When are antibiotics indicated for sore throat? When treatment takes place in a hospital

Taking antibiotics for a sore throat with purulent formations on the tonsils is mandatory. Thanks to treatment using drugs, the disease will not get worse. Antibiotics for purulent sore throat in adults should only be prescribed by a physician, after having previously examined the patient and done a test for susceptibility to the medication.

In order to get rid of purulent sore throat, what antibiotic will help? This question interests many patients. An antibiotic is selected based on age category patient, the possible presence of allergies, difficulties in taking the tablet form of drugs due to pain in the throat. It is also important to know whether the disease occurred for the first time or has already had to be treated, and to determine the susceptibility of the infection using tests.

Purulent tonsillitis is one of the most serious forms of disease, the causative agents of which are streptococcus and pneumococcus.

Causes of the disease:

rhinitis;
sinusitis;
caries;
stomatitis;
chronic pathologies;
long-term illnesses;
failure to comply with hygiene rules.

Symptoms of the disease:

sudden increase in temperature;
tonsils become larger;
formation of pus on the tonsils;
bad breath;
pain when swallowing;
swollen lymph nodes;
diarrhea;
vomit;
weakness in the body;
Possible otitis media.

A diagnosis of purulent tonsillitis can be made by visually examining the patient, also by taking an analysis taken from the surface of the tonsils. Having determined the pathogenesis, the optimal treatment regimen is prescribed.

Can I stop taking medications?

Treatment of purulent sore throat with antibiotics is mandatory for get well soon. Since sore throat is a bacterial disease, antibiotics are needed to eliminate it. By refusing to take it, there may be a risk of developing serious and dangerous complications for life.

It is important to know that purulent formations on the tonsils appear due to bacterial tonsillitis. Viral and fungal tonsillitis develop without pus, although with purulent sore throat a cheesy coating forms. In this case, when a doctor diagnoses a purulent sore throat (he is able to distinguish fungal disease from a bacterial disease), treatment is required using antibiotics and only those that can act on the infection.

How to take an antibiotic correctly?

Purulent tonsillitis should be treated strictly, following the doctor’s instructions. The duration of the course, the doses used, and the set of drugs for complex use must be individual. Since the well-being and course of the disease in patients with angina may be different. If taking an antibiotic gives a positive result for one patient, then it is not suitable for another at all. Also, the dosage of the drug for an adult may not adversely affect him, while for children and pregnant women it may be harmful.

It is important that the treatment of sore throat with antibiotics is carried out by a specialized doctor who will select and prescribe necessary medications on an individual basis.

When taking antibiotics, it is important to follow these rules:

The course of drug use must be completed to the end. This point also applies to cases where the patient’s improvements are noticeable already on the 3rd day. Interruption may give rise to complications. Therefore, if the prescription indicates a period of a week of intake, you need to drink exactly a week, no less;
the minimum use of the product takes 7 days, on average 10 days;
In general, only a doctor can change the antibiotic to another or stop taking it. The doctor can cancel the drug if the treatment does not bring the desired effect, or if the drug is not detected during the test. pathogenic bacteria, and fungi are present. Then you need to treat a fungal disease.

If any side effects, the doctor may replace the drug or prescribe auxiliary agents. They are necessary for the symptomatic treatment of such adverse manifestations.

Contraindications and side effects

Antibiotic for purulent sore throat penicillin group contraindicated in patients with allergic reactions to previously used penicillin, with bronchial asthma, hay fever, urticaria.

Do not use the macrolide group of drugs and cephalosporins if you are allergic to this type.

midecamycin;
roxithromycin;
clarithromycin.

During breastfeeding, women are not prescribed:

josamycin;
clarithromycin;
midecamycin;
roxithromycin;
spiramycin.

The penicillin group of antibiotics has less toxicity when treating purulent tonsillitis. When using them it is possible:

the occurrence of allergies;
skin rash;
development of anaphylactic shock;
state of nausea;
inflammation of the oral mucosa;
diarrhea;
inflammatory process in the tongue;
damage to the skin, mucous membranes, internal organs fungus.

If the dose is exceeded, the patient may become delirious and convulsions are possible.

Macrolide drugs are considered the safest, side effects are rarely observed. The following adverse reactions were recorded:

vomit;
nausea;
diarrhea;
headache;
dizziness;
altered heart rhythm;
inflammation of the vein walls.

Cephalosprorin antibiotics are rarely used, although they appear allergic reactions. It could be:

rash;
bronchospasms;
Quincke's edema.

Also observed anaphylactic shock, the composition of the blood changes, vomiting, diarrhea with blood, stomach pain, candidiasis.

If the patient has renal failure, when consuming high dose may lead to convulsions.

What medications are prescribed for angina?

When the disease occurs, antibiotics are the mainstay of treatment. They are prescribed both in tablets and in injections, if the patient has serious condition diseases.

Treatment of sore throat with purulent formations on the tonsils does not take place without antibiotics of the penicillin group. Typically, the therapist prescribes the following medications for purulent sore throat:

amoxicillin;
phenoxymethylpenicillin;
ampicillin;
oxacillin;
benzathine penicillin.

These drugs are safe for health and have good digestibility, provide effective action for a bacterial infection.

Amoxicillin is often well tolerated. The drug is removed from the body slowly, so it needs to be taken 3 times a day. The dosage is calculated by the doctor based on the patient’s weight, age, condition, and possible complications are taken into account.

There are cases that treatment with antibiotics of the penicillin group does not bring results when used for a long time. This indicates that during this time, strains of bacteria (streptococcus, staphylococcus) appeared that developed resistance to them. Therefore, protected penicillins are often prescribed.

Amoxicillin and clavulanic acid:

amoxiclav;
augmentin;
flemoxin salutab.

Ampicillin and sulbactam:

sultamicillin;
unasin;
sultasin;
ampisid.

Thanks to clavulanic acid or sulbactam, bacterial protection is neutralized, and the antibiotic destroys the bacterial wall.

