Antimicrobial Activity of Azithromycin and Erythromycin against Streptococcus Pyogenes Isolated from Sore Throat Patients in Shendi, Sudan

Abstract

Background: Streptococci is considered one of the predominant flora colonizing the respiratory tract of humans. The group A Streptococci (GAS) causes the broadest range of diseases that can lead to the asymptomatic carriage, superficial infection of the upper respiratory tract mainly throat infection. Objectives: The study was carried out to assess the antimicrobial activity of azithromycin and erythromycin against Streptococcus pyogenes (Group A) isolated from sore throat patients. Methods: Sixty-one throat swab samples from both sexes were collected randomly from different clinics in Shendi, Sudan from patients with clinical findings suggestive of throat infection between August to November 2021. Streptococcus pyogenes were isolated by standard cultural techniques and identified by using Gram stain and biochemical tests. Also, the antimicrobial activity of Azithromycin and Erythromycin were assessed using the disc diffusion method. Result: 19 throat swab samples (31%) out of 61 had S. pyogenes growth, whereas 42 (69%) did not. Of the patients, 12 (63.2% of them) were men, and 7, 36.8%, were women. The ages of the infected patients ranged from 1 to 10 years old in 2 (5.3%) cases, 11 to 20 years old in 2 (10.5%), 21 to 30 years old in 15 (78.9%), and 41 to 50 years old in 2 (5.3%) cases. In contrast to the other 5 (26.3%), 14 of them (73.7%) had recurring throat infections. Out of the 19 S. pyogenes isolates that tested positive, only 12 (63.6%) were susceptible to azithromycin and just 7 (36.8%) were resistant. 13 (68.4%) of the 19 S. pyogenes positive isolates were erythromycin sensitive, whereas 6 (31.6%) were resistant. Conclusion: Azithromycin and erythromycin are more sensitive to S. pyogenes, which indicates less excessive usage of these antibiotics in Shendi. Streptococcal infections in the respiratory tract are challenging to treat, and selecting an antibiotic treatment involves numerous considerations. Any isolated strain's susceptibility to antibiotics should be assessed because this is the only way to ensure quick and successful treatment. In order to improve public health, antibiotic therapy should be accompanied by adequate preventive measures, such as training nursing staff to prevent as many nosocomial infections as possible, educating the general public about the importance of hygiene and encouraging them to stop self-medicating and fostering closer scientific collaboration between clinicians and microbiologists.