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What Antibiotic Is Good For Sore Throat – Background: Streptococcal pharyngitis is a common presentation for primary care and emergency department physicians. Every year in the United States, 10 million patients are treated with antibiotics for pharyngitis. However, less than 10% of these patients have strep throat (Barnett 2013). Giving antibiotics to these patients is based on three arguments:
Of the 10 million patients treated with the antibiotic, 24,000 had a fatal or life-threatening allergic reaction.
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Most importantly, in most patients, strep is a self-limiting disease that resolves within 7 days without any treatment (including supportive care). Adding antibiotics provides some benefit in terms of symptom resolution (12-16 hours) (Del Mar 2006). However, this benefit was compared to placebo, not medical care. Adjunctive therapies, including acetaminophen and NSAIDs, may improve symptoms, but this has not been proven. Finally, we must not forget other side effects associated with antibiotics (such as diarrhea).
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One treatment that has shown significant benefit in terms of symptoms is the use of corticosteroids. Hayward et al.
Conclusion: Corticosteroids are our best option if we are interested in reducing the patient’s symptoms quickly. I usually give Decadrone 10 mg IM.
There are many complications that can occur with strep, including acute otitis media (AOM), sinusitis, and peritonsillar abscess (PTA).
A recent study showed a purulent complication rate of 1.3% and no difference between patients who received antibiotics and those who did not (Little 2013).
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Conclusion: It appears that we need to treat 100 patients to prevent one PTA; A simple treatment.
Post-strep glomerulonephritis (PSG) and rheumatic fever (RF) are two major chronic complications. No studies have shown that PSGN can be prevented, so we left RF.
Evidence for the prevention of RF and subsequent rheumatic heart disease (RHD) comes from several studies conducted at Warren Air Force Base in the 1950s. In this cohort, researchers found that 2% of patients infected with streptococcus developed RF. With antibiotics, this figure drops to 1%, giving an NNT of 50-60 for adequate risk reduction with RF prevention (Denny 1950, Wannamaker 1951, Chamovitz 1954, Siegel 1961). The work of these researchers laid the foundation for treatment over the past five decades.
However, we have to question whether these studies are relevant to our patients today. RHD rates in Western countries are low. In fact, the CDC stopped tracking the incidence in 1995 when it dropped below 1 in a million people. Many RCTs
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Developed countries have shown no cases of RF or RHD in patients treated with chemotherapy (Middleton 1988, de Meyer 1992, Dagneli 1996, Little 1997, Zwart 2003).
Based on the current RF situation in the US, approximately 2 million patients with strep will need treatment to prevent one case of RF. Additionally, only 1 in 3 patients who develop RF will develop RHD. In the West, it is not worth treating millions of patients with pharyngitis to prevent a single dose of RHD.
Every patient with streptococcus pharyngitis is treated. However, epidemiological data contradict this. Streptococcal disease declined before the advent of antibiotics, but continued to decline as public health improved. Improvements in sanitation have led to changes in the serotype of group A beta-hemolytic streptococci causing streptococcal disease in developed countries.
In developed countries, we are doing more harm than good by giving antibiotics to patients with sore throats. This does not apply to developing countries with poor public health (see this post by Casey Parker about treatment in developing countries).
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“Antibiotics are not usually used to treat acute pharyngitis. Most of the time the inflammation and complications following streptococcal infection are easy to treat and it is not always recommended to use antibiotics. In particular, -antibiotics were used only to reduce rheumatic fever during the war. beneficial. in the middle of the 20th century. And the reduction of rheumatic fever was not associated with the use of antibiotics.” (Rosen’s 2014)
Cite this article as: Anand Swaminathan, “Should strep throat patients be treated with antibiotics?”, REBEL EM Blog, January 5, 2015. Available at: https:///patients-strep-throat-need-treated- antibiotics/. ? Or a sore throat? It could be a virus causing your sore throat.
Strep is an infection caused by bacteria in the throat and tonsils. These bacteria are called group A
A sore throat may make you swallow it. The throat may also feel dry and scratchy. A sore throat is a symptom of strep throat, the flu, allergies, or other respiratory infections. The symptoms of a sore throat are similar to those caused by a virus or bacteria called group A streptococcus.
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If you or your child has symptoms of a sore throat, talk to your doctor. They may test you or your baby for strep.
If symptoms do not improve or worsen within a few days, contact your doctor. Tell your doctor if you or your child has frequent sore throats.
A doctor will determine the type of disease by asking about symptoms and performing a physical examination. Sometimes they rub your throat too.
If your baby is less than three months old and has a fever of 100.4°C (38°C) or higher, tell a healthcare professional right away.
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Since strep throat is caused by bacteria, antibiotics are needed to treat the infection and prevent rheumatic fever and other complications. Doctors can’t tell if someone has strep just by looking at their throat. If your doctor thinks you have strep, he may test you to find out what’s causing your illness.
A person with strep should stay home from work, school, or day care until the fever goes away and take antibiotics for at least 12 hours.
Antibiotics will not help if a virus is causing the sore throat. Most sore throats go away on their own within a week. Your doctor may prescribe other medications or give you advice to help you feel better.
Antibiotics won’t help you when you don’t need them, and their side effects can still be harmful. Side effects range from mild reactions like hives to serious health problems. These complications include severe allergic reactions, drug-resistant bacterial infections, and severe C.
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Carefully read and follow the directions on the labels of over-the-counter medicines before giving them to children. Some over-the-counter medications are not recommended for children of certain ages.
Ask your doctor or pharmacist for the correct dosage for your child’s age and size. Also, tell your child’s doctor and pharmacist about all prescription drugs and medications they are taking.
You can help prevent eating disorders by doing things you can to keep yourself healthy and improve other people’s health:
Source: Centers for Disease Control and Prevention, Center for Infectious and Zoonotic Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP) due to the recent virus shortage, I write occasionally. about why treatment is not effective.
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We treat strep to prevent complications, not to make children feel better (the second benefit of treatment). Fortunately, the immune system usually takes care of the infection on its own, so it’s not a problem if antibiotics aren’t available.
Strep is not just a sore throat. Many bacteria can cause a sore throat, but the bacteria streptococcus A, also known as streptococcus pyogenes, is the most common.
Sore throats are not common in children under the age of 3, so it is not recommended that children be screened unless they have had direct contact with strep.
Streptococcal disease is common in children during the winter months and rarely in teenagers and adults.
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Streptococcus infections peak during severe disease and slowly decline over a few weeks if left untreated. A study of the food culture of asymptomatic healthy children during an outbreak of strep throat and pharyngitis at school has shown up to 25% of streptococcal infections. Strep can last for months, but the risk of transmission is low and there are no symptoms.
A streptotest is necessary for the diagnosis of streptococcus in children. Doctors and other health care providers may use the Centaur criteria for adults, but the clinical evaluation is not exclusively for children.
Sore throat usually causes sore throat, fever, swollen tonsils and submandibular saliva (gland). Some children develop sand-like rashes on their trunks. When this happens, it is called scarlet fever. I also see a significant number of children with strep throat and vomiting.
Many parents and their children want it
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