Penicillin Therapy in Scarlet Fever and Complicating Otitis

Jersild, T

doi:10.1016/s0140-6736(48)91965-5

Cited by 31 publications

(4 citation statements)

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“…Although the use of antimicrobials to treat GABHS pharyngitis clearly reduces the incidence of these suppurative sequelae, it is not clear that speed is essential (39). Therefore, there is little or no advantage to RADTs over BAP cultures in this respect.…”

Section: Medical Decision Makingmentioning

confidence: 99%

Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci

2004

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Although commercial rapid antigen detection tests (RADTs) are more expensive than blood agar plate (BAP) cultures, the advantage they offer is the speed with which they provide results. Rapid identification and consequent prompt treatment of patients with pharyngitis due to group A beta-hemolytic streptococci (GABHS) can reduce the risk of spread of GABHS, can allow patients to return to school or work sooner, and may reduce the acute morbidity of this illness. In most studies, RADTs have been compared with BAP cultures as the criterion standard. However, these comparisons are complicated by the fact that there is no universally accepted procedure for performing a BAP culture. The great majority of the RADTs that are currently available have a high specificity (i.e., 95% or greater) and a sensitivity of between 70 and 90% compared with BAP cultures. Few published studies have compared the performance of various RADTs to each other or examined the performance of various RADTs in the office setting. There is also relatively little published information about how physicians in practice actually use RADTs, but the available information suggests that many physicians do not follow recommended guidelines. While the development of easy-to-perform RADTs for the diagnosis of GABHS pharyngitis has altered clinical practice substantially, only limited data about cost-effectiveness are currently available

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Section: Medical Decision Makingmentioning

confidence: 99%

Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci

2004

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“…Several decades ago, studies were done in hospitalised patients [7,8] and in a military population [9,10,11], none of which were double blind or randomised. In the Eighties, 5 clinical trials were done in children.…”

Section: Discussionmentioning

confidence: 99%

Effect of Penicillin on the clinical course of streptococcal pharyngitis in general practice

Meyere¹,

Mervielde

Verschraegen

et al. 1992

Eur J Clin Pharmacol

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The aim of the study was to explore whether penicillin was superior to placebo in altering the clinical course of proven streptococcal pharyngitis. A randomised, parallel, double blind placebo controlled trial of 10 days duration was undertaken in 42 general practices in the Gent region (Flemish part of Belgium). Phenoxymethylpenicillin (adults 250 mg t.i.d. and children 125 mg t.i.d.) or placebo were administrated to 173 patients, aged 5 to 50 y, with acute sore throat and a positive culture for Group A beta-haemolytic streptococci. Penicillin and placebo tablets were identical. Patient compliance was monitored by assay of penicillin in urine (Sarcina lutea method). The primary outcome variable was sore throat as recorded by the physician on Day 3. The experiences of the patients themselves over the 10 day period were also assessed. Secondary outcome variables were other local and general symptoms and signs of streptococcal throat infection. In the penicillin group on Day 3, 23.2% of the patients still complained of sore throat versus 65.9% in the placebo group: difference 42.7% (C.I. 29.4%, 56.1%). This finding was confirmed by survival analysis of the symptom 'sore throat', as recorded by the patients. The physicians recorded on Day 3 a significant positive effect on another symptom (malaise: P < 0.04) and certain clinical signs (abnormal throat: P < 0.07; and redness of throat: P < 0.003). Penicillin had more adverse effects than placebo (P < 0.007). It also inhibited the rise in ASLO (P < 0.001). In this study in general practice, penicillin had a slight but definitive positive effect on the clinical evolution of streptococcal pharyngitis.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…К одной из первых публикаций об успешном примене-нии пенициллина G (бензилпенициллина) при БГСА-ин-фекции относится датированная 1948 г. работа из Дании [11]. Однако истинное значение пенициллина было устано-влено несколькими годами позже в исследованиях, выпол-ненных с привлечением солдат-новобранцев одной из баз ВВС США в штате Вайоминг.…”