The penicillin group of drugs is prescribed to adults if a swab is not taken from the throat and the doctor cannot confidently say about the sensitivity of the sore throat pathogen to a particular drug. Therefore, when choosing a drug for a purulent sore throat, without having a doctor test it, it is taken into account that amoxiclav will provide best action in the fight against bacteria than amoxicillin.

If an adult is intolerant to drugs of the penicillin group, the doctor may prescribe cephalosporins.

Quite often, when purulent tonsillitis occurs, treatment is carried out with the prescription of cefadroxil. This drug is safe compared to penicillins. There are drugs based on cefadroxil.

Biodroxyl.
Duracef.
Cedrox.
Cephalexin.
Cefuroxime.

If complications arise, use meropenem or imepenem. They have a detrimental effect on the majority pathogenic microorganisms.

Cephalosporins are also used as injections. Such drugs have few side effects.

Macrolide antibiotics will help if the patient has a purulent sore throat.

Erythromycin.
Azithromycin.
Spiramycin.
Sumamed.
Midecamycin.
Clarithromycin.
Roxithromycin.
Josamycin.

These drugs are highly effective against the infection that causes purulent sore throat. Although they lead to digestive upset in the patient, so they are prescribed if there is an allergy to the first 2 groups of antibiotics.

The use of lincosamides exclusively for recurrent angina.

Lincomycin.
Clindamycin.

What antibiotics a patient will need for a purulent sore throat will be decided by the doctor individually.

Use of topical antibiotics

Local antibacterial agents play an important role in the treatment of sore throat. These are sprays, lozenges. They are necessary, since high saturation occurs in the lesion with low overall absorption; they can be taken orally, combined with an antibiotic, thereby increasing the effectiveness of treatment.

How to treat a sore throat?

When the antibiotic comes in the form of tablets or capsules, they need to be taken 4 times a day, following the recommendations of the therapist. What is the best way to get rid of this disease? Recently, medications with an active substance have begun to be sold on the pharmacological market, which allows you to reduce consumption to 2 times a day. This is quite convenient for the patient and does not reduce the healing effect.

There are cases when the disease is severe. This is fainting, complete overlap pharyngeal ring, inability to swallow, then injections are prescribed. When an antibiotic solution is prescribed, it is necessary to regularly inject the drug into a muscle or vein into the patient.

This method is used if the patient has chronic diseases stomach, intestines, kidneys, liver, or there is a tendency to them. How often the patient will need injections depends on the composition of the medication. The frequency is 2-4 times a day. If tonsillitis is severe, then the number of injections increases to 6 times.

Sometimes, for a sore throat, they inject drugs that are administered once. They are present in tissues longer and act as long as required to cure the disease. Some of these medications last up to a month. These drugs are from the penicillin series, which are salts of benzylpenicillin (becillins). The peculiarity of such antibiotics is that they are completely broken down and not absorbed in the stomach, so they are administered only inside the muscle.

These drugs are used in the following situations:

when, after curing a sore throat, symptoms of complications arise. The use of bicillins in this case is necessary to prevent the formation of complications and completely suppress them;
if there is serious concern that the patient will not take the prescribed medications. These are, as a rule, patients in psychiatric hospitals, correctional institutions, children;
if there are no other drugs at hand except injections.

The use of sprays, local treatment of inflamed lesions, is indicated for children, pregnant women, and nursing mothers, since they do not cause such aggression to the body as solutions and tablets.

When a patient is undergoing treatment for a sore throat with antibiotics, he is simultaneously prescribed antifungal agents to avoid the formation of fungal infections caused by antibiotics.

When using antibiotics for a sore throat with purulent formations on the tonsils, you should remember that the intake should be carried out constantly certain time and the full course, even if the signs have passed. Given the many reasons to choose necessary antibiotic, dose, duration of use is determined only by the attending physician, having established an accurate diagnosis.

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Angina is an acute infectious disease manifested by inflammation of the tonsils. Since inflammation of other tonsils (lingual, tubal and laryngeal) develops very rarely, the term sore throat always means inflammation of the palatine tonsils. If it is necessary to indicate that the inflammatory process has affected some other tonsil, then doctors talk about lingual, laryngeal or retronasal tonsillitis. Any sore throat is caused by the same pathogenic microorganisms that enter the mucous membrane of the pharynx and oral cavity, so the principles of their treatment are also the same. Therefore, it is advisable to consider the legality and necessity of using antibiotics for sore throats affecting any tonsils.

Antibiotic for sore throat - when should it be used?

General rules for the use of antibiotics for sore throat

The question of the need to use antibiotics for angina should be decided individually in each specific case based on the following factors:

The age of the person with tonsillitis;
Type of sore throat - viral (catarrhal) or bacterial (purulent - follicular or lacunar);
The nature of the course of sore throat (benign or with a tendency to develop complications.

This means that in order to decide on the need to use antibiotics for angina, the age of the patient must be accurately determined, the type of infection and the nature of its course must be determined. Establishing the patient’s age does not pose any problems, so we will dwell in detail on two other factors that determine whether it is necessary to take antibiotics to treat a sore throat in each specific case.

So, to decide whether to take antibiotics, it is necessary to determine whether the sore throat is viral or bacterial. The fact is that viral tonsillitis occurs in 80 - 90% of cases and does not require the use of antibiotics. But bacterial tonsillitis occurs only in 10–20% of cases, and it is this that requires treatment with antibiotics. Therefore, it is very important to be able to distinguish between viral and bacterial sore throat.

Viral sore throat is manifested by the following symptoms:

Sore throat is combined with nasal congestion, runny nose, sore throat, cough and sometimes ulcers on the oral mucosa;
Sore throat began without temperature or against the background of its increase to no more than 38.0 o C;
The throat is simply red, covered with mucus, but without pus on the tonsils.

