ACUTE TONSILLITIS IN CHILDREN: THE PRINCIPLE “ZAP AND IT’S DONE!”?
https://doi.org/10.21518/2079-701X-2018-2-122-128
Abstract
Acute tonsillitis, as one of the most frequent reasons for seeking medical care, especially in paediatrics, is almost the leading nosology that is misinterpreted and improperly treated. It is a fact of life that only pharyngoscopic data are the course for the prescription of a system antibiotic drug, sometimes more than one, for an average of 5 to 7 days, whereas most tonsillitis cases require only symptomatic therapy. But even in case of the right choice and streptococcal aetiology of the disease, this treatment regimen is not sufficient to eradicate the infection and prevent possible serious complications. Therefore, this approach to managing patients with acute tonsillitis does not fit the category “if an antibiotic drug is prescribed, the patient either will recover himself or the antibiotic drug will help.” Acute tonsillitis requires mandatory aetiological diagnosis and the right choice of therapy treatment of clearly defined duration. The article presents the main principles of diagnostics and treatment of acute tonsillitis, and the difficulties that paediatricians have to encounter in everyday practice.
About the Authors
A. S. Polyakova
National Medical Research Center for Children’s Health of the Ministry of Health of Russia; Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
PhD in medicine.
MoscowM. D. Bakradze
National Medical Research Center for Children’s Health of the Ministry of Health of Russia; Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
MD.
Moscow
V. K. Tatochenko
National Medical Research Center for Children’s Health of the Ministry of Health of Russia
Russian Federation
Russian Federation
MD, Prof.
MoscowI. L. Chaschina
National Medical Research Center for Children’s Health of the Ministry of Health of Russia
Russian Federation
Russian Federation
PhD in medicine.
MoscowReferences
1. Adoga AA, Okwori ET, Yaro JP, Iduh AA. Pediatric otorhinolaryngology emergencies at the Jos University Teaching Hospital: Study of frequency, management, and outcomes. Ann Afr Med, 2017 Apr-Jun, 16(2): 81-84. doi: 10.4103/aam.aam_21_16.
2. Esposito S, Rosazza C, Sciarrabba CS, Principi N. Inhaled Antibiotic Therapy for the Treatment of Upper Respiratory Tract Infections. J Aerosol Med Pulm Drug Deliv, 2017 Feb, 30(1): 14-19. doi: 10.1089/jamp.2016.1300.
3. Duffin C. Young people’s changing demands for emergency services. Emerg Nurse, 2017 May 12;25(2):8-9. doi: 10.7748/en.25.2.8.s8.
4. Таточенко В.К. Антибиотико- и химиотерапия инфекций у детей. М.: ИПК Континент пресс, 2008. С. 253.
5. Ababneh MA, Al-Azzam SI, Ababneh R, Rababa’h AM, Demour SA. Antibiotic prescribing for acute respiratory infections in children in Jordan. Int Health, 2017 Mar 1, 9(2): 124-130. doi: 10.1093/inthealth/ihx003.
6. Croche Santander B, Campos Alonso E, Sánchez Carrión A, Marcos Fuentes L, Diaz Flores I, Vargas JC, Fernández Domínguez B, Toro Ibañez C. Appropriateness of antibiotic prescribing in paediatric patients in a hospital emergency department. An Pediatr (Barc), 2017 Jul 12, pii: S1695-4033(17)30220-5. doi:10.1016/j.anpedi.2017.06.001.
7. Williams MR, Greene G, Naik G, Hughes K, Butler CC, Hay AD. Antibiotic prescribing quality for children in primary care: an observational study. Br J Gen Pract, 2018 Jan 15, pii: bjgp18X694409. doi: 10.3399/bjgp18X694409.
8. Heikkinen T, Järvinen A. The common cold. Lancet, 2003; 361: 51.
9. Баранов А.А., Таточенко В.К., Бакрадзе М.Д. Лихорадящий ребенок. Протоколы диагностики и лечения. 3-е изд. М.: Педиатр, 2017. 304 с.
10. O’Brien K, Bellis TW, Kelson M, Hood K, Butler CC, Edwards A. Clinical predictors of antibiotic prescribing for acutely ill children in primary care: an observational study. Br J Gen Pract, 2015 Sep, 65(638): e585-92. doi: 10.3399/bjgp15X686497.
11. Bozic B, Bajcetic M. Use of antibiotics in paediatric primary care settings in Serbia. Arch Dis Child, 2015 Oct, 100(10): 966-9. doi: 10.1136/archdischild-2015-308274.
