitis who received flurbiprofen monotherapy at a dose of 8.75 mg and 19 patients with acute streptococcal tonsillitis who received flurbiprofen in combination with systemic antibiotic therapy); II (control) group – 24 patients (14 patients with acute viral pharyngitis took a placebo and 10 patients with acute streptococcal tonsillitis, who received only systemic antibiotic therapy). The evaluation of the treatment effectiveness of the study participants was carried out on the subjective indicators and objective criteria. <strong>Results.</strong> The results of the study presented that local flurbiprofen application is well absorbed through the mucous membranes and penetrates in the cases of inflammation. The local use leads to the reduction of the mucous membrane edema, decreased mucus hypersecretion, and permeability of the vascular wall, sore throat, and the risk of bacterial complications in patients with acute viral pharyngitis are reduced also. This explains the effectiveness of flurbiprofen use in the case of viral etiology of the disease and the strengthening effect in the systemic antibacterial therapy of acute streptococcal tonsillitis. After the course of treatment of pharynx acute inflammatory processes, it was established that a reliable rapid and significant decrease in pain and inflammatory phenomena was observed in patients of the main group who used flurbiprofen. <strong>Conclusions.</strong> It has been proven that the use of flurbiprofen has a pronounced analgesic and anti-inflammatory effect in diseases of the pharynx, as evidenced by the positive results of the treatment of patients with both acute viral pharyngitis and acute streptococcal tonsillitis. Compared with the use of monotherapy with systemic antibacterial drugs, the use of flurbiprofen simultaneously with systemic antibiotics eliminates the symptoms of streptococcal tonsillitis (sore throat, difficulty swallowing) much faster.
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Sotirović, Jelena. "Acute tonsillitis and acute pharyngitis." Galenika Medical Journal 1, no. 2 (2022): 37–43. http://dx.doi.org/10.5937/galmed2202037s.
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Acute tonsillitis and pharyngitis are common diseases in clinical practice. Uncritical use of antibiotics has led to an increasing problem of antibiotic resistance. On the other hand, it is of great importance to correctly diagnose and timely treat bacterial tonsillopharyngitis in order to prevent complications. The aim of this paper was to review current guides and published papers in the professional literature related to diagnostics and therapy in children and adults, with the aim of their greater implementation in clinical practice. Acute tonsillopharyngitis is far more often - a viral infection, less often - a bacterial infection. In the differential diagnosis of these entities, the combination of clinical scores and rapid test for group A streptococcus is of the greatest importance. According to individual clinical assessment, microbiological analysis of throat swabs and laboratory blood tests may also be important. Viral tonsillopharyngitis is treated symptomatically. In the treatment of bacterial infections, penicillin preparations are the drug of choice. Treatment can be combined with a single dose of orally administered corticosteroid. The basic principle of treatment of acute tonsillopharyngitis must be a measure of clinical parameters, available diagnostics, general condition of the patient and his comorbidities.
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&NA;. "Celecoxib beneficial in acute viral pharyngitis." Inpharma Weekly &NA;, no. 1341 (2002): 15. http://dx.doi.org/10.2165/00128413-200213410-00026.
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Redwan, Muneer A. Farghal Mohammed Nasser yehia Sharahili Alaa Ali A. Al Hunaidi Sara Hameed AlRehaili Farah Hussain Alsaif Ibrahem Hamad Erwe Faisal Fahad Aljuaid Rola Shafeeq Atteyah Rawan Ayed Almalki Tasnim Ali Albatti Sultan Khalid Saeed Kadasah. "MANAGEMENT OF ACUTE PHARYNGITIS IN ADULTS." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 12 (2018): 14080–85. https://doi.org/10.5281/zenodo.1845669.
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<strong><em>Introduction:</em></strong><em> Acute pharyngitis (AP) is a very common respiratory infections in adults.</em> <em>It has a significant effect on the economy as it is responsible for an average of 6.5 days of absence from work. Locally AP is mostly treated with Antibiotics.it is considered to be one of leading cause of antibiotics prescription, with a rate of approximately 80%. However, the most common cause of pharyngitis are viral infections. Bacterial agents such as (Streptococcus pyogenes and group A beta-haemolytic streptococcus) are responsible for less than 30% of pharyngitis cases in children and less than 15% in adults. Generally, Antibiotics are overprescribed in cases of pharyngitis <strong>Aim of work: </strong>In this review, we will discuss the most recent evidence regarding the management and treatment of acute pharyngitis in adults. <strong>Methodology:</strong> We did a systematic search for Management of Acute Pharyngitis in Adults in the emergency department using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). We only included full articles.<strong>Conclusions: </strong>The main objective of this review is to establish a guide for the management of AP in primary care units. the most common cause of AP is viral infections. Regarding bacterial infections, GABHS is believed to be the most important bacterial agent. Due to the absence of specific signs and symptoms of GABHS AP, the incidence of false positive diagnosis is high. And this leads to over prescribing of unnecessary antibiotics. Clinical evaluation scales allow the detection of high risk groups which will benefit of rapid diagnostic test. The community pharmacy, as a healthcare service,</em> <em>should manage AP by applying protocols in order to</em> <em>determine the patients who require pharmaceutical care and those requiring medical care.</em> <strong>Key words:</strong><em> Acute Pharyngitis, Management, Adults, primary care.</em> <strong><em>Introduction:</em></strong><em> Acute pharyngitis (AP) is a very common respiratory infections in adults.</em> <em>It has a significant effect on the economy as it is responsible for an average of 6.5 days of absence from work. Locally AP is mostly treated with Antibiotics.it is considered to be one of leading cause of antibiotics prescription, with a rate of approximately 80%. However, the most common cause of pharyngitis are viral infections. Bacterial agents such as (Streptococcus pyogenes and group A beta-haemolytic streptococcus) are responsible for less than 30% of pharyngitis cases in children and less than 15% in adults. Generally, Antibiotics are overprescribed in cases of pharyngitis <strong>Aim of work: </strong>In this review, we will discuss the most recent evidence regarding the management and treatment of acute pharyngitis in adults. <strong>Methodology:</strong> We did a systematic search for Management of Acute Pharyngitis in Adults in the emergency department using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). We only included full articles.<strong>Conclusions: </strong>The main objective of this review is to establish a guide for the management of AP in primary care units. the most common cause of AP is viral infections. Regarding bacterial infections, GABHS is believed to be the most important bacterial agent. Due to the absence of specific signs and symptoms of GABHS AP, the incidence of false positive diagnosis is high. And this leads to over prescribing of unnecessary antibiotics. Clinical evaluation scales allow the detection of high risk groups which will benefit of rapid diagnostic test. The community pharmacy, as a healthcare service,</em> <em>should manage AP by applying protocols in order to</em> <em>determine the patients who require pharmaceutical care and those requiring medical care.</em> <strong>Key words:</strong><em> Acute Pharyngitis, Management, Adults, primary care.</em>
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Mazur, Elżbieta. "Management of acute streptococcal pharyngitis: still the subject of controversy." Open Medicine 8, no. 6 (2013): 713–19. http://dx.doi.org/10.2478/s11536-013-0216-z.
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AbstractAlthough most cases of acute pharyngitis are viral in origin, antibiotics are overused in its treatment. Streptococcus pyogenes (group A streptococcus, GAS), the principal bacterial pathogen of acute sore throat, is responsible for merely 5–30% of cases. Moreover, GAS pharyngitis is currently the only commonly occurring form of acute pharyngitis for which antibiotic therapy is definitely indicated. Therefore the differentiation between GAS pharyngitis and that of viral etiology is crucial. Accordingly, scientific societies as well as respected advisory bodies in Europe and North America, issued guidelines for the management of acute pharyngitis with the aim of minimizing unnecessary antibiotic prescriptions in its treatment. The aim of this review work is to confront the state of the art in acute GAS pharyngitis diagnosis and treatment with different approaches to its management represented by current European and North American guidelines. Although based on scientific evidence, international guidelines differ substantially in opinions whether GAS pharyngitis diagnosis should be based on microbiological testing, clinical algorithm or a combination of both. On the other hand, some European guidelines consider GAS pharyngitis to be a mild, self-limiting disease that does not require a specific diagnosis or antimicrobial treatment except in high-risk patients. There is an agreement among guidelines that if antibiotic therapy is indicated, phenoxymethyl penicillin should be the drug of choice to treat GAS pharyngitis.
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Sutema, Ida Ayu Manik Partha, Made Sudiari, and I. Gede Palguna Reganata. "Analysis of Factors Affecting Healing of Acute Pharyngitis Viral Patients in Puskesmas I, Klungkung-Bali." WMJ (Warmadewa Medical Journal) 7, no. 2 (2022): 60–69. http://dx.doi.org/10.22225/wmj.7.2.4753.60-69.
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 Antibiotic resistance is closely related to the inappropriate use of antibiotics, namely the indication, dose, frequency, and duration of use. Permenkes No. 5 of 2014 states that acute pharyngitis is given antibiotic therapy if it meets the diagnostic criteria using the center criteria, but this criterion is difficult to apply because doctors take longer to diagnose. Previous research at the Klungkung I Primary Health Center used diagnosis utilizing a swab test. It was found that 100% of bacterial pharyngitis patients were negative. The strategy of delaying antibiotics for 3 days can prevent antibiotic resistance, but in therapy, without antibiotics, it is important to increase the effectiveness of therapy, it is deemed necessary by the researchers to conduct a study to analyze the factors that affect the recovery of patients with acute pharyngitis, which are mainly caused by viruses. Analyzing the factors that affect the recovery of viral pharyngitis patients. The design of the cross-sectional study was through observation of the medical record data of patients who came to the Klungkung Primary Health Center I for 3 months and got diagnostic facilities using the swab test. Patients who got a negative swab test were analyzed for the factors that influenced their recovery. Anti-inflammatory variables, rest, and paracetamol significantly affected the recovery of acute pharyngitis patients (p <0.05), and the importance index in CART analysis found that paracetamol was the most influential, followed by rest, administration of vitamins, and anti-inflammatory. Antibiotics, anti-allergies, and cough medicines do not affect the recovery of patients with acute pharyngitis viral. Paracetamol has the most effect on patient recovery, followed by rest and administration of vitamins, anti-inflammatory has very little effect on the recovery in patients of acute pharyngitis viral.
 Keywords: acute pharyngitis, cure, CART.