Bacterial tonsillitis is manifested by the following symptoms:

The disease began with a sharp increase in temperature to 39 - 40 o C, at the same time a sore throat and pus on the tonsils appeared;
Simultaneously or shortly after the sore throat, abdominal pain, nausea and vomiting appeared;
Along with the sore throat, the cervical lymph nodes became enlarged;
A week after the onset of sore throat, the person’s palms and fingers began to peel;
Simultaneously with purulent tonsillitis, a small red rash appeared on the skin (in this case, the person fell ill with scarlet fever, which is also treated with antibiotics, like bacterial tonsillitis).

That is, viral sore throat is combined with other symptoms of ARVI, such as cough, runny nose and nasal congestion, and there is never pus on the tonsils. And bacterial tonsillitis is never combined with a cough or runny nose, but with it there is always pus on the tonsils. Thanks to such clear signs, it is possible to distinguish a viral sore throat from a bacterial one in any conditions, even without special laboratory tests.

Second important factor The nature of the course of the disease depends on whether it is necessary to take antibiotics for angina in this particular case. In this case, it is necessary to determine whether the sore throat proceeds favorably (without complications) or whether the person has begun to develop complications. Signs of the onset of sore throat complications requiring the use of antibiotics are the following symptoms:

Some time after the onset of sore throat, ear pain appeared;
The condition worsens rather than improves as the disease progresses;
Sore throat increases as the disease progresses;
A noticeable bulge appeared on one side of the throat;
Pain appeared when turning the head to the side and when opening the mouth;
On any day of the course of a sore throat, chest pain, headaches, and pain in one half of the face appeared.

If a person has any of the above symptoms, this indicates the development of complications, which means that a sore throat is unfavorable and requires treatment with antibiotics. mandatory. Otherwise, when the sore throat progresses favorably, antibiotics are not necessary.

Based on all of the above, we present situations in which it is and is not necessary to use antibiotics for sore throat for people of different ages.

From the point of view of the need to use antibiotics for sore throat, all people over 15 years of age, regardless of gender, are considered adults.

Firstly, if the sore throat is viral and proceeds favorably, then antibiotics do not need to be used, regardless of the age of the patient. That is, if a child or adult gets sick with a viral sore throat, which proceeds favorably, without signs of complications, then none of them should use antibiotics for treatment. In such cases, a sore throat will go away on its own within 7 to 10 days. Justified only drinking plenty of fluids and use symptomatic remedies, relieving sore throats and lowering fever.

However, if an adult or child has signs of complications with a viral sore throat, then antibiotics should be started as soon as possible. But you should not take antibiotics to “prevent” complications, since this is ineffective. It is necessary to start taking antibiotics for viral sore throat only when signs of complications appear.

Secondly, if the sore throat is bacterial (purulent) , then the need to use antibiotics is determined by the age of the patient and the nature of the disease.

If purulent sore throat develops in an adult or adolescent over 15 years of age, then antibiotics should be used only when signs of the complications listed above appear. If a sore throat in people over 15 years of age progresses favorably, then there is no need to use antibiotics, since the infection will go away without their use. It has been proven that antibiotics reduce the duration of uncomplicated bacterial sore throat in people over 15 years of age by only 1 day, so their use routinely is inappropriate in all cases. That is, all people over 15 years of age should use an antibiotic for a sore throat only if the signs of complications listed above appear.

Pregnant women and nursing mothers should take an antibiotic for sore throat in the same cases as other adults, that is, only if complications develop in the ears, respiratory and ENT organs.

From the point of view of the need to use antibiotics for sore throat, all people under 15 years of age, regardless of gender, are considered adults.

If a child of any age under 15 years of age develops a viral sore throat, then there is no need to use antibiotics to treat it. For viral sore throat, you should start taking antibiotics only if there are signs of complications in the ears, respiratory and other ENT organs.

If a child aged 3–15 years has developed purulent tonsillitis, then it is imperative to use antibiotics to treat it. In children of this age category, the need to use antibiotics for purulent sore throat is not associated with the treatment of the disease itself, but with the prevention of possible severe complications on the heart, joints and nervous system.

The fact is that bacterial tonsillitis in children under 15 years of age very often causes complications in the form of infection of the joints, heart and nervous system, causing much more severe diseases, such as rheumatism, arthritis and PANDAS syndrome. And the use of antibiotics for such sore throats in children under 15 years of age can almost 100% prevent the development of these complications from the heart, joints and nervous system. It is to prevent severe complications in children under 15 years of age that an antibiotic should be used for purulent sore throat.

Moreover, in order to prevent complications of bacterial tonsillitis on the heart, joints and nervous system, it is not necessary to start taking antibiotics from the first day of infection. As studies and clinical trials have shown, complications of bacterial sore throat in children are effectively prevented if antibiotics are started up to 9 days inclusive from the onset of the disease. This means it is not too late to start giving your child antibiotics on days 2, 3, 4, 5, 6, 7, 8, and 9 after the onset of a sore throat.

As for sore throats in children under 3 years of age, they should use antibiotics only if there is pus on the tonsils or if complications develop in the ears, respiratory and ENT organs. Since purulent bacterial tonsillitis practically does not occur in children under 3 years of age, then, in fact, antibiotics should be used in them to treat inflammation of the tonsils only if complications develop from the respiratory and ENT organs.

Thus, Antibiotics for sore throat in people of any age and gender should be used only in the following cases:

Purulent (follicular or lacunar) tonsillitis, even with a favorable course, in children aged 3–15 years;
Development of complications of sore throat in the ears, respiratory and ENT organs in people over 15 years of age;
Complications of sore throat in the ears, respiratory and ENT organs in children under 3 years of age.

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Antibiotics for purulent tonsillitis (follicular and lacunar)

There are no differences in the rules for using antibiotics for the treatment of lacunar and follicular tonsillitis. Therefore, both of these types of sore throat are often combined into one general term“purulent”, and treatment tactics are considered together. The need to use antibiotics for follicular and lacunar tonsillitis is determined by the age of the patient and the nature of the infection. So, crucial To resolve the issue of the need to take antibiotics for purulent sore throat, the age of the person depends. Moreover, a teenager over 15 years old, from the point of view of the need to use antibiotics for purulent sore throat, is considered an adult, and under 15 years old, accordingly, a child. Let's consider the rules for using antibiotics for sore throat in adults and children.

