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DIAGNOSIS AND TREATMENT OF ACUTE STREPTOCOCCAL PHARYNGITIS IN CHILDREN

https://doi.org/10.15690/pf.v12i1.1256

Abstract

Acute streptococcal pharyngitis is diagnosed in 15–30% of the patients seeking medical advice for fever and sore throat. The local infection is usually mild/moderate; however, it may result in severe purulent and immunopathological complications. Despite high incidence and prevalence of the disease, the issues of diagnosis and treatment of streptococcal tonsillitis and pharyngitis remain highly discussable. The literature review presents information on the modern diagnostic principles, potential of using express tests to detect Streptococcus pyogenes infection and selection of antibacterial therapy of acute streptococcal pharyngitis based on the data of evidence-based studies and systemic reviews. The article emphasizes the most discussable issues of treatment, including antibiotic therapy pattern, and effectiveness of tonsillectomy in the event of chronic or recurrent tonsillitis.

About the Author

T. V. Kulichenko
Scientific Center of Children's Health, Moscow, Russian Federation
Russian Federation


References

1. Swedo S.E., Leonard H.L., Garvey M. et al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 1998;155:264–271.

2. World Health Organization. Initiative for Vaccine Research (IVR). Bacterial infections. Group A Streptococcus. Accessed March 20, 2013. Available at: www.who.int/vaccine_research/diseases/soa_bacterial/en/index3.html

3. CDC. Acute pharyngitis in adults: physician information sheet (adults). Accessed March 20, 2013. Available at: www.cdc.gov/getsmart/campaign-materials/info-sheets/adult-acute-pharyngitis.html

4. Shaikh N., Leonard E., Martin J.M. Prevalence of Streptococcal pharyngitis and Streptococcal carriage in children: А meta-analysis. Pediatrics. 2010;126(3Sept.1):e557−e564.

5. Dajani A., Taubert K., Ferrieri P., Peter G., Shulman S. Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Committee on rheumatic fever, endocarditis, and kawasaki disease of the council on cardiovascular disease in the young, the american heart association. Pediatrics. 1995;96(4Pt.1):758–764.

6. Linder J.A., Stafford R.S. Antibiotic treatment of adults with sore throat by community primary care physicians. JAMA. 2001;286:1181−6.

7. Kozlov S.N., Strachunskii L.S., Rachina S.A. Pharmacotherapy tonsillopharyngitis acute in outpatients: results of a multicenter pharmacoepidemiological study. Ter. arkhiv = Ter. archive. 2004;76(5):45−51.

8. Shaikh N., Swaminathan N., Hooper E.G. Accuracy and precision of the signs and symptoms of Streptococcal pharyngitis in children: A systematic review. Journal of Pediatrics. 2012; 160 (Issue 3): 487−493.e3.

9. Calviño O., Llor C., Gómez F., González E., Sarvisé C., Hernández S. Association between C-reactive protein rapid test and group A Streptococcusinfection in acute pharyngitis. J Am Board Fam Med. 2014 May-Jun; 27 (3): 424−6. Doi: 10.3122/jabfm.2014.03.130315.

10. Chiappini E., Regoli M., Bonsignori F. et al. Analysis of different recommendations from international guidelines for the management of acute pharyngitis in adults and children. Clin Ther. 2011; 33 (1): 48−58.

11. Shet A., Kaplan E.L. Clinical use and interpretation of group a streptococcal antibody tests: a practical approach for the pediatrician or primary care physician. Pediatr Infect Dis J. 2002; 21: 420–6; quiz 27–30.

12. Johnson D.R., Kurlan R., Leckman J., Kaplan E.L. The human immune response to streptococcal extracellular antigens: clinical, diagnostic, and potential pathogenetic implications. Clin Infect Dis. 2010; 50: 481–90.

13. Centor R.M., Witherspoon J.M., Dalton H.P., Brody C.E., Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making. 1981; 1: 239–46.

14. Wald E.R., Green M.D., Schwartz B., Barbadora K. A Streptococcal score card revisited. Pediatr Emerg Care. 1998; 14: 109–11.

15. Attia M.W., Zaoutis T., Klein J.D., Meier F.A. Performance of a predictive model for streptococcal pharyngitis in children. Arch Pediatr Adolesc Med. 2001; 155: 687–91.

16. Linder J.A., Chan J.C., Bates D.W. Evaluation and treatment of pharyngitis in primary care practice: the difference between guidelines is largely academic. Arch Intern Med. 2006; 166: 1374–9.

17. Bisno A.L. Acute pharyngitis: etiology and diagnosis. Pediatrics. 1996; 97: 949–54.

18. Snow V., Mottur-Pilson C., Cooper R.J., Hoffman J.R. Principles of appropriate antibiotic use for acute pharyngitis in adults. Ann Intern Med. 2001; 134: 506–8.

19. Brien J.H., Bass J.W. Streptococcal pharyngitis: optimal site for throat culture. J Pediatr. 1985; 106: 781–3.

20. Gerber M.A. Comparison of throat cultures and rapid strep tests for diagnosis of streptococcal pharyngitis. Pediatr Infect Dis J. 1989; 8: 820–4.