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Dieieva, Julia V. "Evaluation of the clinical efficacy of anti-inflammatory therapy with topical biclotymol-based products." OTORHINOLARYNGOLOGY, No6(5) 2022 (January 30, 2023): 66–72. http://dx.doi.org/10.37219/2528-8253-2022-6-66.
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Topicality: Acute pharyngeal diseases are one of the most common reasons for patients to visit a doctor. According to the UK, approximately 50% of these diseases account for the appointment of antibacterial agents. Most of these prescriptions are not rational, but doctors use them for several reasons - unreal expectations of treatment, patient pressure/insistence on conducting the desired tests or treatment, the doctor's desire to maintain a better doctor-patient relationship, limited consultation time, diagnostic uncertainty, incorrect collection of historical data and others. Despite these reasons, patients with acute pharyngitis and tonsillitis who seek antibiotic therapy want to reduce their symptoms. Therefore, the search for agents that will significantly improve patients' quality of life during acute pharyngeal diseases is crit ical. Aim: To review the literature on the therapeutic efficacy of topical biclotymol-based products for treating acute pharyngeal diseases. Results and discussion: Most cases of acute pharyngitis should be treated with over-the-counter medicines that are primarily intended to control the symptoms of the disease and improve the patient's quality of life. Biclotymol, enoxolone and lysozyme are novel substances that, at the same time, are safe for resolving pain in viral or bacterial pharyngit is. Biclotymol can be used as monotherapy and in combination with other agents. In the analysed data, biclotymol showed its therapeutic efficacy and safety. Therefore, it is safe to recommend biclotymolbased products for use in acute viral and bacterial pharyngitis or tonsillitis both as monocomponent medicine and fixed-dose combination.
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Bisno, Alan L. "Acute Pharyngitis: Etiology and Diagnosis." Pediatrics 97, no. 6 (1996): 949–54. http://dx.doi.org/10.1542/peds.97.6.949.
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Acute pharyngitis may be caused by a wide variety of microbial agents (Table 1). The relative importance of each of these agents varies greatly depending on a number of epidemiologic factors, including age of the patient, season of the year, and geographic locale. Viruses Most cases of acute pharyngitis are viral in etiology and involve the pharynx as well as other portions of the respiratory tract as manifestations of the common cold, influenza, or croup. Examples include the rhinoviruses, coronaviruses, influenza A and B, and the parainfluenza viruses. Certain viral infections causing sore throat may exhibit clinical manifestations that are rather distinctive. Examples include enteroviruses (herpangina due to Coxsackie A), Epstein-Barr virus (infectious mononucleosis), cytomegalovirus (cytomegalovirus mononucleosis), adenovirus (pharyngoconjunctival fever, acute respiratory disease of military recruits), and herpes simplex virus (pharyngitis, gingivitis, and stomatitis). In many instances, however, the illnesses caused by these agents may overlap so broadly with that of streptococcal pharyngitis as to be clinically indistinguishable. Thus, Epstein-Barr virus, adenovirus, and herpes virus may all cause fever, exudative pharyngitis, and cervical adenitis. Several studies have documented the role of primary herpesvirus type 1 infection as a cause of acute pharyngitis in college students.1-4 Herpesvirus type 2 can occasionally cause a similar illness as a consequence of oral-genital sexual contact.5 Although herpesvirus infections may involve the anterior oral cavity (vesicular or ulcerative gingivostomatitis) as well as the posterior pharynx, they do not routinely do so. Only about one-fourth of students with culturally and serologically proven primary herpes simplex type 1 pharyngitis studied by Glezen et al,2 for example, had gingivostomatitis.
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Osiejewska, Aleksandra, Anna Gorajek, Małgorzata Kudan, Anna Grądzik, and Karolina Mikut. "Acute tonsillopharyngitis - a review." Journal of Education, Health and Sport 12, no. 7 (2022): 873–82. http://dx.doi.org/10.12775/jehs.2022.12.07.087.
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Introduction and purpose: Acute pharyngitis and tonsillitis is the most common reason why people want to visit their primary care physician. Viruses are the most common cause of acute pharyngitis and acute tonsillitis in children and adults. The patient complains about pain with sudden onset and throat irritation, pain on swallowing, fever and headache, and in children also abdominal pain, nausea and vomiting.
 Brief description of the state of knowledge: Most acute tonsillopharyngitis is due to rhinoviruses (35%), influenza (30%), RSV and parainfluenza. Bacteria causes 30% of the infections and S. pyogenes is the most common cause. Viral infections are seasonal. S.pyogenes infection is most often in winter and early spring. Changes in the pharyngeal mucosa look similar in both bacterial and viral etiologies. Because of that, scales have been developed to assess the probability of a bacterial infection. The most used is Centor / McIsaac scale. The gold standard of diagnostics is throat swab culture. In the treatment of streptococcal pharyngitis and tonsillitis, penicillins are used as first-line treatment. Antibiotic treatment reduces infectivity, lowers the risk of rheumatic fever and made symptoms disappear two days earlier. Tonsillectomy does not reduce the number of recurrent pharyngitis and tonsillitis, therefore it cannot be recommended.
 Conclusion: Acute tonsillopharyngitis can result in many complications, the most serious of them is rheumatic fever. Therefore, it is very important to properly diagnose and use antibiotic therapy when necessary.
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Choi, Sung-Won, and Hoon Ko. "Benign Acute Childhood Myositis: Perplexing Complication after Acute Viral Pharyngitis." Korean Journal of Family Medicine 39, no. 6 (2018): 375–78. http://dx.doi.org/10.4082/kjfm.17.0113.
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Baranov, Aleksander A., Leyla S. Namazova-Baranova, Yuri V. Lobzin, et al. "Modern Approaches to the Management of Children with Acute Respiratory Viral Infection." Pediatric pharmacology 20, no. 2 (2023): 162–74. http://dx.doi.org/10.15690/pf.v20i2.2539.
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Experts of the Union of Pediatricians of Russia have developed modern guidelines on management of children with acute respiratory viral infection. The term “acute respiratory viral infection” (ARVI) combines following nosological forms: acute nasopharyngitis, acute pharyngitis, acute laryngitis, acute tracheitis, acute laryngopharyngitis, upper respiration tract infection (unspecified). The issues of epidemiology, diagnosis, treatment, and prevention have been considered in detail.
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Fleming-Dutra, Katherine E., Laura M. King, Safia Boghani, Lauri Hicks, John Hou, and Heather S. Kirkham. "969. Antibiotic Prescribing in a Large Retail Health Clinic Chain: Opportunities for Stewardship." Open Forum Infectious Diseases 6, Supplement_2 (2019): S32—S33. http://dx.doi.org/10.1093/ofid/ofz359.071.
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Abstract Background Retail health is a growing outpatient setting. Research using claims data found that antibiotics were linked with 46% of urgent care, 17% of medical office, and 14% of retail health visits for acute respiratory infections (ARIs) for which antibiotics are not needed. We aimed to quantify antibiotic prescribing rates to adult patients in a large retail health clinic chain using electronic health records and to identify future stewardship targets. Methods We included visits by adults ≥18 years to network retail health clinics from 2012 to 2016. We classified diagnoses by ICD codes. We calculated the percent of visits with systemic antibiotics prescribed among all visits, by individual diagnosis, and for ARIs as a group (e.g., pneumonia, sinusitis, pharyngitis, acute otitis media [AOM], bronchitis, and viral upper respiratory infections [URI]). We also assessed the percent of visits for sinusitis and pharyngitis with first-line antibiotics prescribed. Results Of 2,893,413 visits by adults during 2012–2016, 1,866,145 (66%) resulted in antibiotic prescriptions. ARIs accounted for 2,039,423 (72%) of visits and 1,475,069 (79%) of antibiotic prescriptions. The most common diagnoses regardless of antibiotic prescription were sinusitis (31% of visits), pharyngitis (15%, of which 81% were coded as streptococcal pharyngitis), urinary tract infection (9%), viral URI (8%), AOM (7%), and bronchitis (5%). Antibiotics were frequently prescribed for sinusitis, urinary tract infection, pharyngitis, and AOM but not for viral URI and bronchitis (Figure 1). First-line antibiotics were prescribed in the majority of sinusitis and pharyngitis visits (Figure 2). Conclusion ARIs are major drivers of visits by adult patients and of antibiotic prescribing to adults in this retail clinic network. Inappropriate antibiotic use was low in this setting for viral URI and bronchitis and first-line antibiotic selection was high for sinusitis and pharyngitis, although additional opportunities for improvement exist. Future antibiotic stewardship efforts may target examining adherence to guideline-recommended diagnostic criteria for sinusitis, AOM, and pharyngitis and increasing use of watchful waiting for sinusitis and AOM. Disclosures All Authors: No reported Disclosures.
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Shulman, Stanford T. "Evaluation of Penicillins, Cephalosporins, and Macrolides for Therapy of Streptococcal Pharyngitis." Pediatrics 97, no. 6 (1996): 955–59. http://dx.doi.org/10.1542/peds.97.6.955.
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Objective. To review recent clinical experience with treatment of acute streptococcal pharyngitis with penicillins, cephalosporins, and macrolide antibiotics. Methods. Literature review and analysis. Results and Conclusions. Oral penicillin V administered two to three times daily for 10 days is the treatment of choice for acute streptococcal pharyngitis and is the oral standard against which other treatments should be measured. A single intramuscular dose of benzathine penicillin also remains highly effective. Recent studies evaluating alternative oral agents given for less than 10 days or in once-daily regimens have yielded promising results. Studies should make efforts to exclude chronic streptococcal carriers with intercurrent viral pharyngitis because their inclusion in treatment trials substantially confounds the data. As issues of health care costs assume increasing importance, the cost of newer antimicrobial agents will deter their usage for acute streptococcal pharyngitis.
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Marushko, Yu V., S. I. Yesipova, and O. А. Bovkun. "Experience of using Bioplasmix throat spray in the complex treatment of acute viral pharyngitis in children with an atopic background." Modern pediatrics. Ukraine, no. 1(137) (February 28, 2024): 58–66. http://dx.doi.org/10.15574/sp.2024.137.58.