Antibiotic for sore throat in adults

If follicular or lacunar tonsillitis has developed in a person over 15 years of age, then antibiotics should be used to treat it only in cases where there are signs of complications in the ears, respiratory and ENT organs. That is, if purulent tonsillitis in any person over 15 years of age, regardless of gender, proceeds favorably, without complications in the ears and other ENT organs, then there is no need to use antibiotics to treat it. In such situations, antibiotics are practically useless, since they do not reduce the risk of complications in the ears and ENT organs and do not speed up the recovery process.

Accordingly, in people over 15 years of age of both sexes, antibiotics should be used for purulent sore throat only if complications develop in the ears, respiratory and ENT organs. Considering this rule about the use of antibiotics for purulent sore throat in persons over 15 years of age, it is necessary to be able to distinguish favorable course infections from the development of complications. To do this, you need to know the signs of the onset of complications in which you need to take antibiotics. So, the symptoms of complications of follicular or lacunar tonsillitis on the ears, respiratory and ENT organs, when they appear, you need to start taking antibiotics, are the following:

Ear pain appeared;
2 – 4 days after the onset of sore throat, the state of health worsened;
The sore throat has gotten worse;
When examining the throat, a noticeable bulge is visible on one of its sides;
Pain appeared when opening the mouth or turning the head to the right or left;
After 2–3 days of antibiotic use, the condition did not improve;
Sore throat and body temperature above 38 o C last longer than 7 – 10 days;
Chest pain, headaches, and pain in one half of the face appeared.

Any of the above symptoms indicates the development of complications of purulent tonsillitis, for which it is imperative to start taking antibiotics. If these symptoms are absent in a person over 15 years of age who suffers from purulent tonsillitis (follicular or lacunar), then there is no need to take antibiotics.

Antibiotics for sore throat in children

If purulent tonsillitis (follicular or lacunar) has developed in a child of any sex between the ages of 3 and 15 years, then antibiotics must be used to treat it, regardless of the presence of complications in the ears, respiratory and ENT organs.

The fact is that at this age, purulent tonsillitis can give much more severe complications compared to otitis, abscesses and others characteristic of adults over 15 years old, since due to the imperfection of lymphoid tissue, pathogenic bacteria from the tonsils can penetrate through the blood and lymph into kidneys, heart, joints and central nervous system, causing them inflammatory processes, which are very difficult to treat and often become the cause of chronic diseases of these organs.

If the pathogenic microorganism that provokes a purulent sore throat enters the kidneys, it causes glomerulonephritis, the outcome of which is often acute renal failure with transition to chronic. If the microbe enters the heart, it causes an inflammatory process in the tissues of the valves and partitions between the chambers, which lasts for years, as a result of which the structures of the heart change and defects are formed. From the moment the microbe that causes purulent tonsillitis enters the heart until the development of the defect takes from 20 to 40 years. And a person already in adulthood is faced with the consequences of a purulent sore throat suffered in childhood, which are rheumatic heart defects.

When a microbe gets from the tonsils into the joints, acute arthritis develops, which passes after some time, but creates favorable conditions for joint diseases in the future. And when a microbe enters the central nervous system from the tonsils, PANDAS syndrome develops, characterized by a sharp decrease in emotional stability and cognitive functions (memory, attention, etc.), as well as the appearance of spontaneous uncontrolled movements and actions, for example, involuntary urination, tongue twitching, etc. In some children, PANDAS syndrome goes away completely within 6–24 months, while in others it remains to varying degrees of severity for many years.

Thus, in children 3 to 15 years old, the most dangerous complications with purulent sore throat are complications on the kidneys, heart, joints and nervous system, and not on the ears, respiratory and ENT organs. Accordingly, treatment of sore throat should be aimed not so much at the infection itself, which in most cases goes away on its own without special therapy, but at preventing these complications from the heart, joints and central nervous system. And it is precisely to prevent these severe complications that the mandatory use of antibiotics for purulent sore throat in children aged 3 to 15 years is aimed.

The fact is that the use of antibiotics for purulent sore throat in children 3–15 years old can reduce the risk of developing these severe complications to the heart, joints and nervous system to almost zero. Therefore, doctors consider it necessary to give antibiotics to children aged 3–15 years with purulent sore throat.

You need to know that prevention and reduction of the risk of severe complications is achieved by starting the use of antibiotics not only from the first day of sore throat development. Thus, in the course of research and clinical observations, it was found that the prevention of complications is effective if antibiotics are started to be given to the child before the 9th day inclusive from the onset of sore throat. That is, to prevent complications on the heart, joints and central nervous system, you can start giving your child antibiotics on days 1, 2, 3, 4, 5, 6, 7, 8 and 9 from the onset of sore throat. More late start the use of antibiotics is no longer effective in preventing complications in the heart, joints and central nervous system.

If parents for some reason do not want to use antibiotics for purulent sore throat in a child aged 3–15 years, despite high risk complications on the heart, joints and central nervous system, then they may not do this. However, if a child shows signs of complications from the ears, respiratory and ENT organs (increased sore throat, deterioration in health, pain in the ear, chest, half of the face, etc.), then you should definitely resort to the use of antibiotics.

Rules for treating sore throat with antibiotics

If the sore throat is viral, then, regardless of the age of the patient, antibiotics should be taken only from the moment when signs of complications in the ears, respiratory and other ENT organs become noticeable (increased sore throat, pain in the ear, on one side of the face or in the chest, deterioration in health, increase in temperature, etc.). If signs of complications do not appear with a viral sore throat, then there is no need to take antibiotics.

If the sore throat is bacterial (purulent), then a child aged 3–15 years should start giving antibiotics as early as possible. However, if it was not possible to start using antibiotics from the first days of a sore throat, then this can be done up to 9 days inclusive from the onset of the infectious disease. That is, for a purulent sore throat, a child 3–15 years old can start giving antibiotics on days 1, 2, 3, 4, 5, 6, 7, 8 and 9 of the disease.

