Acute Tonsillopharyngitis
CURRENT RESEARCH ABOUT ACUTE TONSILLOPHARYNGITIS
TREATMENT AND PREVENTION OF STREPTOCOCCAL TONSILLOPHARYNGITIS
Author
Michael E Pichichero, MD
Section Editors
Daniel J Sexton, MD
Morven S Edwards, MD
Deputy Editor
Elinor L Baron, MD, DTMH
Disclosures
All topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: Dec 2012. | This topic last updated: Oct 17, 2012.
INTRODUCTION — Group A streptococcal (GAS) tonsillopharyngitis presents with abrupt onset of sore throat, tonsillar exudate, tender cervical adenopathy, and fever, followed by spontaneous resolution within two to five days. Patients with sore throat lasting longer than one week usually do not have GAS tonsillopharyngitis.
Issues related to treatment and prevention of group A streptococcal tonsillopharyngitis will be reviewed here [1]. A general approach to patients with pharyngitis and the factors responsible for antibiotic failure are discussed separately.
GOALS OF THERAPY — Goals of antimicrobial therapy for eradication of GAS from the pharynx in the setting of acute streptococcal pharyngitis include: * Reducing duration and severity of clinical signs and symptoms, including suppurative complications * Reducing incidence of nonsuppurative complications (eg, acute rheumatic fever) * Reducing transmission to close contacts by reducing infectivity
Considerations of treatment include ease of antibiotic administration and limited expense with as few adverse effects as possible [2-4].
Reducing clinical symptoms — Antibiotic therapy is most beneficial for hastening resolution of symptoms if instituted within the first two days of illness [5-9]. Antibiotic therapy is also beneficial for reducing suppurative complications such as peritonsillar abscess, cervical lymphadenitis, and mastoiditis. Additional issues related to antibiotic therapy for reducing clinical symptoms are discussed further below.
Reducing nonsuppurative
TREATMENT AND PREVENTION OF STREPTOCOCCAL TONSILLOPHARYNGITIS
Author
Michael E Pichichero, MD
Section Editors
Daniel J Sexton, MD
Morven S Edwards, MD
Deputy Editor
Elinor L Baron, MD, DTMH
Disclosures
All topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: Dec 2012. | This topic last updated: Oct 17, 2012.
INTRODUCTION — Group A streptococcal (GAS) tonsillopharyngitis presents with abrupt onset of sore throat, tonsillar exudate, tender cervical adenopathy, and fever, followed by spontaneous resolution within two to five days. Patients with sore throat lasting longer than one week usually do not have GAS tonsillopharyngitis.
Issues related to treatment and prevention of group A streptococcal tonsillopharyngitis will be reviewed here [1]. A general approach to patients with pharyngitis and the factors responsible for antibiotic failure are discussed separately.
GOALS OF THERAPY — Goals of antimicrobial therapy for eradication of GAS from the pharynx in the setting of acute streptococcal pharyngitis include: * Reducing duration and severity of clinical signs and symptoms, including suppurative complications * Reducing incidence of nonsuppurative complications (eg, acute rheumatic fever) * Reducing transmission to close contacts by reducing infectivity
Considerations of treatment include ease of antibiotic administration and limited expense with as few adverse effects as possible [2-4].
Reducing clinical symptoms — Antibiotic therapy is most beneficial for hastening resolution of symptoms if instituted within the first two days of illness [5-9]. Antibiotic therapy is also beneficial for reducing suppurative complications such as peritonsillar abscess, cervical lymphadenitis, and mastoiditis. Additional issues related to antibiotic therapy for reducing clinical symptoms are discussed further below.
Reducing nonsuppurative