Preview

Pediatric pharmacology

Advanced search

ACUTE TONSILLITIS ON THE PEDIATRIC DISTRICT: ETIOLOGIC DIAGNOSIS AND TREATMENT

https://doi.org/10.15690/pf.v12i2.1283

Abstract

Relevance. Acute tonsillitis is one of the most prevalent infectious diseases in children starting from the 6th month of live. Acute tonsillitis is more often triggered by viri rather than bacteria. Among the latter, the most significant etiological agent is the ß-hemolytic streptococcus of group A (BHSA). The difficulty of bacterial confirmation of a BHSA infection out-patient conditions, the fear of complications produce an excess usage of antibiotics while treating acute tonsillitis. It is possible to avoid the drawbacks of cultural studies (connected with a late response — around 4–5 days — and with the logistics of the material to the bacteriological laboratory) by using the highly specific and sensitive express-test, which allows to determine a BHSA etiology of the acute tonsillitis right at the patient’s bed in 5–10 minutes. Aim: to optimize the diagnostics and treatment of acute tonsillitis in children in out-patient conditions. Patients and methods. In the conditions of a single paediatric district with 935 children aged 0 to 18 years 79 cases of acute tonsillitis were registered over the period of 1 year of surveillance. The criteria were: hyperemia of the back side of the throat, inflammation of the tonsils in the form of hyperemia/impositions. Along with general clinical methods all children received and additional express-test. Results. The population prevalence of acute tonsillitis was 84 per 1000 children, while the prevalence of BHSA-induced tonsillitis was 7.3 per 1000. The overall percentage of BHSA tonsillitis among other types of tonsillitis was 8.8%. Children with an acute BHSA-induced tonsillitis were prescrived with amoxicilline 50 mg/kg for 10 days. Conclusion. Using the express-diagnostics of the BHSA infection allows for a reduction in antibiotics usage in children with acute tonsillitis to 8.8%.

 

 

About the Authors

E. N. Cherkasova
Orel state University, Russian Federation Children's polyclinic № 1, Orel region, Russian Federation
Russian Federation


T. A. Kuznetsova
Orel state University, Russian Federation
Russian Federation


References

1. Tatochenko V.K., Bakradze M.D., Darmanyan A.S. Acute tonsillitis in children: diagnosis and treatment. Farmateka = Pharmateca. 2009; 14: 65−69.

2. Marshall G.S., Edwards K.M., Butler J., Lauton A.R. Syndrome of periodic fever, pharyngitis, and aphthous stomatitis. J Pediatr. 1987; 110 (1): 43−46.

3. Marshall G.S., Edwards K.M., Lauton A.R. PFAPA syndrome [letter]. Pediatr Infect Dis J. 1989; 8: 658−659.

4. International Study Group for Behcet’s Disease. Criteria for diagnosis of Behcet’s disease. Lancet. 1990; 335: 1078−1080.

5. Shpynev K.V., Krechikov V.A. Sovremennye podkhody k diagnostike streptokokkovogo faringita [Modern Approaches to the Diagnosis of Streptococcal Pharyngitis]. Smolensk, NII antimikrobnoi terapii. 2007; 9 (1). UDK [616.327-002-02:579.862.1]-07.

6. Shaikh N., Leonard E., Martin J.M. Prevalence of Streptococcal pharyngitis and Streptococcal carriage in children: a meta-analysis. Pediatrics. 2010; 126 (3; Sept. 1): 557−564.

7. Bisno A.L., Gerber M.A., Gwaltney J.M. et al. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis. 2002; 35: 113−125.

8. Kvaerner K.J., Nafstad P., Jaakkola J.J. Upper respiratory morbidity in preschool children: a cross-sectional study. Arch Otolaryngol Head Neck Surg. 2000 Oct; 126 (10): 1201−6.

9. Tatochenko V.K., Katosova L.K. Antibiotics for bacterial acute respiratory infections in children. Antibiotiki i khimioterapiya = Antibiotics and chemotherapy. 1999; 9: 13−18.

10. Otvagin I.V., Sokolov N.S. Modern aspects of diagnosis of infections caused by streptococcus group A. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya = Clinical microbiology and antimicrobial chemotherapy. 2011; 13 (3): 223.

11. Mcisaac W.J., White D., Tannenbaum D., Low D.E. A clinical score to reduce unnecessary antibiotic use in patient with sore trroat. Can Med Assos. 1998; 158: 75−83.

12. Linder J.A., Bates D.W., Lee G.M., Finkelstein J.A. Antibiotic treatment of children with sore throat. JAMA. 2005 Nov 9; 294 (18): 2315−22.

13. Leung A.K., Newman R., Kumar A. et al. Rapid antigen detection testing in diagnosing group A beta-hemolytic streptococcal pharyngitis. Expert Rev MolDiagn. 2006; 6 (5): 761−6.

14. Lean W.L., Arnup S., Danchin M., Steer A.C. Rapid Diagnostic Tests for group A Streptococcal pharyngitis: a meta-analysis. Pediatrics. 2014 Sep 8. PII: peds. 2014−1094.


Review

For citations:


Cherkasova E.N., Kuznetsova T.A. ACUTE TONSILLITIS ON THE PEDIATRIC DISTRICT: ETIOLOGIC DIAGNOSIS AND TREATMENT. Pediatric pharmacology. 2015;12(2):197-200. https://doi.org/10.15690/pf.v12i2.1283

Views: 1797


ISSN 1727-5776 (Print)
ISSN 2500-3089 (Online)