Adults over 15 years of age with purulent sore throat should use antibiotics only when there are signs of complications in the ears, respiratory and other ENT organs. That is, if a person over 15 years of age with purulent sore throat has no signs of complications, then there is no need to use antibiotics at all.

What antibiotics are needed for angina

Since in 90 - 95% of cases, bacterial tonsillitis or viral complications are provoked by group A beta-hemolytic streptococcus or staphylococci, then for treatment it is necessary to use antibiotics that have a detrimental effect on these bacteria. Currently, they are destructive against beta-hemolytic streptococci and staphylococci, and, accordingly, are effective for the treatment of angina, the following groups antibiotics:

Penicillins(for example, Amoxicillin, Ampicillin, Amoxiclav, Augmentin, Oxacillin, Ampiox, Flemoxin, etc.);
Cephalosporins(for example, Cifran, Cephalexin, Ceftriaxone, etc.);
Macrolides(for example, Azithromycin, Sumamed, Rulid, etc.);
Tetracyclines(for example, Doxycycline, Tetracycline, Macropen, etc.);
Fluoroquinolones(for example, Sparfloxacin, Levofloxacin, Ciprofloxacin, Pefloxacin, Ofloxacin, etc.).

The drugs of choice for purulent sore throat are antibiotics from the penicillin group. Therefore, if a person is not allergic to penicillins for purulent sore throat, penicillin antibiotics should always be used first. And only if they turned out to be ineffective, you can switch to the use of antibiotics from other specified groups. The only situation when treatment of a sore throat should be started not with penicillins, but with cephalosporins, is a sore throat that is very severe, with high fever, severe swelling of the throat and severe symptoms of intoxication (headache, weakness, chills, etc.).

If cephalosporins or penicillins are ineffective or a person is allergic to antibiotics of these groups, then macrolides, tetracyclines or fluoroquinolones should be used to treat sore throat. At the same time, with angina of average and light weight antibiotics from the tetracycline or macrolide groups should be used, and if severe course infections - fluoroquinolones. Moreover, it should be borne in mind that macrolides are more effective than tetracyclines.

Thus, we can conclude that for severe angina, antibiotics from the groups of cephalosporins or fluoroquinolones are used, and for mild and moderate angina, macrolides, penicillins or tetracyclines are used. In this case, the drugs of choice are antibiotics from the groups of penicillins and cephalosporins, the first of which are optimal for the treatment of sore throat of moderate and mild degree severity, and the second - in case of severe infection. If penicillins or cephalosporins are ineffective or cannot be used, then it is optimal to use antibiotics from the fluoroquinolone group for severe sore throat and macrolides for mild to moderate severity. The use of tetracyclines should be avoided whenever possible.

How many days should I take it?

For purulent sore throat or complications of infection, any antibiotics must be taken for 7–14 days, and optimally for 10 days. This means that any antibiotic must be taken within 10 days, regardless of what day from the onset of sore throat antibiotic therapy was started.

The only exception is the antibiotic Sumamed, which needs to be taken for only 5 days. Other antibiotics should not be taken for less than 7 days, since shorter courses of antibiotic therapy may not kill all pathogenic bacteria, from which antibiotic-resistant varieties are subsequently formed. Due to the formation of such antibiotic-resistant varieties of bacteria, subsequent sore throats in the same person will be very difficult to treat, as a result of which it will be necessary to use drugs with a wide spectrum of action and high toxicity.

Also, you cannot use an antibiotic for a sore throat for more than 14 days, because if the drug does not lead to complete cure within 2 weeks, this means that it is not effective enough in this particular case. In such a situation, it is necessary to conduct an additional examination (culture of throat discharge with determination of sensitivity to antibiotics), based on the results of which, select another drug to which the sore throat pathogen is sensitive.

Names of antibiotics for sore throat

We present the names of antibiotics for the treatment of sore throat in several lists, formed on the basis of each specific drug belonging to a particular group (penicillins, cephalosporins, macrolides, tetracyclines and fluoroquinolones). In this case, the list will first indicate the international name of the antibiotic, and next to it in brackets the commercial names under which drugs containing this antibiotic as an active substance.

Names of penicillins

So, among the antibiotics of the penicillin group, the following are used to treat sore throat:

Amoxicillin (Amoxicillin, Amosin, Gramox-D, Ospamox, Flemoxin Solutab, Hiconcil, Ecobol);
Amoxicillin + clavulanic acid (Amovicombe, Amoxivan, Amoxiclav, Arlet, Augmentin, Bactoclav, Verklav, Klamosar, Liklav, Medoclav, Panclave, Ranclave, Rapiclav, Fibell, Flemoclav Solutab, Foraclave, Ecoclave);
Ampicillin (Ampicillin, Standacillin);
Ampicillin + Oxacillin (Ampiox, Oksamp, Oksampicin, Oksamsar);
Benzylpenicillin (Benzylpenicillin, Bicillin-1, Bicillin-3 and Bicillin-5);
Oxacillin (Oxacillin);
Phenoxymethylpenicillin (Phenoxymethylpenicillin, Star-Pen, Ospen 750).

Names of cephalosporins

Among the antibiotics of the cephalosporin group, the following drugs are used to treat angina:

Cefazolin (Zolin, Intrazolin, Lizolin, Natsef, Orizolin, Orpin, Totacef, Cesolin, Cefazolin, Cefamezin);
Cephalexin (Cephalexin, Ecocephron);
Ceftriaxone (Azaran, Axone, Betasporin, Biotraxone, Ificef, Lendacin, Lifaxone, Loraxone, Medaxone, Movigip, Oframax, Roceferin, Rocephin, Stericef, Tercef, Torocef, Triaxone, Hizon, Cephaxone, Cephatrin, Cefogram, Cefson, Ceftriabol, Ceftriaxone) ;
Ceftazidime (Bestum, Vicef, Lorazidim, Orzid, Tizim, Fortazim, Fortoferin, Fortum, Cefzid, Ceftazidime, Ceftidine);
Cefoperazone (Dardum, Medocef, Movoperiz, Operaz, Ceperon, Cefobid, Cefoperabol, Cefoperazone, Cefoperus, Cefpar);
Cefotaxime (Intrataxime, Kefotex, Clafobrine, Claforan, Liforan, Oritax, Oritaxim, Resibelacta, Tax-o-bid, Talcef, Tarcefoxime, Cetax, Cephabol, Cephantral, Cefosin, Cefotaxime).