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Rational Antimicrobial Therapy for Group a Streptococcal Tonsillitis Is the Basis for the Primaryprevention of Rheumatic Fever

Белов¹

2011

Modern Rheumatology Journal

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Острый тонзиллит (ангина)* характеризуется острым воспалением одного или нескольких лимфоидных образо-ваний глоточного кольца (чаще -небных миндалин) и от-носится к числу широко распространенных инфекционных заболеваний верхних дыхательных путей.Наиболее значимым бактериальным возбудителем острого тонзиллита является β-гемолитический стрепто-кокк группы А (Streptococcus pyogenes, БГСА). По данным метаанализа [1], частота выделения БГСА у детей и под-ростков с синдромом «воспаленного горла» (sore throat) составляет 23-58% (табл. 1). Реже острый тонзиллит вы-зывают вирусы, стрептококки групп C и G, Arcanobacterium haemolyticum, Neisseria gonorrhoeae, Corynebacterium diphtheria (дифтерия), анаэробы и спиро-хеты (ангина Симановского-Плаута-Венсана), крайне редко -микоплазмы и хламидии [2].БГСА передается воздушно-капельным путем. Вероят-ность заражения увеличивается при высокой обсемененно-сти и тесном контакте с больным. Источниками инфекции являются больные и (реже) бессимптомные носители. Хара-ктерна быстрота распространения инфекции, особенно в организованных коллективах. Поражаются преимущест-венно дети 5-15 лет и лица молодого возраста. Точные дан-ные официальной статистики по БГСА-инфекциям отсут-ствуют. Однако, как свидетельствуют результаты американ-ских исследователей [3], практически каждый ребенок, дос-тигший 5 лет, имеет в анамнезе перенесенную БГСА-ин-фекцию глотки, а к 13 годам количество эпизодов заболева-ния достигает трех. При этом прямые и косвенные расходы, (спирамицин, азитромицин, рокситромицин, кларитромицин, джозамицин, мидекамицин). При наличии хронического рецидивирующего БГСА-тонзиллита, когда вероятность колонизации очага инфекции микроорганизма-ми, продуцирующими β-лактамазы, достаточно высока, применяют ингибитор-защищенные пенициллины (амоксициллин-клаву-ланат) или цефалоспорины II поколения (цефуроксим-аксетил). Антибиотики -линкозамины (линкомицин, клиндамицин) исполь-зуют в терапии острого и хронического БГСА-тонзиллита как препараты резерва. Ключевые слова: А-стрептококковый тонзиллит, антибиотикотерапия. Контакты: Борис Сергеевич Белов belovbor@yandex.ru RATIONAL ANTIMICROBIAL THERAPY FOR GROUP A STREPTOCOCCAL TONSILLITIS IS THE BASIS FOR THE PRIMARY PREVENTION OF RHEUMATIC FEVER B.S. Belov Research Institute of Rheumatology, Russian Academy of Medical Sciences, MoscowAcute tonsillitis caused by group A β-hemolytic streptococcus (GABHS) remains an urgent problem. The paper provides evidence that suggests the resurgence of high-virulence GABHS infection and the increase in the frequency of its complications (acute rheumatic fever, toxic shock syndrome) and that there is a need for rational antibacterial therapy for this pathology. The drugs of choice for the treatment of the acute forms of GABHS tonsillitis are penicillins (amoxicillin, benzathine penicillin, phenoxymethylpenicillin) and first-generation cephalosporins (cefadroxil) and those for intolerance of β-lactam antibiotics are macrolides (spiramycin, azitromycin, roxithromycin, clarithromycin, josamycin, and midecamycin)....

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Penicillin Therapy in Scarlet Fever and Complicating Otitis

Cited by 31 publications

References 0 publications

Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci

Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci

Effect of Penicillin on the clinical course of streptococcal pharyngitis in general practice

Rational Antimicrobial Therapy for Group a Streptococcal Tonsillitis Is the Basis for the Primaryprevention of Rheumatic Fever

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