21. Kellogg J.A. Suitability of throat culture procedures for detection of group A streptococci and as reference standards for evaluation of streptococcal antigen detection kits. J Clin Microbiol. 1990; 28: 165–9.

22. Randolph M.F., Gerber M.A., DeMeo K.K., Wright L. Effect of antibiotic therapy on the clinical course of streptococcal pharyngitis. J Pediatr. 1985; 106: 870–5.

23. Gerber M.A., Shulman S.T. Rapid diagnosis of pharyngitis caused by group A streptococci. Clin Microbiol Rev. 2004; 17: 571–80.

24. Little P., Hobbs F.D., Moore M. et al. PRImary care Streptococcal Management (PRISM) study: in vitro study, diagnostic cohorts and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness study. Health Technol Assess. 2014 Jan; 18 (6): vii−xxv, 1−101. Doi: 10.3310/hta18060.

25. Edouard S., Michel-Lepage A., Raoult D. Does it make sense to detect Streptococcus pyogenes during tonsillitis in Europe to prevent acute rheumatic fever? Clin Microbiol Infect. 2014 Oct 8. Doi: 10.1111/1469-0691.12802. [Epub ahead of print].

26. Tanz R.R., Shulman S.T., Shortridge V.D. et al. Community-based surveillance in the united states of macrolide-resistant pediatric pharyngeal group A streptococci during 3 respiratory disease seasons. Clin Infect Dis. 2004; 39: 1794–801.

27. Dingle T.C., Abbott A.N., Fang F.C. Reflexive culture in adolescents and adults with group a streptococcal pharyngitis. Clin Infect Dis. 2014Sep1;59(5):643−50. Doi: 10.1093/cid/ciu400. [Epub 2014 May 27].

28. Shulman S.T., Bisno A.L., Clegg H.W., Gerber M.A., Kaplan E.L. et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55:1279–1282. Doi: 10.1093/cid/cis847.

29. Kulichenko T.V., Kabaloeva A.M., Lashkova Yu.S., Lazareva M.A. Diagnosis of acute pharyngitis in children. Pediatricheskaya farmakologiya = Pediatric pharmacology. 2014;11(4):59−66.

30. Ruiz-Aragón J., Rodríguez López R., Molina Linde J.M. Evaluation of rapid methods for detecting Streptococcus pyogenes. Systematic review and meta-analysis. An Pediatr (Barc). 2010;72:391−402.

31. Stewart E.H., Davis B., Clemans-Taylor B.L., Littenberg B., Estrada C.A., Centor R.M. Rapid antigen group A streptococcus test to diagnose pharyngitis: a systematic review and meta-analysis. PLoS One. 2014Nov4;9(11):e111727. Doi: 10.1371/journal.pone.0111727. eCollection 2014.

32. Fierro J.L., Prasad P.A., Localio A.R., Grundmeier R.W., Wasserman R.C., Zaoutis T.E., Gerber J.S. Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians. Infect Control Hosp Epidemiol. 2014Oct;35(Suppl.3):S79−85. Doi: http://dx.doi.org/10.1086/677820

33. Van Brusselen D., Vlieghe E., Schelstraete P., De Meulder F., Vandeputte C., Garmyn K., Laffut W., Van de Voorde P. Streptococcal pharyngitis in children: to treat or not to treat? Eur J Pediatr. 2014Oct;173(10):1275−83. Doi: 10.1007/s00431-014-2395-2. [Epub 2014 Aug 12].

34. Spinks A., Glasziou P.P., Del Mar C.B. Antibiotics for sore throat. Cochrane Database Syst Rev. 2013Nov5;11:CD000023. Doi: http://dx.doi.org/10.1002/14651858.cd000023.pub4

35. Irlam J.H., Mayosi B.M., Engel M.E., Gaziano T.A. A cost-effective strategy for primary prevention of acute rheumatic fever and rheumatic heart disease in children with pharyngitis. S Afr Med J. 2013Sep3;103(12):894−5. Doi: http://dx.doi.org/10.7196/samj.7244

36. Little P., Stuart B., Hobbs F.D. et al. Antibiotic prescription strategies for acute sore throat: a prospective observational cohort study. Lancet Infect Dis. 2014Mar;14(3):213−9. Doi: 10.1016/S1473-3099(13)70294-9. [Epub 2014 Jan 17].

37. Spurling G.K., Del Mar C.B., Dooley L., Foxlee R., Farley R. Delayed antibiotics for respiratory infections. Cochrane Database Syst Rev. 2013Apr30;4:CD004417. Doi: 10.1002/14651858.CD004417.pub4.

38. Report of the Committee on Infectious Disease. Pickering L.K., editor. 29th Edition, Group A Streptococcal Infections. Elk Grove Village, IL: American Academy of Pediatrics. 2012. Р. 668–80.