Names of macrolides

Used to treat sore throat the following antibiotics macrolide groups:

Erythromycin (Eomycin, Erythromycin);
Clarithromycin (Arvicin, Zimbaktar, Kispar, Klabax, Clarbact, Clarexid, Clarithromycin, Clarithrosin, Claricin, Claricit, Claromin, Klasine, Klatsid, Clerimed, Coater, Lekoklar, Romiclar, Seydon-Sanovel, Fromilid, Ecositrin);
Azithromycin (Azivok, Azimicin, Azitral, Azitrox, Azithromycin, Azithrocin, AzitRus, Azicide, Zetamax, Zitnob, Zi-factor, Zitrolide, Zitrocin, Sumaclid, Sumamed, Sumametcin, Sumamox, Sumatrolide Solutab, Sumatrolide Solution, Tremak-Sanovel, Hemomycin, Ecomed);
Midecamycin (Macropen);
Josamycin (Vilprafen, Vilprafen Solutab);
Spiramycin (Rovamycin, Spiramisar, Spiramycin-Vero);
Roxithromycin (Xitrocin, Remora, Roxeptin, RoxyHexal, Roxithromycin, Roxolit, Romik, Rulid, Rulitsin, Elrox, Esparoxi).

Names of fluoroquinolones

The following fluoroquinolone antibiotics are used to treat sore throat:

Levofloxacin (Ashlev, Glevo, Ivacin, Lebel, Levolet R, Levostar, Levotek, Levoflox, Levofloxabol, Levofloxacin, Leobeg, Leflobakt, Lefoksin, Maklevo, OD-Levox, Remedia, Signicef, Tavanik, Tanflomed, Flexid, Floracid, Hyleflox, Ecolevid , Eleflox);
Lomefloxacin (Xenaquin, Lomacin, Lomefloxacin, Lomflox, Lofox);
Norfloxacin (Lokson-400, Nolicin, Norbactin, Norilet, Normax, Norfacin, Norfloxacin);
Ofloxacin (Aschof, Geoflox, Zanotsin, Zoflox, Oflo, Oflox, Ofloxabol, Ofloxacin, Ofloxin, Oflomak, Oflocid, Tarivid, Tariferid, Taritsin);
Ciprofloxacin (Basijen, Ificipro, Quintor, Procipro, Ceprova, Ciplox, Cipraz, Ciprex, Ciprinol, Ciprobay, Ciprobid, Ciprodox, Ciprolacare, Ciprolet, Cipronate, Cipropan, Ciprofloxabol, Ciprofloxacin, Cifloxinal, Cifran, Cifracid, Ecotsifol).

Names of tetracyclines

The following tetracycline antibiotics are used to treat sore throat:

Minocycline (Minolexin).

Names of antibiotics for sore throat in children

The following antibiotics can be used in children of different ages:

1. Penicillins:

Amoxicillin (Amoxicillin, Amosin, Gramox-D, Ospamox, Flemoxin Solutab, Hiconcil) – from birth;
Amoxicillin + clavulanic acid (Amovicombe, Amoxiclav, Augmentin, Verklav, Klamosar, Liklav, Fibell, Flemoklav Solutab, Ecoclave) – from 3 months or from birth;
Ampicillin – from 1 month;
Ampioks – from 3 years;
Ampicillin + Oxacillin (Oxamp, Oxampicin, Oksamsar) – from birth;
Benzylpenicillin (Benzylpenicillin, Bicillin-1, Bicillin-3 and Bicillin-5) – from birth;
Oxacillin – from 3 months;
Phenoxymethylpenicillin (Phenoxymethylpenicillin, Star-Pen) – from 3 months;
Ospen 750 – from 1 year.

2. Cephalosporins:

Cefazolin (Zolin, Intrazolin, Lizolin, Natsef, Orizolin, Orpin, Totacef, Cesolin, Cefamezin) – from 1 month;
Cephalexin (Cephalexin, Ecocephron) – from 6 months;
Ceftriaxone (Azaran, Axone, Betasporin, Biotraxone, Ificef, Lendacin, Lifaxone, Loraxone, Medaxone, Movigip, Oframax, Roceferin, Rocephin, Stericef, Tercef, Torocef, Triaxone, Hizon, Cephaxone, Cephatrin, Cefogram, Cefson, Ceftriabol, Ceftriaxone) – for full-term babies from birth, and for premature babies from the 15th day of life;
Ceftazidime (Bestum, Vicef, Lorazidim, Orzid, Tizim, Fortazim, Fortoferin, Fortum, Cefzid, Ceftazidime, Ceftidine) – from birth;
Cefoperazone (Dardum, Medocef, Movoperiz, Operaz, Ceperon, Cefobid, Cefoperabol, Cefoperazone, Cefoperus, Cefpar) – from the 8th day of life;
Cefotaxime (Intrataxime, Kefotex, Clafobrine, Claforan, Liforan, Oritax, Oritaxim, Resibelacta, Tax-o-bid, Talcef, Tarcefoxime, Cetax, Cephabol, Cephantral, Cefosin, Cefotaxime) - from birth, including for premature babies.