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The problem of therapy of acute respiratory infections in children remains relevant. The most common infectious pathology of the upper respiratory tract in both children and adults is acute viral pharyngitis. Irrational prescribing of antibiotics leads to medication-induced side effects and the spread of resistance of microorganisms to antibiotics in society. Topical application of respiratory probiotics may be an important component in the supportive treatment of acute respiratory infections and reducing antibiotic dependence. The use of probiotics in children with an atopic background is of particular importance due to the possible occurrence of adverse reactions. Purpose - to assess the safety and effectiveness of the local application of Bioplasmix throat spray in the complex treatment of acute viral pharyngitis in children with an atopic background. Materials and methods. 45 children aged 6-18 years with acute viral pharyngitis took part in the study. 2 research groups were formed: the Group I - main (n=25) - received protocol treatment + Bioplasmix throat spray locally and the Group II - comparison (n=20) - only protocol treatment. All patients were assessed for the severity of clinical symptoms (fever, headache, sore throat, scratching, cough) and oropharyngoscopy data (hyperemia, swelling of the mucous membrane of the oropharynx, granularity of the back wall of the pharynx) on the 1st, 2nd, 3rd, 4th, 5th and 7th days of using the product. Results. The use of the local application of Bioplasmix throat spray for acute pharyngitis in children ensures a faster reduction in the severity of the main clinical manifestations and signs of inflammation of the oropharynx. In the Group I, compared to the Group II, there were better indicators of a decrease in the severity of cough (1.2±0.91 points vs. 1.76±0.85 points), a scratching (1.12±0.92 points vs. 1.7±0.86 points), sore throat (1.6±0.81 points vs. 2.23±0.76 points) and hyperemia of the pharynx (1.4±0.7 points vs. 2.1±0.9 points) from the 3rd day, swelling of the pharynx (1.22±0.86 points vs. 1.8±1.04 points) from the 4th day. Adverse reactions were not noted during the use of the local application of Bioplasmix throat spray. Conclusions. Local probiotic therapy is an important component of the complex therapy of acute pharyngitis, the use of bacteria of the genus Bacillus in the form of Bioplasmix throat spray shows a positive effect on the course of acute viral pharyngitis in children, which manifests by a faster decrease in the severity of subjective symptoms of pharyngitis and inflammatory signs of the oropharynx. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.
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Wi, Dasom, and Soo-Han Choi. "Positive Rate of Tests for Group a Streptococcus and Viral Features in Children with Acute Pharyngitis." Children 8, no. 7 (2021): 599. http://dx.doi.org/10.3390/children8070599.
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Group A streptococcus (GAS) is an important cause of acute pharyngitis. We investigated the positive rate of GAS tests and clinical viral features in children with acute pharyngitis. A retrospective review was conducted for patients <15 years old with both rapid antigen detection test (RADT) and throat culture results. Patients were excluded if they were diagnosed with influenza or had received antibiotics within two weeks before these tests. A total of 377 patients were eligible. The median age of patients was 3.5 years, and 45.4% of total patients were <3 years old. Among all patients, 68.7% had at least one viral feature, and 39% had more than two. The overall positiv rate for GAS was 11.4%. The GAS positive rate was significantly lower in patients <3 years old than in older patients (1.8% vs. 19.4%, p < 0.0001). The overall sensitivity and specificity of RADT were 75.0% (95% CI: 57.8–87.9) and 97.9% (95% CI: 95.8–99.2), respectively. The GAS positive rate was not significantly different between patients with and without viral features (12.4% vs. 9.3%, p = 0.4854). In patients aged 3–14 years, the GAS positive rate was not associated with the modified Centor score or the frequency of clinical viral features. Despite a low prevalence of GAS pharyngitis, testing for GAS was frequently performed in children <3 years old in this study. Appropriate use of laboratory testing for GAS pharyngitis and judicious prescription of antibiotics were imperative.
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Biała, Martyna, Patrycja Leśnik, Mateusz Babicki, and Brygida Knysz. "Prevalence of Asymptomatic Group A Streptococcus Carriage Based on Rapid Antigen Detection Test in Healthy Adults in Poland." Journal of Clinical Medicine 14, no. 6 (2025): 2008. https://doi.org/10.3390/jcm14062008.
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Background: Acute pharyngitis is one of the most prevalent disorders seen in general practitioners’ consultations. Most cases of acute pharyngitis in adults are caused by respiratory viruses and are self-limited. However, clinical manifestations of viral pharyngitis can overlap with bacterial pharyngitis, mainly caused by group A Streptococcus (GAS). A rapid antigen test for GAS can help diagnose streptococcal pharyngitis, but misdiagnosing S. pyogenes infection in a patient with a viral condition can lead to inappropriate antibiotic use. Some patients with a sore throat due to a virus or other causes will test positive for GAS because of carriage. The aim of our study was to analyze rapid strep test results in healthy adults. Methods: A cohort study was conducted in an outpatient clinic in Wroclaw. We used the rapid strep test BIOSYNEX STREP A. Results: A total of 350 healthy volunteers (≥18 years old) were enrolled in this study. The presence of Streptococcus pyogenes, based on a rapid strep test, was detected in 17 adults (4.9%). The strep test positivity rate was higher in younger adults. Conclusions: In healthy individuals in Poland, the prevalence of pharyngeal carriage of GAS is 4.9%. This finding emphasizes that the rapid antigen detection test should only be used in cases of suspected bacterial pharyngitis to avoid inappropriate antibiotic use.
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Solodovnikova, O. N., A. Yu Diagileva, and A. A. Ploskireva. "Inosine pranobex in the treatment of children with acute respiratory viral infections. Non-interventional observation program ‘Ambulatory’." Voprosy praktičeskoj pediatrii 16, no. 6 (2021): 167–72. http://dx.doi.org/10.20953/1817-7646-2021-6-167-172.
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Respiratory infections are currently very common among children of different ages. Acute upper respiratory tract infections usually accounted for more than 88% of all infectious and parasitic diseases, which is consistent with data for the last 10 years. Therefore, the issues related to both causal and pathogenetic therapy for viral infections in children remain highly relevant. Key words: acute respiratory viral infections, children, infectious diseases, acute nasopharyngitis, acute pharyngitis, acute laryngitis, acute tracheitis, acute laryngopharyngitis, acute upper respiratory tract infection not otherwise specified
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Liang, Chih-Wei, Mei-Cheng Hsiao, Shin-Huei Kuo, et al. "Do Hospitalized Adult Patients with Acute Pharyngotonsillitis Need Empiric Antibiotics? The Impact on Antimicrobial Stewardship." Microorganisms 13, no. 3 (2025): 628. https://doi.org/10.3390/microorganisms13030628.
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Acute pharyngotonsillitis is a common reason to visit primary care providers. Group A Streptococcal (GAS) pharyngitis is the most common bacterial infection which needs antibiotic treatment. GAS accounts for only 10–15% of adult acute pharyngitis cases. The overuse of antibiotics for viral pharyngotonsillitis is common and may lead to inappropriate antimicrobial stewardship and the emergence of bacterial resistance. However, the etiology of acute pharyngotonsillitis for hospitalized adult patients is rarely studied. So, we reported the 10-year surveillance data of hospitalized adult patients with acute pharyngotonsillitis in a regional hospital in Taiwan. Every consecutive adult patient admitted with acute pharyngotonsillitis in 2011–2021 was recruited for a complete etiology study. The etiology of acute pharyngotonsillitis was identified in 117 patients. Overall, 42 herpes simplex virus cases, 26 adenovirus cases, 16 acute human immunodeficiency virus cases, 12 influenza cases, three parainfluenza cases, six Epstein–Barr virus cases, one cytomegalovirus case, four enterovirus cases, one varicella-zoster virus case, four Mycoplasma pneumoniae cases, one Chlamydophila pneumoniae case, and only one GAS case were identified. The average of the points for the Modified Centor Criteria was 1.38 (55% of patients with 0–1 points and 45% with 2–3 points). However, 88.9%of patients received antibiotics at the emergency department, and 76.9%also received antibiotics while hospitalized. Only a few patients required antibiotic treatment, while the majority of patients with viral illness needed only symptomatic treatment. However, distinguishing viral etiology from GAS pharyngitis is challenging even in the presence of tonsil exudates, high C-reactive protein, and leukocytosis. A diagnostic algorithm and the application of the Modified Centor Criteria should be considered for hospitalized adults with acute pharyngotonsillitis to improve antimicrobial stewardship.
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Pepaś, Renata, Łukasz Przysło, Robert Bieda, and Wiesław Konopka. "Paediatric autoimmune neuropsychiatric syndrome in recurrent acute bacterial pharyngitis – a case report." Pediatria i Medycyna Rodzinna 18, no. 1 (2022): 84–88. http://dx.doi.org/10.15557/pimr.2022.0011.
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Pharyngitis and tonsillitis, regardless of their aetiology, are one of the most frequent reasons for visiting a family doctor or a paediatrician. Nearly 85% of pharyngitis cases are viral. It is estimated that bacterial throat infection occurs in 15% of schoolage children and in 4–10% of adult patients. Streptococcus pyogenes is the most common cause of bacterial pharyngitis. PANDAS stands for paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. The term is used to describe a subgroup of children and adolescents who develop acute obsessive-compulsive disorder or tics as a result of group A streptococcal infection, such as tonsillitis. The aim of the paper is to describe a case of a 4-year-old boy who presented to the Laryngology Clinic due to recurrent tonsillitis, time-correlated with obsessive-compulsive disorder.
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Dayhes, Nikolai A., Alexander A. Baranov, Yurii V. Lobzin, et al. "Modern Clinical Guidelines for the Management of Patients with Acute Tonsillitis and Pharyngitis." Pediatric pharmacology 22, no. 2 (2025): 164–77. https://doi.org/10.15690/pf.v22i2.2897.
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Acute tonsillitis and pharyngitis are common infectious diseases of upper respiratory tract causing significant discomfort and various complications in patients. This article covers all the issues of tonsillitis and pharyngitis etiology, pathogenesis, classification. Modern clinical guidelines focus on optimizing the diagnosis, management, and prevention of these conditions, ensuring high quality of medical care.Centor, McIsaac, or FeverPAIN scores can be used for differential diagnosis of viral and streptococcal tonsillopharyngitis. Particular attention is given to the management tactics of patients with these diseases, including the antibiotic therapy for streptococcal tonsillitis. Modern clinical guidelines emphasize the need for individual approach for every patient considering their age, concomitant diseases, and infection course aspects. These guidelines implementation in practice can increase the treatment efficacy, reduce the risk of any complications, and improve the quality of life of patients with acute tonsillitis and pharyngitis.
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Esposito, Susanna, Francesco Blasi, Samantha Bosis, et al. "Aetiology of acute pharyngitis: the role of atypical bacteria." Journal of Medical Microbiology 53, no. 7 (2004): 645–51. http://dx.doi.org/10.1099/jmm.0.05487-0.