12. Tyrstrup M, van der Velden A, Engstrom S, Goderis G, Molstad S, Verheij T, Coenen S, Adriaenssens N. Antibiotic prescribing in relation to diagnoses and consultation rates in Belgium, the Netherlands and Sweden: use of European quality indicators. Scand J Prim Health Care, 2017 Mar, 35(1): 10-18. doi: 10.1080/02813432.2017.1288680. Epub 2017 Mar 3.
13. Tyrstrup M, Beckman A, Mölstad S, Engström S, Lannering C, Melander E, Hedin K. Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records. BMC Infect Dis, 2016 Nov 25, 16(1): 709.
14. Duarte VM, McGrath CL, Shapiro NL, Bhattacharrya N. Healthcare costs of acute and chronic tonsillar conditions in the pediatric population in the United States. Int J Pediatr Otorhinolaryngol, 2015 Jun, 79(6): 921-5. doi: 10.1016/j.ijporl.2015.04.019. Epub 2015 Apr 18.
15. Chazan B, Raz R, Edelstein H, Kennes Y, Gal V, Colodner R. Susceptibility of Group A Streptococcus to Antimicrobial Agents in Northern Israel: A Surveillance Study. Microb Drug Resist, 2015 Oct, 21(5): 551-5. doi: 10.1089/mdr.2015.0040.
16. Поляков Д.П. Принципы антибактериальной терапии стрептококкового тонзилло фарингита. Вопросы современной педиатрии, 2014, 13(2): 83-88.
17. Brook I, Dohar JE. Management of group A beta-haemolytic streptococcal pharyngotonsillitis in children. J. Fam. Pract., 2006, 55(12): 1–11.
18. Kanji K, Saatci D, Rao GG, Khanna P, Bassett P, Williams B, Khan M. Antibiotics for tonsillitis: should the emergency department emulate general practice? J Clin Pathol, 2016 Sep, 69(9): 834-6. doi: 10.1136/jclinpath-2016-203808. Epub 2016 Jun 29.
19. Sayyahfar S, Fahimzad A, Naddaf A, Tavassoli S. Antibiotic Susceptibility Evaluation of Group A Streptococcus Isolated from Children with Pharyngitis: A Study from Iran. Infect Chemother, 2015 Dec, 47(4): 225-30. doi: 10.3947/ic.2015.47.4.225. Epub 2015.
20. Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C. IDSA Guideline for GAS Pharyngitis, Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 2012, 3: 1-17.
21. Regoli M, Chiappini E, Bonsignori F, Galli L, de Martino M. Update on the management of acute pharyngitis in children. Italian Journal of Pediatrics, 2011, 37: 10.
22. Белов Б.С. Острая ревматическая лихорадка и хроническая ревматическая болезнь сердца: диагностика, лечение, профилактика. Consilium Medicum. Инфекции сердечно-сосудистой системы, 2006, 1(4): 341–347.
23. Espadas Maciá D, Flor Macián EM, Borrás R, Poujois Gisbert S, Muñoz Bonet JI. Streptococcus pyogenes infection in paediatrics: from pharyngotonsillitis to invasive infections. An Pediatr (Barc), 2017 Mar 31, pii: S1695-4033(17)30056-5. doi: 10.1016/j.anpedi.2017.02.011.
24. Seerig MM, Chueiri L, Jacques J, de Mello MFPC, da Silva MBC, Zatt DB, Cunha RCO, Maranhão ASA. Bilateral Peritonsillar Abscess in an Infant: An Unusual Presentation of Sore Throat. Case Rep Otolaryngol, 2017, 2017: 4670152. doi: 10.1155/2017/4670152. Epub 2017 Aug 21.
25. Freire GSM, Dos Santos JHZ, Rolón PA, Pinheiro GB, Sampaio ALL. Peritonsillar abscess: epidemiology and relationship with climate variations. J Laryngol Otol, 2017 Jul, 131(7): 627-630. doi: 10.1017/S0022215117000895. Epub 2017 May 2.
26. Gahleitner C, Hofauer B, Stark T, Knopf A. Predisposing factors and management of complications in acute tonsillitis. Acta Otolaryngo, 2016 Sep, 136(9): 964-8. doi: 10.3109/00016489.2016.1170202.
27. Дарманян А.С. Совершенствование методов диагностики и лечения острых тонзиллитов у детей: дис. … канд. мед. наук. М., 2010.
28. Баранов А.А., Намазова-Баранова Л.С., Лобзин Ю.В., Усков А.Н., Таточенко В.К., Бакрадзе М.Д., Вишнева Е.А., Селимзянова Л.Р., Полякова А.С. Острый тонзиллит у детей. Клинические рекомендации МЗРФ. 2016. 24 с.