3. Macrolides:

Erythromycin (Eomycin, Erythromycin) – from birth;
Azithromycin (injections Sumamed and AzitRus) – from the moment the child’s body weight exceeds 10 kg;
Azithromycin (suspension for oral administration Zitrocin, Hemomycin, Ecomed) – from 6 months;
Macropen in the form of a suspension for oral administration – from birth;
Spiramycin (Spiramisar, Spiromycin-Vero) – from the moment the child’s body weight becomes more than 20 kg;
Roxithromycin (Xitrocin, Remora, Roxeptin, RoxyHexal, Roxithromycin, Roxolit, Romik, Rulid, Rulitsin, Elrox, Esparoxi) - from 4 years.

4. Tetracyclines:

Minocycline - from 8 years.

This list lists first international titles, then next to it in parentheses are the commercial names of the drugs under which they are sold. After this, the age at which the listed antibiotics can be used in children is indicated.

It should be remembered that fluoroquinolones should not be used for children under 18 years of age, and other antibiotics, as a rule, can be used from 12 or 14 years of age.

Antibiotic for adults with sore throat in tablets

Antibiotics for the treatment of sore throat from various groups, intended for adults, are reflected in the table.

Penicillins	Cephalosporins	Macrolides	Fluoroquinolones	Tetracyclines
Amoxicillin: Amoxicillin Amosin Ospamox Flemoxin Solutab Hiconcil Ecoball	Cephalexin	Erythromycin: Eomycin Erythromycin	Levofloxacin: Glevo Lebel Levostar Levotek Levoflox Levofloxacin Leflobakt Lefoccin Maklevo OD-Levox Remedia Tavanik Tanflomed Flexid Floracid Hyleflox Eleflox Ecolevid	Minocycline
	Ecocephron

		Clarithromycin: Arvitsin Clubax Klarbakt Clarexide Clarithromycin Claricin Claricite Claromine Klasine Klacid Clerimed Coater Seydon-Sanovel Lecoclar Fromilid Ecositrine




Amoxicillin + clavulanic acid: Amoxiclav Augmentin Arlet Bactoclav Honeyclave Panclave Ranklav Rapiklav Flemoklav Solutab Ecoclave










			Lomefloxacin: Xenaquin Lomacin Lomefloxacin Lomflox Lofox
		Azithromycin: Zimbaktar Kispar SR-Klaren Sumamed Macropen Azivok Azimicin Azitral Azitrox Azithromycin Azitrocin AzitRus Azicide Z factor Zitrolide Sumaclid Sumamecin Sumamox Sumatrolide Solutab Tremak-Sanovel Hemomycin Ecomed Zitnob Sumatrolide Solution

Ampicillin: Ampicillin Standacillin


Ampicillin + Oxacillin: Ampioks Oxamp			Norfloxacin: Loxon-400 Nolitsin Norbactin Norilet Normax Norfacin Norfloxacin



Oxacillin
Phenoxymethylpe- nicillin


			Ofloxacin: Geoflox Zanotsin Zoflox Oflo Oflox Ofloxacin Ofloxin Oflomak Oflocide Tariwid Tariferid











			Ciprofloxacin: Ificipro Quintor Procipro Tseprova Ciplox Tsipraz Cyprex Tsiprinol Tsiprobay Ciprobid Ciprodox Tsiprolet Cypronate Cypropane Ciprofloxacin Tsifran

		Josamycin: Vilprafen Vilprafen Solutab



		Spiramycin: Rovamycin Spiramisar Spiramycin-Vero



		Roxithromycin: Xytrocin Remora Roxeptine RoxyHexal Roxithromycin Roxolit Romik Rulid Rulitsin









		Midecamycin: Macropen
		Midecamycin: Macropen

The best antibiotic for sore throat

Since purulent sore throats are most often caused by beta-hemolytic streptococcus type A and viridans staphylococcus, the best antibiotics for treating the infection will be those that have a detrimental effect on these pathogenic microorganisms. Currently, the most effective antibiotics for treating sore throat are different groups are the following:

Sore throat is an acute infectious disease that affects the palatine tonsils. The disease often occurs in both children and adult patients. To cope with the disease faster, the doctor may prescribe to the patient antibacterial therapy. To ensure that the treatment does not harm the patient’s body, you need to know which antibiotics are allowed to be taken in tablets for a sore throat in an adult.

When do you need antibiotics for a sore throat?

Treatment of sore throat with antibiotics is important for the bacterial form of the disease. Other types of disease are not affected by such medications. Since in most cases, tonsillitis immediately begins to manifest itself quite acutely (with an increase in temperature, signs of general intoxication of the body, pustular deposits), strong drugs are often prescribed from the very beginning of therapy.

Reception antibacterial drugs permitted only under the supervision of the attending physician. Only if the medicine is chosen correctly can it be possible to quickly and successfully cope with the disease.

It is important to complete the treatment and not give up medications after all the unpleasant symptoms of the disease have disappeared. If not treated, pathogenic microorganisms will develop resistance to the prescribed antibiotic and will need to use a stronger agent next time.

Classification of drugs

To treat tonsillitis, 4 groups of drugs are used:

Penicillins. Doctors usually give preference to drugs in this group if the patient is not allergic to them. First-line antibiotics are available and fast-acting. True, many bacteria develop resistance to them.
Cephalosporins. Such antibiotics can cope with most known bacteria. The doctor will choose second-line drugs instead of penicillins if the patient has a high fever, severe swelling of the mucous membrane, and others severe symptoms. As a rule, medications are used in a hospital setting and in the form of injections.
Macrolides. If allergic reactions are detected to the above drugs, they can be replaced with macrolides. Such medicines cope well with the disease medium degree gravity.
Fluoroquinols. The prescription of antibiotics in this group is determined by severe complications of the disease.