39. Clegg H.W., Ryan A.G., Dallas S.D. et al. Treatment of streptococcal pharyngitis with once-daily compared with twice-daily amoxicillin: a noninferiority trial. Pediatr Infect Dis J. 2006;25:761–7.

40. Lennon D.R., Farrell E., Martin D.R., Stewart J.M. Once-daily amoxicillin versus twice-daily penicillin V in group A beta-haemolytic streptococcal pharyngitis. Arch Dis Child. 2008;93:474–8.

41. Casey J.R., Pichichero M.E. Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children. Pediatrics. 2004;113:866–882.

42. Gerber M.A. Antibiotic resistance in group A streptococci. Pediatr Clin North Am. 1995;42:539–51.

43. Wickman P.A., Black J.A., Moland E.S., Thomson K.S. In vitro activities of DX-619 and comparison quinolones against gram-positive cocci. Antimicrob Agents Chemother. 2006;50:2255–7.

44. Logan L.K., McAuley J.B., Shulman S.T. Macrolide treatment failure in streptococcal pharyngitis resulting in acute rheumatic fever. Pediatrics. 2012;129:e798−e802.

45. Kaplan E.L., Gooch I.W., Notario G.F., Craft J.C. Macrolide therapy of group A streptococcal pharyngitis: 10 days of macrolide therapy (clarithromycin) is more effective in streptococcal eradication than 5 days (azithromycin). Clin Infect Dis. 2001;32:1798–802.

46. Van Driel M.L., De Sutter A.I., Keber N., Habraken H., Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database Syst Rev. 2013Apr30;4:CD004406. Doi: 10.1002/14651858.CD004406.pub3.

47. Zeng L., Zhang L., Hu Z., Ehle E.A., Chen Y. Liu L., Chen M. Systematic review of evidence-based guidelines on medication therapy for upper respiratory tract infection in children with AGREE instrument. PLoS One. 2014Feb20;9(2):e87711. Doi: 10.1371/journal.pone.0087711. eCollection 2014.

48. Altamimi S., Khalil A., Khalaiwi K.A., Milner R.A., Pusic M.V., Al Othman M.A. Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children. Cochrane Database Syst Rev. 2012Aug15;8:CD004872. Doi: 10.1002/14651858.CD004872.pub3.

49. Falagas M.E., Vouloumanou E.K., Matthaiou D.K. Effectiveness and safety of short-course vs long-course antibiotic therapy for group a beta hemolytic streptococcal tonsillopharyngitis: A meta-analysis of randomized trials. Mayo Clin Proc. 2008;83:880–889.

50. Weber R. Pharyngitis. Prim Care. 2014Mar;41(1):91−8. Doi: 10.1016/j.pop.2013.10.010. [Epub 2013 Nov 21].

51. Demeslay J., De Bonnecaze G., Vairel B. et al. Possible role of anti-inflammatory drugs in complications of pharyngitis. A retrospective analysis of 163 cases. Eur Ann Otorhinolaryngol Head Neck Dis. 2014Nov;131(5):299−303. Doi: 10.1016/j.anorl.2013.08.005. [Epub 2014 Oct 23].

52. Burton M.J., Glasziou P.P., Chong L.Y., Venekamp R.P. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev. 2014 Nov 19;11:CD001802. Doi: 10.1002/14651858.CD001802.pub3.

53. Murphy T.K., Lewin A.B., Parker-Athill E.C., Storch E.A., Mutch P.J. Tonsillectomies and adenoidectomies do not prevent the onset of pediatric autoimmune neuropsychiatric disorder associated with group A streptococcus. Pediatr Infect Dis J. 2013;32(8):834−838.

54. Johansson E., Hultcrantz E. Tonsillectomy-clinical consequences twenty years after surgery? Int J Pediatr Otorhinolaryngol. 2003;67:981–988.

55. Stewart T., McDonald R., Currie B. Acute rheumatic fever: adherence to secondary prophylaxis and follow up of Indigenous patients in the Katherine region of the Northern Territory. Aust J Rural Health. 2007; 15: 234–240.

56. Baugh R.F., Archer S.M., Mitchell R.B. et al. Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg. 2011;144:S1–30.

57. Ikincioğullari A., Doğu F., ikincioğullari A. et al. Is immune system influenced by adenotonsillectomy in children? Int J Pediatr Otorhinolaryngol. 2002;66:251–257.

58. Kaygusuz I., Alpay H.C., Gödekmerdan A. et al. Evaluation of long-term impacts of tonsillectomy on immune functions of children: a follow-up study. Int J Pediatr Otorhinolaryngol. 2009;73:445–449.

59. Matthys J., De Meyere M., van Driel M.L., De Sutter A. Differences among international pharyngitis guidelines: not just academic. Ann Fam Med. 2007;5:436–443. Doi: 10.1370/afm.741.


Review

For citations:


Kulichenko T.V. DIAGNOSIS AND TREATMENT OF ACUTE STREPTOCOCCAL PHARYNGITIS IN CHILDREN. Pediatric pharmacology. 2015;12(1):104-111. (In Russ.) https://doi.org/10.15690/pf.v12i1.1256

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