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In order to establish the role of atypical bacteria and compare characteristics of different infectious agents in acute pharyngitis, 127 patients with acute pharyngitis (66 males; median age, 5.33 years; range, 6 months to 14 years) and 130 healthy subjects of similar sex and age were studied. Serology with paired samples and PCR on nasopharyngeal aspirates and throat cultures were used to identify bacteria and viruses. Viruses were identified in 43 patients (33.8 %) and five controls (3.8 %; P < 0.0001), potential bacterial pathogens in 34 patients (26.8 %) and 26 controls (20 %; P = 0.256) and mixed viral/bacterial pathogens in 26 patients (20.5 %) and none of the controls (P < 0.0001). The main aetiological agents were adenovirus, respiratory syncytial virus (RSV), Mycoplasma pneumoniae, Streptococcus pyogenes and Chlamydia pneumoniae. M. pneumoniae was the agent found most frequently as a single pathogen. A history of recurrent pharyngitis, having older siblings and a negative outcome were significantly more common among patients with acute M. pneumoniae infection than among those with infections due to other pathogens or healthy controls. This study demonstrates that: (i) adenovirus and RSV have a prominent role in acute pharyngitis; (ii) S. pyogenes is found frequently, but it is not possible to distinguish simple carriers from patients with a true infection; (iii) M. pneumoniae appears to be able to cause acute pharyngitis per se; and (iv) C. pneumoniae seems to be mainly a co-pathogen. To avoid the risk of an incorrect therapeutic approach, simple laboratory investigations that allow rapid identification of M. pneumoniae infections are urgently needed.
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Miller, Kate M., Robert R. Tanz, Stanford T. Shulman, et al. "Standardization of Epidemiological Surveillance of Group A Streptococcal Pharyngitis." Open Forum Infectious Diseases 9, Supplement_1 (2022): S5—S14. http://dx.doi.org/10.1093/ofid/ofac251.
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Abstract Pharyngitis, more commonly known as sore throat, is caused by viral and/or bacterial infections. Group A Streptococcus (Strep A) is the most common bacterial cause of pharyngitis. Strep A pharyngitis is an acute, self-limiting disease but if undertreated can lead to suppurative complications, nonsuppurative poststreptococcal immune-mediated diseases, and toxigenic presentations. We present a standardized surveillance protocol, including case definitions for pharyngitis and Strep A pharyngitis, as well as case classifications that can be used to differentiate between suspected, probable, and confirmed cases. We discuss the current tests used to detect Strep A among persons with pharyngitis, including throat culture and point-of-care tests. The type of surveillance methodology depends on the resources available and the objectives of surveillance. Active surveillance and laboratory confirmation is the preferred method for case detection. Participant eligibility, the surveillance population and additional considerations for surveillance of pharyngitis are addressed, including baseline sampling, community engagement, frequency of screening and season. Finally, we discuss the core elements of case report forms for pharyngitis and provide guidance for the recording of severity and pain associated with the course of an episode.
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Ruzhentsova, Т. А., I. V. Babachenko, N. D. Odinaeva, et al. "Current challenges and treatment options for upper respiratory tract infections in children." Infekcionnye bolezni 21, no. 3 (2023): 127–36. http://dx.doi.org/10.20953/1729-9225-2023-3-127-136.
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This article presents the resolution and materials of the Expert Council meeting held in Saint Petersburg on May 24, 2023. The meeting was devoted to topical issues of treatment of oropharyngeal infections in children. Leading infectious disease specialists, pediatricians and immunologists from Moscow, Saint Petersburg, Kazan, and other cities of Russia took part in the discussion. According to the resolution, today in the Russian Federation there is a high incidence of acute respiratory infections among children with a high frequency of complications, and fatal outcomes are registered. Numerous cases of active herpesvirus infections are recorded, especially among frequently ill children. The current clinical guidelines for the treatment of acute respiratory viral infections lack algorithms for differentiated therapeutic approaches that reduce disease duration, prevent the development of complications and recurrent episodes of respiratory infections. In clinical practice, there is excessive, often unjustified prescription of antimicrobial therapy, which aggravates intestinal disorders, reducing colonization and immune resistance, and provokes oral infections and inflammations caused by opportunistic pathogens. Based on the presented data, it is necessary to correct clinical recommendations for the treatment of acute respiratory viral infections in children with the introduction of indications for prescribing benzydamine in cases of tonsillitis, pharyngitis (tonsillopharyngitis) and stomatitis as a first-choice medication for sore mouth and throat. It also seems necessary to include data on the efficacy of inosine pranobex in symptoms of acute respiratory viral infections of various etiologies, including COVID-19 and active herpesvirus infections. Key words: benzydamine, herpesvirus infections, inosine pranobex, microbiome, acute respiratory viral infections, ARI, tonsillitis, tonsillopharyngitis, pharyngitis, COVID-19, SARS-CoV-2
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Kalogeropoulou, E., S. Damianidou, and G. Vrioni. "Etiological diagnosis of streptococcal pharyngitis based on throat swab." ACTA MICROBIOLOGICA HELLENICA 59, no. 3 (2014): 37–47. https://doi.org/10.5281/zenodo.10017242.
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Sore throat is a common reason for consulting pediatricians and primary-care physicians. Most cases are of viral origin. Streptococcus pyogenes (Group A Streptococcus, GAS) is the most frequent etiology of bacterial pharyngitis, and may cause more than 30% of pharyngitis cases in paediatric patients and 5–10% of sore throats among adults. Culture remains the microbiological reference method for detection of S. pyogenes. A definitive diagnosis is based on the results of a throat culture. Unfortunately, accurate diagnosis is difficult because (1) the majority of sore throats are viral in origin, (2) culture-based identification requires 24-48 hours, and (3) up to 15% of children are asymptomatic throat carriers of S. pyogenes. Other methods, like Rapid Antigen Detection Tests (RADT) and Direct Nucleic Acid Amplification Tests (NAATs), may aid in the etiological diagnosis of streptococcal pharyngitis. RADTs are only screening tests for group A Streptococcus throat infections. In pediatric patients, if the direct antigen test is negative, and if this specific direct antigen test is known to have a sensitivity of <80%, a second throat swab should be examined by a more sensitive direct NAAT or by culture as a means of arbitrating possible false negative direct antigen test results. A convenient means of facilitating this two-step algorithm of testing for S. pyogenes in pediatric patients is to collect a dual swab initially, recognizing that the second swab will be discarded if the direct antigen test is positive. Although this is generally not necessary for negative test results in adults, new guidelines suggest that either conventional culture or confirmation of negative rapid antigen test results by culture should be used to achieve maximal sensitivity for diagnosis of S. pyogenes pharyngitis in adults. NAATs for S. pyogenes are more sensitive than direct antigen tests and, as a result, negative direct NAAT results do not have to be arbitrated by a secondary test. Culture is necessary for susceptibility testing. Even thought penicillin remains the drug of choice with no reporting of resistance in S. pyogenes isolates, macrolide resistance rates have been increasing in Europe as well as in North America.
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Bartlett, A., S. Bola, and R. Williams. "Acute tonsillitis and its complications: an overview." Journal of The Royal Naval Medical Service 101, no. 1 (2015): 69–73. http://dx.doi.org/10.1136/jrnms-101-69.
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AbstractAcute tonsillitis may be defined as inflammation of the tonsils, predominantly due to infection. It is part of the spectrum of pharyngitis, which ranges from localised tonsillar infection to generalised infection of the pharynx and commonly affects young healthy adults. Simple sore throats secondary to viral or bacterial pharyngitis are very common and generally do not require hospital admission or antimicrobial treatment. Supportive management in the form of analgesia and adequate hydration is often sufficient. However, there is potential for life-threatening complications to develop, highlighting the need for basic knowledge in the management of these conditions.This article aims to provide an overview of acute tonsillitis and its complications, including peritonsillar and parapharyngeal abscess formation. Specific attention will be given to the pathogenesis, diagnosis, investigation and management of each condition, in particular advising on emergency pre-shore treatment and indications for referral to an Ear, Nose and Throat Department. We will also summarise important guidelines and evidence from the literature to support these management decisions.
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Jin, Guanyuan, and Louis Lei Jin. "Chinese Herbs for Pharyngitis Including COVID-19-Related Sore Throat." Chinese medicine and natural products 02, no. 04 (2022): e185-e192. http://dx.doi.org/10.1055/s-0042-1759765.
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AbstractSore throat is one of the most prominent clinical manifestations seen among mild cases of coronavirus disease 2019 (COVID-19). Traditional Chinese medicine (TCM) modalities, especially Chinese herbs, have accumulated rich experience in successfully treating sore throats in both acute and chronic pharyngitis. By sharing a real-world case study of three patients suffering pharyngeal discomfort including sore throat that might be related to the new coronavirus infection and have similar manifestations to general viral-induced pharyngitis, the article systematically presents and summarizes key Chinese herbs for acute and chronic pharyngitis based on TCM herbal prescriptions (principles of herbal formula writing) below: clearing heat and removing toxins, nourishing yin and the throat, loosening the stools and soothing the throat, along with TCM syndrome differentiation or disease differentiation and treatment. Moreover, a modern interpretation of these principles in terms of the relationship between Shanghuo and Fire Rising, which may often be characterized by local redness, swelling, fever, and pain in the mouth or throat along with possible inflammation, and the correspondence between the pharynx and the anus are proposed. Finally, the article will share their experience in applying specific herbs locally via various pharyngeal delivery modalities to improve efficacy including recommended prescriptions for a variety of acute and chronic pharyngitis, as well as those that may be caused by the new coronavirus infection.
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Jin, Ling, Kai Fan, Shiwang Tan, Shuangxi Liu, Yang Wang, and Shaoqing Yu. "Analysis of the characteristics of outpatient and emergency diseases in the department of otolaryngology during the “COVID-19” pandemic." Science Progress 104, no. 3 (2021): 003685042110363. http://dx.doi.org/10.1177/00368504211036319.
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The pandemic of “Corona Virus Disease 2019” (COVID-19) has changed the lives of people. There have been changes in common outpatient and emergency cases in otolaryngology, so an analysis of data pertaining to this was completed. This study is to evaluate the impact of viral infection disease in otolaryngological common disease. This study uses the data of common diseases in the outpatient and emergency department during the “COVID-19” pandemic (from February to April 2020) and the same period in the past 3 years from the Department of Otolaryngology. During the “COVID-19” period compared with the same period last year, the ranking of cases by diseases has changed. Diseases such as chronic pharyngitis, allergic rhinitis, sudden deafness, and tinnitus increased, meanwhile acute pharyngitis and acute laryngopharyngitis decreased ( p < 0.05). The viral infection has impacted the mental behaviors of people, therefore mental-related disease cases of the department of Otolaryngology have increased indirectly. This study provides real data to illustrate mental-related diseases. It also provides experience and shows the importance of keeping and maintaining mental health.
