Angina, or acute tonsillitis, always proceeds with a strong fever, sore throat, intoxication. In this case, the disease usually lasts no more than a week. If in this short time the patient is not provided with the necessary treatment, angina can cause chronic tonsillitis. In addition, angina caused by group A streptococcus often causes a number of complications in the heart, joints and kidneys - rheumatism.
Thus, the question of the correct treatment of angina is very acute.
It is known that streptococcus sore throat should be treated with antibiotics.
The success of sore throat therapy determines the correct selection of an antibacterial drug, as well as its dosage and duration of administration.
All this is necessary for the complete destruction of the bacterial focus and the prevention of severe complications.
Studies show that the majority of the population neglects prescriptions by ending antibiotics prematurely. For many people, the use of antibiotics against the background of a significant improvement in well-being after 2-3 days of administration seems unnecessary.
Why can't you stop taking your medication prematurely? How many days to take antibiotics for angina for a full recovery? We will answer these and other questions in this article.
When are antibiotics needed?
It is important to understand that acute tonsillitis requires antibiotic treatment only if it is caused by a bacterial infection of the tonsils. Studies show that only 30% of sore throat cases are associated with a bacterial infection; the remaining 70% are caused by viral infections - adenovirus, respiratory syncytial, parainfluenza, Coxsackie, Epstein-Barr.
Not being the predominant cause of sore throat, bacterial infection is of greatest concern, since it is this type of sore throat that is often very difficult and causes a number of serious complications.
More than 90% of cases of bacterial tonsillitis in adults and children are caused by group A β-hemolytic streptococcus (GABHS). Much less often, inflammation of the tonsils is associated with the activity of groups C and G streptococcus, gonococcus, diphtheria bacillus and some anaerobic bacteria.
The cell wall of group A streptococcus contains proteins similar in structure to proteins of human connective tissue. Immune cells react violently to streptococcus, "memorizing" its proteins and destroying them.
Long-term presence of streptococcal infection in the body can cause a malfunction of the immune system.
Immune cells begin to destroy their own proteins, like streptococcal ones. First of all, this affects the work of the heart valves, joints and kidneys, since the connective tissue of these organs contains a large amount of proteins, similar in structure to streptococcal ones. This condition is known as rheumatism.
That is why the therapy of streptococcal sore throat necessarily includes a course of antibiotics.
The difficulty of diagnosing and prescribing treatment is that it is not always possible to outwardly distinguish bacterial tonsillitis from viral.
MacIsaac scale
This is the method proposed for calculating the likelihood of a patient having streptococcal tonsil infection. It is used to make a preliminary assessment of the feasibility of prescribing antibiotics.
The method includes a list of symptoms characteristic of bacterial sore throat.
To assess the likelihood of the presence of streptococcal microflora, it is proposed to answer the following questions:
- Does the patient's body temperature exceed 38 C?
- Is a mucopurulent or yellow plaque visible on the surface of the tonsils?
- Does palpation of the anterior cervical lymph nodes cause pain?
- The disease proceeds without coughing and runny nose - is it so?
- Is the patient less than 15 years old?
- Is the patient less than 45 years old?
For each affirmative answer, the patient is awarded 1 point. Next, the result of the survey is assessed:
- if the patient scored 0-1 points in total, the probability of having streptococcal sore throat is less than 10%;
- scored 2-3 points indicate the likelihood of streptococcal sore throat within 17-35%;
- if the patient scored more than 4 points (that is, answered in the affirmative to 4-6 questions), the probability of bacterial tonsillitis exceeds 50%.
The results of this method are preliminary and must be confirmed by laboratory results.
If tonsillitis is accompanied by a cough, runny nose and conjunctivitis, the likelihood of a viral etiology of the disease is high. In this case, the antibiotic is prescribed only after the test results (bacteriological culture of a throat smear and / or a blood test for ASLO).
The beginning of taking an antibiotic on the 3-4th day of illness (this is how much time is needed to pass and receive test results) does not affect the effectiveness of therapy and does not increase the risk of developing rheumatism.
Antibiotic therapy for angina
The standard of treatment for acute bacterial tonsillitis is the appointment of an antibiotic course. Antibacterial drugs are taken orally.
How many days is it recommended to drink antibiotics for angina? The course usually lasts 10 days.
A course of treatment lasting less than 10 days is often ineffective. So, with a reduction in the course of treatment, the symptoms of angina reappear within a month in 70% of patients.
What antibiotics are prescribed for tonsillitis? It is known that streptococcus is highly sensitive to almost all representatives of the penicillin and cephalosporin series of antibiotics.
The first choice drugs are:
- phenoxymethylpenicillin (synonyms - Vegacillin, Penicillin-Fau, Apopen, Ascillin, Penbene, etc.) - 500-750 mg per day for children under 12 years old, 1.5 g per day for adults;
- cephalexin (Ospeksin, Keflex, Flexin) - 40 mg per day per 1 kg of patient weight;
amoxicillin (Flemoxin Solutab, Gramox, Ospamox) - 45 mg per day per 1 kg of patient weight; it is worth noting that amoxicillin and its analogs are prescribed only in the absence of symptoms of an Epstein-Barr infection (otherwise, taking amoxicillin causes a skin rash in the patient).
amoxicillin (Flemoxin Solutab, Gramox, Ospamox) - 45 mg per day per 1 kg of patient weight; it is worth noting that amoxicillin and its analogs are prescribed only in the absence of symptoms of an Epstein-Barr infection (otherwise, taking amoxicillin causes a skin rash in the patient).In addition to penicillins and cephalosporins, many doctors prescribe macrolides (eg, erythromycin, clarithromycin) to patients. However, recently discovered strains of streptococcus resistant to macrolides. So, on the territory of Russia, the prevalence of erythromycin-resistant streptococci ranges from 8 to 30%. At the same time, practically no strains resistant to such macrolides as josamine (synonym - Wilprafen) were found.
The frequency of resistant forms of streptococcus to tetracycline exceeds 40%, therefore this drug and its analogues are not used in the treatment of bacterial tonsillitis.
If chronic tonsillitis of streptococcal etiology is suspected, the course of treatment is at least 14 days.
Antibiotic rules
Antibiotics are aggressive drugs with many side effects. However, the consequences of antibiotic use are difficult to compare with the severity of complications that can result from insufficient treatment for streptococcal sore throat.
Remember the following rules:
- A doctor should prescribe an antibiotic.
- To confirm the presence of a bacterial infection, consult a bacteriological bacteriology. Bacterial culture allows not only to determine the type of causative agent of the disease, but also to assess its sensitivity to various antibiotics.
- Do not take an antibiotic "just in case." You do not need to ask your doctor for a prescription for antibiotics if he does not see the need for them.
- Write down which antibiotics you used - this may be needed when prescribing a course of treatment in the future.
- Adhere to the prescribed course - the frequency of admission, dosage, duration of use.
Thus, taking antibacterial drugs should be approached responsibly.