29. Dominguez O, Rojo P, de Las Heras, et al. Clinical presentation and characteristics of pharyngeal adenovirus infections. The pediatric infections disease journal, 2005, 24(8): 733–34.
30. Christensen AM, Thomsen MK, Ovesen T, Klug TE. Are procalcitonin or other infection markers useful in the detection of group A streptococcal acute tonsillitis? Scand J Infect Dis, 2014 May, 46(5): 376−83.
31. Skovbjerg S, Roos K, Olofsson S, Lindh M, Ljung A, Hynsjö L, Holm SE, Adlerberth I, Wold AE. High Cytokine Levels in Tonsillitis Secretions Regardless of Presence of Beta-Hemolytic Streptococci. J Interferon Cytokine Res, 2015 Sep, 35(9): 682-9. doi: 10.1089/jir.2014.0123.
32. Гадлия Д.Д. Клинико-лабораторная диагностика тяжелых бактериальных инфекций у детей. Автореферат. 2016.
33. Шпынев К.В., Кречиков В.А. Современные подходы к диагностике стрептококковых фарингитов. Клин. микробиол. антимикроб. химиотер., 2007, 9(1): 20-33.
34. Fontes MJ, Bottrel FB, Fonseca MT, Lasmar LB, et al. Early diagnosis of streptococcal pharyngotonsillitis: assessment by latex particle agglutination test. J Pediatr (Rio J), 2007, 83(5): 465-70.
35. Козлов С.Н., Страчунский Л.С., Рачина С.А. Фармакотерапия острого тонзиллофарингита в амбулаторной практике: результаты многоцентрового фармакоэпидемиологического исследования. Терапевтический архив, 2004, 5: 45-51.
36. Vranjes Z, Katić V, Vinter-Repalust N, Jurković L, Tiljak H, Cerovecki-Nekić V, Simunović R, Petric D, Katić M. Acute infections of the upper respiratory tract–factors that contribute to diagnosis and antibiotic prescription decisions. Acta Med Croatica, 2007 Feb, 61(1): 83-90.
37. Chang LY, Lai CC, Chen CJ, Cho CY, Luo YC, Jeng MJ, Wu KG. Recent trends in prescribing antibiotics for acute tonsillitis in pediatric ambulatory care in Taiwan, 2000-2009: A nationwide population-based study. J Microbiol Immunol Infect, 2017 Aug, 50(4): 500-506. doi: 10.1016/j.jmii.2015.08.021. Epub 2015 Sep 9.
38. Chiappini E, Principi N, Mansi N, Serra A, De Masi S, Camaioni A, Esposito S, Felisati G, Galli L, Landi M, Speciale AM, Bonsignori F, Marchisio P, de Martino M. Management of acute pharyngitis in children: summary of the Italian National Institute of Health guidelines. Clin Ther, 2012 Jun, 34(6): 1442-1458.
39. Овчинников А. Ю. Современные представления об этиопатогенезе и адекватном лечении воспалительных заболеваний ротоглотки. Российская оториноларингология, 2011, 5(54): 194-198.
40. Sauermann R, Gattringer R, Graninger W, Buxbaum A and Georgopoulos A. Phenotypes of macrolide resistance of group A streptococci isolated from outpatients in Bavaria and susceptibility to 16 antibiotics. Journal of Antimicrobial Chemotherapy, 2003, 51: 53–57.
41. Сидоренко С.В., Грудинина С.А., Филимонова О.Ю., Столярова Л.Г., Савинова С.А. Резистентность к макролидам и линкозамидам среди Streptococcus pneumoniae и Streptococcus pyogenes в Российской Федерации. Клиническая фармакология и терапия, 2008, 17-2: 1-4.
42. Хохлова Т.А., Полякова А.С., Бакрадзе М.Д. Место джозамицина в терапии острых респираторных инфекций бактериальной этиологии у детей. Медицинский совет, 2015, 1: 7-10.
43. Бодяева Е.В., Рачина С.А., Отвагин И.В., Гудков И.В. Анализ эффективности комплексного вмешательства у пациентов с острым тонзиллофарингитом в амбулаторной практике Смоленска. Клин. микробиол. антимикроб. химиотер., 2011, 13(1): 46–55.
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For citations:
Polyakova AS, Bakradze MD, Tatochenko VK, Chaschina IL. ACUTE TONSILLITIS IN CHILDREN: THE PRINCIPLE “ZAP AND IT’S DONE!”? Meditsinskiy sovet = Medical Council. 2018;(2):122-128. (In Russ.) https://doi.org/10.21518/2079-701X-2018-2-122-128
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