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Banerjee, Dithi, Jordan Crawford, Christopher J. Harrison, Brian Rha, Joana Y. Lively, and Rangaraj Selvarangan. "2185. Group A Streptococcus (GAS) Detection by PCR in Children with Viral Acute Respiratory Illness and Healthy Children." Open Forum Infectious Diseases 6, Supplement_2 (2019): S742—S743. http://dx.doi.org/10.1093/ofid/ofz360.1865.
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Abstract Background Acute pharyngitis is mostly of viral etiology; GAS, the leading bacterial cause, comprises 20%–30% of pediatric pharyngitis. Patients with pharyngitis and additional acute respiratory illness (ARI) symptoms more suggestive of viral etiology, including cough, rhinorrhea and conjunctivitis, are not recommended for GAS testing. The use of highly sensitive GAS PCR assays in patients with sore throat and viral ARI symptoms may detect GAS colonization and lead to antibiotic overuse. We evaluated GAS PCR in viral ARI inpatients and asymptomatic healthy controls (HC) to illustrate the potential negative impact of offering GAS PCR test in poorly selected patients. Methods In November 2015–June 2016, 458 ARI inpatients (< 18 years) and 205 HC (< 5 years, no ARI symptoms within 72 hours) in Kansas City were enrolled in the New Vaccine Surveillance Network study. Mid-turbinate and throat swabs were tested by multiplex respiratory panel PCR and leftover nucleic acid extracts were further tested by real-time GAS PCR. Presenting symptoms of cough, rhinorrhea and/or conjunctivitis, plus sore throat were assessed by parent interview. Results Overall, 6.3% of HC < 5 years old and 8.7% of ARI subjects < 18 years were GAS (+); mostly in the 3–15 year old age group (25/40, 62.5%). Among 3–15 year old GAS (+) ARI subjects, 92.8% had cough, 76.2% rhinorrhea and 37.2% conjunctivitis; 80% had > 2 of 3 symptoms noted above. Among 40 GAS (+) ARI subjects, a virus was co-detected in 34 (85%), among which Rhinovirus/Enterovirus were predominant 22/34 (55%). Of the 130 (28%) ARI subjects with sore throat, more tested positive for viruses (107/130, 82.3%) than for GAS (9/130, 6.9%). All GAS (+) HC (13/205, 6.3% overall) were < 3 year olds. Conclusion PCR detected GAS in 6.3% HC < 5 years old and 8.7% ARI subjects < 18 years old; mostly in 3- to 15-year-old ARI subjects. Most GAS (+) ARI children had cough, rhinorrhea or conjunctivitis and/or virus co-detection suggesting GAS carriage. Our data demonstrate that GAS may be detected in patients with a low clinical suspicion for acute GAS pharyngitis. These findings highlight the need to review patient selection and exercise caution in implementing highly sensitive GAS PCR assays especially in such clinical settings. Disclosures All authors: No reported disclosures.
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Peiter, Tina, Monika Haering, Spasenija Bradic, Graça Coutinho, and Karel Kostev. "Reducing Antibiotic Misuse through the Use of Point-of-Care Tests in Germany: A Survey of 1257 Medical Practices." Healthcare 11, no. 17 (2023): 2466. http://dx.doi.org/10.3390/healthcare11172466.
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Though more than 80% of acute pharyngitis (AP) cases have a viral etiology, it remains one of the most common causes for the unnecessary prescription of antibiotics (ABs). Half of patients receive antibiotics in general practice. Point-of-Care Tests (POCTs) distinguish between bacterial and viral pharyngitis. The objective of this study was to evaluate the use of POCTs using throat swabs to detect β-Streptococcus pyogenes Group A (strep A) infection among patients with sore throat/acute pharyngitis in primary care practices across Germany. A study was conducted in 1257 primary care practices. Two questionnaires were administered concerning frequency, POCT results and whether antibiotics were prescribed. Of the 1257 physicians, 60% used POCTs. Of these, 25% used a POCT before prescribing an antibiotic, 39% in cases of severe sore throat, 40% in cases of long-lasting pharyngitis and 25% in other cases. In total, 83% considered the adoption of POCTs in everyday practice to be important or very important for the diagnosis of strep A, 90% considered it important or very important for achieving a more sensible use of antibiotics and the prevention of bacterial resistance and 80% considered it important or very important for justifying to patients whether or not an antibiotic is needed. POCT results and information on AB prescriptions were available for 583 patients. Of these, 22.5% tested positive for strep A, and 21.8% were prescribed antibiotics. Our study shows that the use of swab tests in patients with sore throat in primary care practices results in high levels of physician satisfaction and can strongly reduce the misuse of antibiotics in clinical practice.
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Aseel, Muthanna Yousif Al-Sammarraie, and Ali Hussein Al-Nuaimi Al-Hadi Mudher. "Identifying and Isolating Bacterial Pathogens Causing Acute Pharyngitis." INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND BIO-MEDICAL SCIENCE 03, no. 07 (2023): 364–68. https://doi.org/10.5281/zenodo.8182660.
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Acute pharyngitis is a prevalent inflammatory condition primarily caused by viral or bacterial infections. Accurate identification of the causative agent is crucial for appropriate treatment selection. This study aimed to investigate the bacterial profile of patients with tonsillitis admitted to Marjan Teaching Hospital, as well as evaluate the potential psychological impact on affected individuals. Tonsil swabs were collected from male and female patients presenting with symptoms such as fever, dysphagia, swollen lymph nodes and pharyngeal tissues, voice alterations, and vomiting. Customized growth media was utilized for culturing the samples. Out of 250 samples, all exhibited positive bacterial growth (100%). Phenotypic and biochemical analyses were conducted to identify the bacteria. The most prevalent bacterium found was Staphylococcus aureus (40%, or 10 isolates), followed by Bacillus cereus (20%, or 5 isolates), Streptococcus pyogenes (16%, or 4 isolates), Streptococcus viridans (12%, or 3 isolates), Staphylococcus epidermidis (8%, or 2 isolates), and Streptococcus pneumoniae (4%). The results indicated a higher susceptibility to infection among male patients compared to females, particularly within the age range of 6-12 years old. These findings contribute to understanding the etiology of acute pharyngitis and underline the importance of accurate pathogen identification for effective treatment strategies.
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Zakirova, A. M., T. B. Moroz, E. M. Pokrovskaya, et al. "Influenza and acute viral infection prevention in children with recurrent respiratory pathology." Meditsinskiy sovet = Medical Council, no. 1 (February 27, 2024): 213–20. http://dx.doi.org/10.21518/ms2023-492.
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Introduction. Despite numerous scientific works devoted to the problem of acute respiratory diseases, its relevance does not decrease throughout the world, since serious complications with an unfavorable prognosis are possible.Aim. To evaluate the effectiveness of preventive antiviral therapy in children with recurrent respiratory pathology.Materials and methods. Under observation were 43 children (average age 7.43 ± 3.05 years) with recurrent respiratory pathology, who underwent health treatment in the summer period once for 14 days. The main group consisted of 22 children who were prescribed the antiviral therapy as a monotherapy for prophylactic use. The comparison group included 21 patients who underwent preventive treatment using nasopharyngeal irrigation with local antiseptic chemicals. The observation period was 3 months after prophylactic treatment.Results and discussion. After preventive treatment, the total number of episodes of ARI during the observation period in the main group in relation to the comparison group was according to nosologies: acute pharyngitis (p = 0.0317), exacerbation of chronic tonsillitis (p = 0.0137), acute rhinitis (p = 0.0692), rhinosinusitis (p = 0.0429). In the main group, during the observation period, when episodes of upper respiratory tract diseases occurred, antibacterial drugs were prescribed statistically significantly less frequently (p = 0.0296). After the preventive course, compared with the initial data, there was a decline in the number of cases of upper respiratory tract diseases per child on average per quarter. Thus, in the main group, a more pronounced significant difference was revealed in all nosological forms (acute rhinitis, rhinosinusitis p = 0.0081, acute pharyngitis p = 0.0129, tonsillopharyngitis p = 0.0384). In the comparison group – respectively: p = 0.0426; 0.0387; 0.0439.Conclusions. Carrying out preventive treatment as monotherapy in children with recurrent respiratory pathology demonstrated high effectiveness (86.37%) of the antiviral therapy.
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Peters, Steven, and Kristen Brown. "Acute Cryptogenic Stroke During West Nile Virus Infection: Case Report." Neurohospitalist 11, no. 1 (2020): 62–65. http://dx.doi.org/10.1177/1941874420940944.
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West Nile virus is an emerging infection in North America but has not traditionally been associated with acute vascular events. We report a 57-year-old healthy male who developed pharyngitis and a corporeal rash, followed 1 week later by an acute cryptogenic stroke. Following successful endovascular thrombectomy, cerebrospinal fluid analysis revealed acute West Nile virus infection. While severe cases of vasculopathy have been described with flavivirus infection, stroke associated with relatively mild symptoms has not been. Given increasing evidence that viral and bacterial infections of many varieties may be stroke triggers, West Nile virus and other flaviviruses may represent an uncommon but underappreciated trigger of cryptogenic stroke. We review indirect evidence that viral endothelial tropism or a nonspecific peri-infectious inflammatory state may be causative mechanisms.
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McMillan, Julia A., Cathy Sandstrom, Leonard B. Weiner, et al. "Viral and bacterial organisms associated with acute pharyngitis in a school-aged population." Journal of Pediatrics 109, no. 5 (1986): 747–52. http://dx.doi.org/10.1016/s0022-3476(86)80687-4.
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Higgins, P. M. "Splenomegaly in acute infections due to group A streptococci and viruses." Epidemiology and Infection 109, no. 2 (1992): 199–209. http://dx.doi.org/10.1017/s0950268800050160.
