Journal of Bioequivalence & Bioavailability

Management of acute pharyngo tonsillitis according to polish recommendations 2010

International Conference and Exhibiton on Pharmaceutical Regulatory Affairs

6-7 September 2011 Baltimore, USA

Elzbieta Mazur

Scientific Tracks Abstracts: JBB

Abstract:

B acterial resistance is currently recognized as a global health problem. Many countries have national guidelines for the diagnosis and treatment of respiratory tract infections to minimize unnecessary antibiotic prescriptions. National recommendations for the management of acute pharyngotonsillitis diff er substantially with regard to the use of microbiological examination and indications for antibiotic treatment. According to Polish Recommendations 2010 the basic aim of clinical diff erentiation is to evaluate the likelihood of streptococcal etiolog y. Depending on its result the decision is made about microbiological examination (if streptococcal phryngotosillitis is suspected) or about only symptomatic treatment and no further di agnostics (if the clinical picture suggests viral pharyngotonsillitis). Polish Recommendations consider Centor/McIssac?s scale to be the most useful one. In patients who obtained 2 or more points according to this scale a defi nitive diagnosis of streptococcal pharyngotonsillitis depends on the identifi cation of the bacterium, which can be performed by throat swab culture or by rapid antigen detection test. Phenoxymethyl penicillin for 10 days is currently the antibiotic therapy of choice. Patients aller gic to penicillin should be treated with fi rst generation cephalosporin. Only pat ients allergic to beta-lactam antibiotics can be treated with macrolides, however, since susceptibility of S. pyogenes to macrolides is unpredictable, treatment with these antibiotics must be preceded by performing antibiotic susceptibility test. Amoxicillin is now consider ed by some American recommendations as alternative for penicillin. However, administration of amoxicillin in small doses, enough to treat acute pharyngotonsillitis, selects for S. pneumoniae strains resistant to penicillin. Th erefore, amoxicillin is not recommended by Polish Recommendations 2010.

Biography :

El ż bieta Mazur, MD PhD, is a clinical microbiologist, working as a tutor at the Medical Microbiology Department, Medical University of Lublin, Poland. She is a regional consultant in clinical microbiology. She has published over 45 original and review papers.