#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Pharyngitis Caused by Streptococcus Pyogenes


Authors: Z. Kuchynková 1;  E. Bébrová 2;  D. Kučerová 1
Authors‘ workplace: Medical ORL, s. r. o., Praha , Ústav lékařské mikrobiologie UK 2. LF a FN Motol, Praha 1;  přednosta MUDr. O. Nyč, Ph. D. 2
Published in: Otorinolaryngol Foniatr, 61, 2012, No. 1, pp. 60-66.
Category: Review Article

Overview

The objective of the contribution is to summarize information on the recommended procedures for diagnosis and therapy of pharyngitis caused by Streptococcus pyogenes. Therefore, Czech recommended procedures as well as those of several European countries and the United States of America were examined. Pharyngitis caused by Streptococcus pyogenes is an acute infectious disease of oropharynx and/or nasopharynx. In most cases the disease results in spontaneous recovery. Immunogenic consequences of streptococcal infection are redoubtable, but presently rare complications in the Czech Republic

Typical symptoms of acute pharyngitis include sore throat and increased temperature. Diseases with such symptoms are caused by viral infection in most cases, only in about 5-30% by bacteria including S. pyogenes. The bacteria can produce the erthrogenic toxic in rare cases, causing that the described symptoms are accompanied by exanthema.

The diagnosis of pharyngitis caused by S. pyogenes is confirmed by cultivation or demonstration of the antigen. The control cultivation examination is not performed in patients who underwent antibiotic therapy and in inapparent carriers.

Patients with pharyngitis caused by S. pyogenes are treated with antibiotics, which mitigate subjective symptoms, limit spreading of the infection, prevent local complications and also present primary prevention of immunogenic consequences. Oral penicillin for 10 days is the treatment of choice, which in patients allergic to penicillin is a macrolide antibiotic. Patients with scarlatina are treated with injection penicillin. The antibiotic therapy is not indicated in carriers without symptoms. In relapsing acute pharyngitis caused by S. pyogenes it is not recommended to use long-term antibiotic therapy. A repeated acute inflammation is again treated by penicillin.

In the Czech Republic there are no binding epidemiological measures for pharyngitis caused by S. pyogenes, only scarlatina is the subject of acknowledgement (reporting).

Key words:
pharyngitis, Streptococcus pyogenes, recommended procedures, antibiotics, immunogenic consequences, acute inflammation.


Sources

1. Alho, O. P., Koivunen, P., Penna, T. et al.: Tonsillecomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial. BMJ, 334, 2007, s. 939.

2. Bébrová, E., Beneš, J., Čížek, J. et al.: Doporučený postup pro antibiotickou léčbu komunitních respiračních infekcí v primární péči. http://www.infekce.cz/Standardy/ ATBproPLDP.pdf.

3. Bisno, A. L., Gerber, M. A., Kaplan, E. I. et al.: Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin. Infect. Dis., 35, 2002, 2, s. 113-125.

4. Casey, J. R., Pichiero, M. E.: Meta-analysis of cephalosporins versus penicillin for treatment of group A streptococcal tonsillopharyngitis in adults. Clin.. Infect. Dis., 38, 2004, 11, s. 1526-1534.

5. Cilliers, A., Manyemba, J., Saloojee, H.: Anti-inflammatory treatment for carditis in acute rheumatic fever. Cochrane Database of Systematic Reviews, 2003, Issue 2. Art. No.: CD003176. DOI: 10.1002/14651858. CD003176.

6. Cooper, R. J., Hoffman, J. R., Barlett, J. G. et al.: Principles of appropriate antibiotik use for acute pharyngitis in adults: background. Ann. Intern. Med., 134, 2001, 6, s. 509-517.

7. Eison, T. M., Ault, B. H, Jones, D. P. et al.: Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis. Pediatr. Nephrol., 26, 2011, 2, s. 165-180.

8. Gerber, M. A., Baltimore, R. S., Baton, CH. B. et al.: Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis. Circulation, 119, 2009; s. 1541-1551.

9. Shaikh, N., Leonard, E., Martin, J. M.: Transferring evidence from research into practice: 1. The role of clinical care research evidence in clinical decisions. ACP J. Club., 125, 1996, 3, s. A14-A16.

10. Hoza, J., Jindrák, V., Marešová, V. et al.: Konsensus používání antibiotik I. Penicilinová antibiotika. http: /www.cls-cz/další-odborne-projekty.

11. Choby, B. A.: Diagnosis and treatment of Streptococcal Pharyngitis. Am. Fam. Physicican, 79, 2009, 5, s. 383-390.

12. Leitlinien der Dt. Ges. f. Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Antibiotikatherapie der Infektionene an Kops und Hals. http://www.awmf.org/ leitlinien/detail/11/017-066.html

13. Mayer, D.: Essential evidence-based medicine. Cambridge University Press, second edition, 2010.

14. Motlová, J.: Vyjádření k anginám a nosičství streptokoků skupiny A ve školkách. http://www.szu.cz/ vyjadreni-k-anginam-a-nosicstvi-streptokoku-skupiny-a-ve-skolkach.

15. Orvidas, L. J., St Sauver, J. L., Weaver, A. L.: Laryngoscope, 116, 2006, 11, s. 1946-1950.

16. Perronne, CH.: Antibiothérapie par voie générale en pratique courante dans les infections respiratoires hautes de l adulte et l infant http://www.afssaps.fr/ var/afssaps_site/storage/original/application/490d564f355c8c55f3cad38d4f643943.pdf.

17. Petersen, I., Johnson, A. M., Duckworth, G. et al.: Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database. BMJ, 335, 2007, s. 982.

18. Respiratory tract infections-antibiotic prescribing. Prescribing of antibiotics for self-limiting respiratory tract infections in adults and children in primary care. http://www.nice.org.uk/CG069

19. Shaikh, N., Leonard, E., Martin, J. M.: Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis. Pediatrics, 126, 2010, 3, s. 557-564.

20. Spinks, A., Glasziou, P. P., Del Mar, C. B.: Antibiotics for sore throat. Cochrane Database of Systematic Review, 2006, Issue 4. Art. No.: CD000023. DOI: 10.1002/ 14651858.CD000023.pub3.

21. Tanz, R. R., Hulman, S. T.: Pediatr. Infect. Dis. J., 26, 2007, 2, s. 175-176.

22. Urbánková, P., Marešová, V., Jindrák, V. et al.: Konsenzus používání antibiotik II. Makrolidová antibiotika. http:/www.cls-cz/další-odborne-projekty.

23. van Driel, M. L., De Sutter, A., Keber, N. et al.: Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database of Systematic Reviews, 2010, Issue 10. Art. No.: CD004406. DOI: 10.1002/ 14651858.CD004406.pub2.

24. Wessels, M. R.: Streptococcal pharyngitis. N. Engl. J. Med., 364, 2011, s. 648-655.

Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#