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SUMMARYOver a period of 9 years in general practice temporary enlargement of the spleen was found in 29 episodes of pharyngitis or tonsillitis, in 2 episodes of acute upper respiratory tract infection other than pharyngitis and in 6 episodes of acute cervical lymphadenitis. In five patients more than one episode of illness associated with splenomegaly was recorded.In 26 of the 37 episodes a possible aetiology was identified. Evidence only of infection with group A streptococci was found in 14 episodes, adenoviruses or coxsackie B viruses were isolated alone in 4 episodes and in 4 episodes the only finding was the presence in the blood of more than occasional atypical mononuclear cells; in 4 episodes there was evidence of both streptococcal and viral infection. Episodes with evidence of streptococcal infection only tended to be of shorter duration and to be more evenly distributed over the year than were episodes without such evidence. Temporary splenomegaly was noted also in two children with varicella (one of whom also had streptococcal infection) and in an adult with probable rubella.
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Schmutzler, Lukas, Moritz Mirna, Uta C. Hoppe, and Michael Lichtenauer. "From Streptococcal Pharyngitis/Tonsillitis to Myocarditis: A Systematic Review." Journal of Cardiovascular Development and Disease 9, no. 6 (2022): 170. http://dx.doi.org/10.3390/jcdd9060170.
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(1) Background: Myocarditis following group A streptococcal pharyngitis and tonsillitis is a relatively rare medical condition. The aim of this systematic review was to identify specific ECG changes, laboratory parameters and signs, and symptoms associated with this disease. (2) Methods: A systematic literature review was performed in concordance with the current PRISMA guidelines, including the databases PubMed/MEDLINE, Web of Science, CDSR, CENTRAL, CCAs, EBM Reviews, and LILACS. Articles were included if they covered myocarditis after streptococcal pharyngitis/tonsillitis in humans. Exclusion criteria were rheumatic, autoimmune, or toxic myocarditis. (3) Results: Patients that developed myocarditis after group A streptococcal throat infection frequently presented with chest pain, elevated cardiac markers, and ST-segment elevations, making it a condition that shows more similarities to acute coronary syndrome than viral myocarditis. (4) Conclusions: Myocarditis after streptococcal pharyngitis and/or tonsillitis is a rather infrequently described disease; however, it is necessary to consider this condition when investigating streptococcal sore throat because it can be associated with severe adverse events for the individual patient.
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Bonsignori, F., E. Chiappini, and M. De Martino. "The Infections of the Upper Respiratory Tract in Children." International Journal of Immunopathology and Pharmacology 23, no. 1_suppl (2010): 16–19. http://dx.doi.org/10.1177/03946320100230s105.
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Upper respiratory tract infections in children are common and usually self-limiting conditions, which include acute otitis media (AOM), acute rhinosinusitis (ARS), and acute pharyngitis (AP). Management of pediatric AOM considers observation strategy for selected and uncomplicated cases, older than 2 years of age, only when adequate follow-up can be ensured. Otherwise, an antibiotic treatment should be prescribed. Amoxicillin should be preferred as the first-choice therapy. Switch therapy to ceftriaxone is suggested if amoxicillin regimen failure occurs within 48–72 hours. The diagnosis of ARS is established by the persistence of purulent nasal of post-nasal draining lasting at least 10 days especially if accompanied by supporting symptoms and signs. Amoxicillin is the first choice drug for mild ARS in children. When symptoms persist or worsen, amoxicillin/clavulanate or cefpodoxime proxetil, or ceftriaxone are recommended. Clinical criteria alone are not sufficiently accurate in children with AP to distinguish bacterial and viral etiology. Thus microbiological evaluation is needed and positive throat colture or rapid antigen detection test are required to establish the diagnosis of streptococcal pharyngitis and consequently to prescribe antibiotic treatment. The first choice treatment in European countries still remains amoxicillin or amoxicillin/clavulanate.
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Mohammed Malik Afroz, Karthiga Kannan, Chanchala H P, et al. "A Case Presentation on Acute Lymphonodular Pharyngitis with a Review." International Journal of Research in Pharmaceutical Sciences 12, no. 1 (2021): 392–95. http://dx.doi.org/10.26452/ijrps.v12i1.4033.
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Acute lymphonodular pharyngitis is a viral infection predominantly caused by coxsackievirus and is seen in children. The infection is characterized by typical prodromal symptoms of mild fever, sore throat, difficulty in deglutition. The characteristic clinical presentation reveals multiple raised, discrete, yellowish-white non-vesicular lesions with surrounding erythematic appearance commonly seen on the roof of the posterior aspect of the oral cavity. The lesions have been identified as early as 1962, described in detail in the literature. These lesions may be common but are often overlooked due to less knowledge among the patients or rather the patients not directly reporting to the dental office. We present with a case of a five-year-old apparently healthy child with a detailed description of symptoms, clinical features, follow up, differential diagnosis and review. This article aims to bring awareness of the disease in the present form to the readers with the purpose of early detection and identification of condition for treatment. We found very less review in the literature over past years which bring us to understand that it is overlooked though it has been identified in the early years. The disease may be reported less, but it is not obsolete to be discarded.
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Azevedo, Rita, Leonardo Vinagre, Diana Marques, et al. "The impact of rapid antigen detection test (RADT) for group A streptococcus on the antibiotic prescription: an observational study from a primary care setting in Lisbon." Revista Portuguesa de Clínica Geral 39, no. 2 (2023): 121–28. http://dx.doi.org/10.32385/rpmgf.v39i2.13468.
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Introduction: Acute pharyngitis is a common diagnosis in primary care. Although viruses are the most common aetiology, antibiotic therapy is frequently prescribed. The inappropriate antibiotic prescription should be avoided to prevent antibiotic resistance. Many national and international guidelines recommend testing for group A streptococcus (GAS) before antibiotic treatment when clinical presentation suggests GAS infection. Aim: This study aims to describe the feasibility of the implementation of the rapid antigen detection test (RADT) in a primary care setting and its impact on antibiotic prescription. Secondary goals include the evaluation of possible associations between symptoms and RADT results. Methods: From October 2019 to March 2020, patients presenting with acute pharyngitis at USF do Parque were eligible. A questionnaire was applied to divide the individuals into four different groups (clearly viral, probably viral, diagnostic doubt, and probably bacterial), and to assess the previous intention to prescribe antibiotics. We applied 136 questionnaires and performed 133 RADT. Nursing staff classified the specimen collection process and result from interpretation according to its difficulty. The proportion of antibiotics avoided was estimated as the number of times physicians changed their intended antibiotic prescription following a negative RADT result. Results: Among the tests performed, 97.7% were easy to interpret. Without RADT, 45 patients were going to be prescribed an antibiotic. After the test result, 27 antibiotic prescriptions were avoided. Tonsil hypertrophy, palatal petechiae, and fever increased the odds of a positive RADT result. Cough was associated with a negative RADT result. Conclusions: This study showed that RADT is easy to implement and contributed to appropriate antibiotic prescription. Tonsil hypertrophy, palatal petechiae, and fever were significantly associated with a positive RADT result, and cough was associated with a negative RADT result. Primary care centers would benefit from having RADT available when there is strong suspicion or doubt of bacterial pharyngitis.
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Shrivastava, Ravi. "Instant Antibacterial and Anti-Inflammatory Osmotic Polymeric Film to Treat Sore Throat in Children." Journal of Clinical Research and Reports 7, no. 04 (2021): 01–08. http://dx.doi.org/10.31579/2690-1919/161.
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Background: Pharyngitis, a common viral throat infection in children, involving inflammation, widespread local bacterial contamination and tissue destruction. When clinical signs appear, the disease already became multifactorial. In the absence of any multitarget treatment, we conceived a new generation of topical, osmotic, anti-inflammatory, throat surface cleaning polymeric film, capable of detaching and draining throat surface contaminants nearly instantly. Material and methods: A glycerol and polymer containing osmotic film was prepared. Osmotic film attracts hypotonic liquid from the throat tissue, which detach and drain throat surface contaminants and create a favorable environment for cell growth and healing. Specific pro-inflammatory cytokine and virus glycoprotein binding polymers were incorporated in the film to suppress the inflammation. An observational, randomized, placebo-controlled study was performed after the approval of ethical committee on 30 children aged between (3-15), presenting symptoms of acute pharyngitis. After randomization, test product (n=20) and saline control (n=10) solutions were applied as 3-4 throat sprays 4-5 times / day for 15-days. Change in all the key pharyngitis symptom (difficulty swallowing, throat inflammation, irritation, redness, and bacterial deposit) were evaluated employing two-tailed Student’s test for followed by the post hoc Bonferroni’s test for comparisons of multiple groups Results: Only a few specific polymers were able to bind with viral proteins and/or cytokines in adequate filmogen concentrations. Throat surface cleaning and cytokine neutralization strongly decrease all the pharyngitis symptoms and need for antibiotic therapy compared to controls (p<0.05 from day 3 onwards). No adverse effects were noted in any of the groups. Conclusion: Clinical results showed excellent efficacy and safety of osmotically active polymeric film. Polymeric drugs may represent an excellent multitarget treatment approach to minimize the use of antibiotics and chemical drugs in the future.
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Osiejewska, Aleksandra, Anna Gorajek, Małgorzata Kudan, Anna Grądzik, and Karolina Mikut. "Acute tonsillopharyngitis - a review." Journal of Education, Health and Sport 12, no. 7 (2022): 873–82. https://doi.org/10.12775/JEHS.2022.12.07.087.
