particularly rheumatic fever, which is still prevalent in many countries. Evidence about the effectiveness of antibiotics for preventing nonsuppurative and suppurative complications comes from studies on military personnel living in overcrowded barracks in the late 1940s and early 1950s. This evidence has little relevance to management of sore throat in modern communities, at least in the developed world, where rheumatic fever is now very uncommon. Similarly experience with the use of antibiotics to prevent cross-infection in sore throat comes mainly from army barracks and other closed institutions. It is very unlikely (and unproven) that trying to eradicate Str. pyogenes with routine antibiotic therapy for sore throat will produce any measurable health gain in the general public in Western countries, whereas it is likely that this would increase the prevalence of antimicrobial resistance.
A patient information leaflet may be of value in the management of acute sore throat and may assist in MANAGING FUTURE episodes at home without general practitioner involvement. Patients who are skeptical about withholding antibiotics can be given a prescription with the suggestion that they do not use it unless their symptoms persist for more than 3 days. Only about 30% of patients who are given delayed prescriptions go to the pharmacy to get their antibiotics.
If antibiotics are to be prescribed the drugs of choice are penicillin V or a macrolide, and these should be given for at least 10 days to eradicate the organism and prevent recurrence. Glandular fever commonly causes symptoms and signs that are indistinguishable from streptococcal throat infection (including a very impressive purulent exudate on the tonsils). Ampicillin, amoxicillin, and co-amoxiclav should not be used, as they will cause a rash if the sore throat is the herald of glandular fever. Tetracyclines are also inappropriate because of the high incidence of resistance among streptococci.
particularly rheumatic fever, which is still prevalent in many countries. Evidence about the effectiveness of antibiotics for preventing nonsuppurative and suppurative complications comes from studies on military personnel living in overcrowded barracks in the late 1940s and early 1950s. This evidence has little relevance to management of sore throat in modern communities, at least in the developed world, where rheumatic fever is now very uncommon. Similarly experience with the use of antibiotics to prevent cross-infection in sore throat comes mainly from army barracks and other closed institutions. It is very unlikely (and unproven) that trying to eradicate Str. pyogenes with routine antibiotic therapy for sore throat will produce any measurable health gain in the general public in Western countries, whereas it is likely that this would increase the prevalence of antimicrobial resistance.A patient information leaflet may be of value in the management of acute sore throat and may assist in MANAGING FUTURE episodes at home without general practitioner involvement. Patients who are skeptical about withholding antibiotics can be given a prescription with the suggestion that they do not use it unless their symptoms persist for more than 3 days. Only about 30% of patients who are given delayed prescriptions go to the pharmacy to get their antibiotics.If antibiotics are to be prescribed the drugs of choice are penicillin V or a macrolide, and these should be given for at least 10 days to eradicate the organism and prevent recurrence. Glandular fever commonly causes symptoms and signs that are indistinguishable from streptococcal throat infection (including a very impressive purulent exudate on the tonsils). Ampicillin, amoxicillin, and co-amoxiclav should not be used, as they will cause a rash if the sore throat is the herald of glandular fever. Tetracyclines are also inappropriate because of the high incidence of resistance among streptococci.
การแปล กรุณารอสักครู่..