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<strong>Osiejewska Aleksandra, Gorajek Anna, Kudan Małgorzata</strong><strong>, Grądzik Anna</strong><strong>, </strong><strong>Mikut Karolina</strong><strong>. Acute tonsillopharyngitis - a review</strong><strong>. J</strong><strong>ournal of Education, Heal</strong><strong>th and Sport. 2022;12(7):873-882</strong><strong>. eISSN 2391-8306. DOI </strong><strong>http://dx.doi.org/10.12775/JEHS.2022.12.07.087</strong> <strong>https://apcz.umk.pl/JEHS/article/view/JEHS.2022.12.07.087</strong> <strong>https://zenodo.org/record/6939667</strong> <strong>The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343.</strong> <strong>Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences).</strong> <strong>Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159.</strong> <strong>Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu).</strong> <strong>© The Authors 2022;</strong> <strong>This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland</strong> <strong>Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike.</strong> <strong>(http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.</strong> <strong>The authors declare that there is no conflict of interests regarding the publication of this paper.</strong> <strong>Received: 16.07.2022. Revised: 17.07.2022. Accepted: 29.07.2022.</strong> <strong>Acute tonsillopharyngitis - a review</strong> <strong>Aleksandra Osiejewska<sup>1</sup>, Anna Gorajek<sup>2</sup>, Małgorzata Kudan<sup>2</sup></strong><strong>, Anna Grądzik<sup>1</sup></strong><strong>, </strong><strong>Karolina Mikut<sup>3</sup></strong> University Clinical Center, Medical University of Warsaw, 02-097 Warsaw, Poland Central Clinical Hospital of the Ministry of Interior and Administration, 02-507, Warsaw, Poland Collegium Medicum Nicolaus Copernicus University, 85-067, Toruń, Poland Corresponding author: Aleksandra Osiejewska, aleksandraosiejewska@gmail.com ORCID ID and e-mail: Aleksandra Osiejewska: https://orcid.org/0000-0002-1729-9905; aleksandraosiejewska@gmail.com Anna Gorajek: https://orcid.org/0000-0002-8043-2246; agorajek@vp.pl Małgorzata Kudan: https://orcid.org/0000-0001-6463-6735; malgorzata.kudan@gmail.com Anna Grądzik: https://orcid.org/0000-0002-8457-5172; anna.gradzik123@gmail.com Karolina Mikut: https://orcid.org/0000-0001-7022-581X; karolina.mikut@gmail.com <strong>Keywords: </strong>pharyngitis, tonsillopharyngitis, tonsillitis, phenoxymethylpenicillin, Streptococcus pyogenes <strong>ABSTRACT</strong> <strong>Introduction and purpose:</strong> Acute pharyngitis and tonsillitis is the most common reason why people want to visit their primary care physician. Viruses are the most common cause of acute pharyngitis and acute tonsillitis in children and adults. The patient complains about pain with sudden onset and throat irritation, pain on swallowing, fever and headache, and in children also abdominal pain, nausea and vomiting. <strong>Brief description of the state of knowledge:</strong> Most acute tonsillopharyngitis is due to rhinoviruses (35%), influenza (30%), RSV and parainfluenza. Bacteria causes 30% of the infections and S. pyogenes is the most common cause. Viral infections are seasonal. S.pyogenes infection is most often in winter and early spring. Changes in the pharyngeal mucosa look similar in both bacterial and viral etiologies. Because of that, scales have been developed to assess the probability of a bacterial infection. The most used is Centor / McIsaac scale. The gold standard of diagnostics is throat swab culture. In the treatment of streptococcal pharyngitis and tonsillitis, penicillins are used as first-line treatment. Antibiotic treatment reduces infectivity, lowers the risk of rheumatic fever and made symptoms disappear two days earlier. Tonsillectomy does not reduce the number of recurrent pharyngitis and tonsillitis, therefore it cannot be recommended. <strong>Conclusion:</strong> Acute tonsillopharyngitis can result in many complications, the most serious of them is rheumatic fever. Therefore, it is very important to properly diagnose and use antibiotic therapy when necessary.
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Nisreen Jawad Kadhim. "Study Characteristics of Streptococcus pyogenes Isolation From Pharyngitis in children." Academic International Journal of Medical Update 2, no. 1 (2024): 33–42. http://dx.doi.org/10.59675/u215.
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Background: Streptococcus pyogenes is a common cause of bacterial pharyngitis in children. Although distinguishing between viral and bacterial pharyngitis solely on the basis of signs and symptoms can be difficult, culture-based diagnosis and study characteristics are crucial to avert potentially fatal outcomes. Therefore, the purpose of this investigation was to ascertain the occurrence of S. pyogenes using a culture approach that followed a biochemical test and a PCR experiment that targeted the 16S rRNA, sepl, and spek genes. By logging and evaluating the results, the PCR assay's sensitivity, specificity, positive, and negative predictive values were established in relation to the culture method. Methods: Between 2022 and 2023, a total of 170 throat swabs were taken from pharyngitis patients who were referred to Fallujah General Teaching Hospital and AL Hussein Teaching Hospital for children in Iraq ages 2 to 10.The identification of S. pyogenes using biochemical testing, 16S rRNA, and multiplex polymerase chain reaction (multiplex PCR) for the detection of virulence factor genes (SpeL and SpeK genes). Results: This study included a total of 170 children with acute pharyngitis. Of these, 75 (44.11%) were culture optimistic for S. pyogenes, a biochemical test and 16SrRNA based on the Multiplex PCR examination presented, sepl 9 (12%)and spek 6 (8%) genes were noticed in 10.51% and 8.55%, respectively, of the isolates. Conclusion: The study aimed to identify risk factors for S. pyogenes infection among children in a large clinical trial in Iraq.
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Voitl, Peter, Rosmarie Meyer, Astrid Woditschka, Christian Sebelefsky, Andreas Böck, and Verena Schneeberger. "Occurrence of patients compared in a pediatric practice and pediatric hospital outpatient clinic." Journal of Child Health Care 23, no. 4 (2019): 512–21. http://dx.doi.org/10.1177/1367493519853431.
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The frequency of consultations and the waiting times in pediatric hospital outpatient clinics are steadily increasing. The aim of this study was to compare the occurrence of patients in a large pediatric group practice and a hospital-based general pediatric outpatient clinic. Primary parameters were the most common reasons for consultation, the waiting times and the reasons for selecting a certain institution. Most frequent diagnoses in the pediatric practice were upper respiratory tract infections (22.7% ( n = 141/621)), otitis media (5.2% ( n = 32/621)), and viral pharyngitis (3.9% ( n = 24/621)). Most common reasons for consultation in the hospital outpatient clinic were upper respiratory tract infections (18.4% ( n = 121/658)) and bacterial pharyngitis (17.9% ( n = 118/658)). In the pediatric practice, bacterial pharyngitis was only diagnosed in 3.1% ( n = 19/621) of the cases. Only slight differences exist between the two institutions regarding the observed entities, which mainly comprise mild to moderate acute illnesses. It can be concluded from this that the majority of patients might as well be treated in the nonhospital setting. Facilitating the communication and coordination between practices and hospitals might allow a better utilization of capacities. Thereby, waiting times, unnecessary reexaminations, and costs in the health-care system could be reduced.
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Sheybani, Fereshte, HamidReza Naderi, Seddigheh Sadat Erfani, and Masoumeh Gharib. "A Complicated Course of Acute Viral Induced Pharyngitis, Icteric Hepatitis, Acalculous Cholecystitis, and Skin Rash." Case Reports in Medicine 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/6796094.
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This case reveals the complexities and challenges in the diagnosis of acute Epstein-Barr virus (EBV) infection, indicating the potential relationship between EBV infection and severe icteric hepatitis, acalculous cholecystitis, and lymphocytic vasculitis. We suggest including EBV infectious mononucleosis in the list of differential diagnoses when any of these clinical syndromes (or a combination thereof) occurs without apparent cause, especially in the presence of lymphocytosis. To our knowledge, this is the first report to suggest the possible role of EBV in the pathogenesis of cutaneous lymphocytic vasculitis. Also it is possible that EBV infection triggered the flare-up of the underlying rheumatologic disease. Therefore, it could be assumed that a part of the clinical syndrome (e.g., dermatologic manifestations) might be related to the flare-up of the underlying rheumatologic disease.
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Dao, Van-Anh, Sabrina Overhagen, Andreas Bilstein, Carina Kolot, Uwe Sonnemann, and Ralph Mösges. "Ectoine lozenges in the treatment of acute viral pharyngitis: a prospective, active-controlled clinical study." European Archives of Oto-Rhino-Laryngology 276, no. 3 (2019): 775–83. http://dx.doi.org/10.1007/s00405-019-05324-9.
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Sarma, Shohinee, Derek Henry Wallace Little, Tooba Ali, Emily Jones, and Shariq Haider. "Cytomegalovirus Primary Infection in an Immunocompetent Female with Mononucleosis Features: A Review of Mononucleosis-Like Syndromes." Canadian Journal of General Internal Medicine 13, no. 3 (2018): 39–43. http://dx.doi.org/10.22374/cjgim.v13i3.258.
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Background
 The clinical triad of fever, pharyngitis, and lymphadenopathy was first described in 1889 as “glandular fever” and later defined as infectious mononucleosis. We present a case report and review of mononucleosis-like syndromes in an immunocompetent patient. The review of common etiologies includes Epstein-Barr virus (EBV), acute human immunodeficiency virus (HIV), human herpesvirus 6 (HHV-6), cytomegalovirus (CMV), and Toxoplasmosis gondii.
 Case Vignette
 A 37-year- old, immunocompetent female presented with a three-week history of fever, pharyngitis, fatigue, night sweats, and abdominal pain. Physical examination revealed hepatosplenomegaly, but no lymphadenopathy, rashes, or tender joints. Investigations showed lymphocytosis and a normal peripheral smear. A Hematology consultation excluded hematologic malignancy. Her CD4/CD8 ratio was 0.2 in keeping with a viral infection, but EBV monospot test was negative. Serology for hepatitis B and C were negative. Human immunodeficiency virus (HIV) testing was not done in the absence of risk factors. Quantitative PCR for CMV was positive with a value of 965.25 units/mL. The patient was diagnosed with CMV viremia and treated with a two-week course of valganciclovir with resolution of symptoms. A two-month follow-up revealed a normal complete blood count and resolving hepatosplenomegaly.
 Conclusions
 In immunocompetent patients presenting with symptoms of mononucleosis, the differential diagnosis should include EBV, CMV, HHV-6, acute HIV and Toxoplasmosis gondii. CMV commonly affects young patients and is less associated with tonsillitis, pharyngitis, and lymphadenopathy. HHV-6 can present with headaches, encephalitis, and abdominal pain. Consideration of acute HIV mononucleosis should prompt early serologic testing. Toxoplasmosis is often associated with undercooked food or cat excrement, requiring anti-IgM antibody testing to distinguish from EBV. Although EBV infectious mononucleosis may be suspected, the general practitioner should consider a complete review of other infectious etiologies.
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Bo, Zhuang Mian, Wei Keat Tan, Christina Shook Cheng Chong, et al. "Respiratory microorganisms in acute pharyngitis patients: Identification, antibiotic prescription patterns and appropriateness, and antibiotic resistance in private primary care, central Malaysia." PLOS ONE 17, no. 11 (2022): e0277802. http://dx.doi.org/10.1371/journal.pone.0277802.
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Acute pharyngitis (AP) is a common reason for private primary care consultations, thus providing an avenue for widespread antibiotic intake among the community. However, there is limited data on the antibiotic prescription appropriateness and resistance information in the Malaysian private primary care setting, therefore, this study aimed to investigate the prevalence of isolated viruses and bacteria, antibiotic resistance patterns, antibiotic prescription patterns and appropriateness by general practitioners (GPs) and factors affecting antibiotic resistance and antibiotic prescription patterns. To investigate, a cross-sectional study was conducted among 205 patients presenting with AP symptoms at private primary care clinics in central Malaysia from 3rd January 2016 to 30th November 2016. Throat swabs were collected from 205 AP patients for two purposes: (i) the detection of four common respiratory viruses associated with AP via reverse-transcription real-time PCR (qRT-PCR); and (ii) bacterial identification using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Bacterial isolates were then subjected to antibiotic susceptibility screening and McIsaac scoring was calculated post-prescription based on GP selection of criteria. Generalized estimating equations analysis with multiple logistic regression was conducted to identify factors associated with presence of virus and antibiotic prescription. The results showed that 95.1% (195/205) of patients had at least one of the four viruses, with rhinovirus (88.5%) being the most prevalent, followed by adenovirus (74.9%), influenza A virus (4.6%) and enterovirus (2.1%). A total of 862 non-repetitive colonies were isolated from the culture of throat swabs from 205 patients who were positive for bacteria. From a total of 22 genera, Streptococcus constitutes the most prevalent bacteria genus (40.9%), followed by Neisseria (20%), Rothia (13.0%), Staphylococcus (11%) and Klebsiella (4.9%). Only 5 patients carried group A beta-hemolytic streptococci (GABHS). We also report the presence of vancomycin-resistant S. aureus or VRSA (n = 9, 10.1%) among which one isolate is a multidrug-resistant methicillin-resistant S. aureus (MDR-MRSA), while 54.1% (n = 111) were found to carry at least one antibiotic-resistant bacteria species. Application of the McIsaac scoring system indicated that 87.8% (n = 180) of patients should not be prescribed antibiotics as the majority of AP patients in this study had viral pharyngitis. The antibiotic prescription appropriateness by applying post-prescription McIsaac scoring was able to rule out GABHS pharyngitis in this sample with a GABHS culture-positive sensitivity of 40% (n = 2/5) and specificity of 90% (180/200). In conclusion, antibiotic-resistant throat isolates and over-prescription of antibiotics were observed and McIsaac scoring system is effective in guiding GPs to determine occurrences of viral pharyngitis to reduce unnecessary antibiotic prescription.
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Machado-Duque, Manuel E., Diego Arturo García, Melissa Hiromi Emura-Velez, Andrés Gaviria-Mendoza, Claudia Giraldo-Giraldo, and Jorge E. Machado-Alba. "Antibiotic Prescriptions for Respiratory Tract Viral Infections in the Colombian Population." Antibiotics 10, no. 7 (2021): 864. http://dx.doi.org/10.3390/antibiotics10070864.
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Antimicrobials are frequently inappropriately prescribed for the management of upper respiratory tract infections (URTIs); therefore, the frequency of antibiotic prescriptions for patients with viral URTIs was assessed in this study. A cross-sectional study, including ambulatory patients diagnosed with viral URTI, was conducted, and records of antimicrobial prescriptions were obtained. Sociodemographic, clinical (diagnostic), and pharmacological (antimicrobial) variables were assessed. Through multivariate analysis, variables associated with the use of antibiotics for viral infections were identified. A total of 341,182 patients with viral URTIs were identified. The patients, who were from 26 different departments of Colombia, had a mean age of 29.7 ± 23.5 years and a female predominance of 58.7% (n = 200,195). The most frequent viral infections were as follows: acute rhinopharyngitis (common cold) (n = 206,211; 60.4%); unspecified acute tonsillitis (n = 27,432; 8.0%); and acute pharyngitis (n = 26,411; 7.7%). A total of 24.8% of the patients (n = 84,453) received a prescription for antibiotics, predominantly penicillins (n = 61,871; 18.1%) and cephalosporins (n = 10,926; 3.2%). Patients treated in Atlántico, Valle, and Risaralda departments, along with those older than 5 years, were more likely to receive antibiotics for the treatment of viral infections. Antibiotics are frequently prescribed for the management of URTIs, which is considered an inappropriate practice due to a lack of clinical benefits, increased generation of antimicrobial resistance, and a risk of adverse reactions due to the use of medications that patients do not require. Drug utilization studies are a great tool for monitoring how antibiotics are being used and planning interventions to improve their use.
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Drozdova, M. V., Yu S. Preobrazhenskaya, S. V. Ryazantsev, and S. S. Pavlova. "Inflammatory diseases of the pharynx in children." Meditsinskiy sovet = Medical Council, no. 1 (February 26, 2022): 51–57. http://dx.doi.org/10.21518/2079-701x-2022-16-1-51-57.
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Introduction. Inflammatory diseases of the lymphoid ring of the pharynx in children are widespread and account for more than 30% in the structure of ENT pathology. Lymphoid tissue, especially the palatine tonsils, largely determines the formation of local and general protective reactions of the child’s body.The aim of this work is to assess the efficacy and safety of using topical bacterial lysate in chronic tonsillitis of streptococcal and herpes viral etiology in frequently ill children.Materials and methods. The study was conducted on a sample of 31 children aged 7–17 who were treated in the pediatric department of the Saint Petersburg Research Institute of Ear, Throat, Nose and Speech inpatiently or outpatiently, which were divided into 2 groups. Group 1 consisted of 15 children with decompensated chronic tonsillitis of streptococcal etiology, who were prescribed tonsillectomy according to indications. Group 2 consisted of 16 children with chronic compensated tonsillitis, who, after an acute respiratory infection, showed signs of acute pharyngitis in the form of pain and discomfort in the throat, perspiration, low-grade body temperature. In both groups children were prescribed to take topical baclerial lysates.Results. A subjective pain relief of sore throat in patients (groups 1 and 2) was observed from day 2–3 of administration of the topical bacterial lysate. The clinical therapeutic effect resulted in decreased intensity of inflammation of the posterior pharyngeal wall, reduction in size and tenderness of regional lymph nodes from day 4–5 of administration of the drug. The clinical recovery from acute pharyngitis in children of both groups was observed in 98% of cases at visit 3.Conclusion. The persistence of pathogenic viruses and bacteria contributes to the development of secondary immunodeficiency states and participates in the formation of a kind of “vicious circle” In these causes prescription of topical baclerial lysates may be an effective conservation therapy as well as antibiotics and antiviral drugs. The drug showed its efficacy in the treatment of acute and chronic diseases of the pharynx in children of both viral and bacterial etiology.
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Hashimoto, Hideki, Hiroki Matsui, Yusuke Sasabuchi, et al. "Antibiotic prescription among outpatients in a prefecture of Japan, 2012–2013: a retrospective claims database study." BMJ Open 9, no. 4 (2019): e026251. http://dx.doi.org/10.1136/bmjopen-2018-026251.
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ObjectivesTo investigate oral antibiotic prescribing patterns and identify factors associated with antibiotic prescriptions, with the aim of guiding future interventions to reduce inappropriate prescribing.DesignRetrospective cohort study.SettingDatabase of public health insurance claims in Kumamoto prefecture (Japan).ParticipantsBeneficiaries of the national or late elders’ health insurance system between April 2012 and March 2013.Main outcome measuresOf the 7 770 481 outpatient visits, 682 822 had a code for antibiotics (860 antibiotic prescriptions per 1000 population). Third-generation cephalosporins (35%), macrolides (32%) and quinolones (21%) were the most frequently prescribed. Acute respiratory tract infections (ARTIs), including viral upper respiratory infections (URI) (22%), pharyngitis (18%), bronchitis (11%) and sinusitis (10%) were the most frequently diagnosed for antibiotic prescribing, followed by gastrointestinal (9%), urinary tract (8%) and skin, cutaneous and mucosal infections (5%). Antibiotic prescribing rates for viral URI, pharyngitis, bronchitis, sinusitis and gastrointestinal infections were 35%, 54%, 53%, 57% and 30%, respectively. In multivariable analysis for ARTIs and gastrointestinal infections, patient age (10–19 years especially), patient sex (male) and facility scale (free-standing clinics or small-scale hospital-based clinics) were associated with increased antibiotic prescribing.ConclusionsBroad-spectrum antibiotics constituted 88% of oral outpatient antibiotic prescriptions. Approximately 70% of antibiotics were prescribed for ARTIs and gastroenteritis with modest benefit from antibiotic treatment. The quality of antibiotic prescribing needs to be improved. Antimicrobial stewardship interventions should target ARTIs and gastroenteritis, as well as young patients and small-scale institutions.
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Kasimova, A. R., and A. S. Kolbin. "Clinical and economic assessment of using topical bacterial lysate Imudon® for the treatment and prevention of acute upper respiratory tract infections in children." FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology 17, no. 2 (2024): 163–71. http://dx.doi.org/10.17749/2070-4909/farmakoekonomika.2024.243.
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Objective: pharmacoeconomic analysis of the feasibility of using topical bacterial lysate Imudon® for the treatment and prevention of acute upper respiratory tract infections in the pediatric population in comparison with other medicines belonging to the class of topical antiseptics.Material and methods. For the population calculated on the basis of Rosstat data, taking into account the Russian clinical recommendations "Acute respiratory viral infection (ARVI)" and "Acute tonsillitis and pharyngitis (acute tonsillopharyngitis)", the direct medical costs of medical care were determined. The cost of basic therapy of 1 case of acute respiratory infection (ARI) with symptoms of pharyngitis was calculated for two variants of clinical course: favorable (when ARI proceeds without complications and the patient does not need to be prescribed antibacterial drugs), and unfavorable (when confirmed bacterial infection joins and antibiotics are required). The indirect costs of child care are associated with lost gross domestic product (GDP). In estimating the GDP shortfall, it was assumed that the parent does not contribute to the country’s GDP during the entire childcare period.Results. GDP per capita for 2022 amounted to 2853.13 rubles per day. Thus, with a favorable course of the disease, indirect costs will be 19,972 rubles, and with an unfavorable course – 39,944 rubles. The total costs of the healthcare system and the state for 1 ARI patient are 32,192 rubles in case of favorable course and 71,644 rubles in case of unfavorable course. Imudon® administration allows reducing direct costs of parents for purchase of medicines for treatment of 1 ARI case by 23.6% compared to the therapeutic strategy associated with the use of local antiseptics.Conclusion. For the first time in Russian economic conditions, the use of Imudon® for the treatment and prevention of acute upper respiratory tract infections in children was evaluated. Its use from the first ARI symptoms allows refusing the use of local antiseptics, shortens the duration of the disease symptoms, and reduces the need for antibiotics, i.e. is feasibleable compared to local antiseptics.