Features of the use of antibiotics in the treatment of angina in adult patients:

In middle-aged and older people, intolerance to a certain drug often occurs; in addition, when treating such patients, it is necessary to know how antibiotics are combined with other medications taken;

A complication in the form of superinfection - develops when antibiotics are abused, as a result the causative agent of the disease acquires resistance and becomes insensitive to most antibacterial drugs medicines;

Violations of the course of treatment due to the irresponsibility and lack of compliance of the patient. This problem occurs less frequently when treating angina in children, since they are usually constantly monitored by one of the parents;

Exacerbation of chronic tonsillitis, in which treatment with antibiotics alone is not enough. Complex therapy is required, including removal purulent plugs in the throat and taking immunomodulatory drugs;

A variety of release forms - adults, unlike children, can take antibiotics in any form: powder, tablet preparations, capsules and injection solutions;

Side effects from taking antibiotics for a sore throat in adults are usually not as severe as in children, but this does not mean there is no risk. In addition to typical side effects (digestion and sleep disorders), non-standard reactions may occur that need to be detected and corrected in time, or the medication must be changed.

Based on the above features, the doctor selects a specific drug for the treatment of sore throat in an adult patient.

The choice of antibiotics for sore throat depending on the situation

Allergy to antibiotics in adults

An allergy to a certain drug can only develop if a person has taken it previously. Accordingly, adults are more prone to allergic manifestations than children, since mature age Every person has taken antibiotics at least once. You must tell your doctor about all antibacterial drugs taken previously and allergic reactions to them.

Most often, adults are allergic to penicillin and antibiotics based on it. Among the drugs in this group, ampicillin, amoxicillin, and phenoxymethylpenicillin are often used to treat angina.

Allergy to penicillin occurs in 6% of adult patients, half of them also have increased sensitivity to cephalosporins. People who are sensitized to both penicillins and cephalosporins are likely to have a beta-lactam ring allergy. This phenomenon is not lifelong; every year 10% of patients in this group lose hypersensitivity to the components of modern penicillin antibiotics.

However, in the presence of allergic reactions to both cephalosporins and penicillins, treatment with macrolide antibiotics is prescribed, the most common of which is erythromycin.

If the patient has never taken antibiotics before, or did so more than ten years ago, then the negative reaction is probably caused by other reasons - within ten years, allergic manifestations disappear in 78% of sensitized patients. You should pay attention to the composition of antipyretics and other drugs that are traditionally used in the treatment of sore throat in adults.

If there is a simultaneous allergy to the beta-lactam ring and drugs of the macrolide group, the patient is prescribed lincosamides; one of the common drugs in this group is lincomycin. They should be taken with caution and only under the supervision of a doctor, as they have many side effects.

High frequency of cases of resistance of the angina pathogen to antibiotics

Amoxicillin is effective and safe remedy for the treatment of sore throat, and is also very affordable. At the same time, treatment of sore throat in adults cannot always be carried out with the help of this antibiotic due to the lack of sensitivity to the drug in the causative agents of the disease. In such cases, it is necessary to use a combination of amoxicillin with clavulanic acid, which protects the antibiotic from destruction and enhances its effect. However, this drug has more side effects than pure amoxicillin, and its price is higher. In some cases, therapy with macrolides may be required, which may have digestive disorders among the side effects.

What causes the sensitivity of sore throat pathogens to antibiotics to decrease?

This is almost always associated with violation of the rules for taking antibiotics:

For example, when self-medicating, adult patients sometimes put drops in their nose or smear their throat with solutions based on crushed antibiotics for systemic use. This is ineffective in treating the disease, since the concentration of the active substance with this method of use is too low to kill the pathogen, but is sufficient for it to get used to and lose sensitivity to the components of the drug;

Any antibiotic has a course of use that must be followed. In most cases, the patient ignores these rules and stops taking the medicine as soon as negative symptoms disappear and relief comes. At the same time, some pathogens remain viable, acquiring signs of antibiotic resistance, and give rise to a population of bacteria resistant to antibacterial drugs;

Preventive use of antibiotics as part of self-medication gives negative results - with frequent use of such drugs, pathogenic microorganisms develop resistance to active ingredients, accordingly, the treatment is subsequently more difficult.

In the 1990s, there was an outbreak in Finland streptococcal diseases, the pathogens of which were resistant to popular antibiotics - macrolides, in particular erythromycin. The fact is that doctors often prescribed these drugs to treat sore throat, even when it was possible to do without them. The decrease in the number of antibiotic-resistant strains of streptococcus was discovered only after the explanatory work of the Ministry of Health.

The attending physician cannot prescribe antibacterial drugs without a preliminary analysis, therefore, before treating sore throat and other infectious diseases, it is necessary to do bacterial culture. The sensitivity test takes three to four days. In most cases, the patient is prescribed one of the common broad-spectrum antibiotics: drugs based on amoxicillin (Amoxilav, Flemoxin Solutab, Augmentin), a complex of ampicillin and sulbactam (Ampisid, Sultamicillin), Azithromycin, Timentin, Cefoperazone, Vilprafen.

The price of the above drugs is quite high, not counting antibiotics based on amoxicillin and azithromycin. As a result, self-medication costs the patient much more than a timely visit to the doctor and strict adherence to his instructions.

For comparison: in most cases, ordinary sore throat is treated with amoxicillin, the price of which is about 100 rubles, while a disease complicated by resistant strains of bacteria requires expensive antibiotics and treatment costs two to three thousand rubles.

The best antibiotic for sore throat in adults - amoxicillin. It is completely absorbed in the stomach and is highly effective against sore throat pathogens. However, if patients were more attentive to the specialist’s instructions and followed the rules for taking antibiotics, then almost any sore throat would be successfully cured with amoxicillin.

Due to the prevalence of resistant strains of angina pathogens, when a diagnosis of angina is made, the patient is required to do a bacterial culture and pay for tests. This makes it easier for a doctor to determine the sensitivity of bacteria to a certain group of antibiotics and prescribe adequate treatment.

Poor performance in adult patients

Improper treatment of sore throat can be as dangerous as completely ignoring the disease. And if among the patients younger age The first situation is more common - worried mothers give their children antibiotics at the first signs of the disease, even if it does not require such radical measures, while adults in most cases suffer from sore throat “on their feet.”

For the treatment of disciplined patients, antibiotics are prescribed in the form of capsules, tablets, suspensions, while patients who are unable to adhere to the course of treatment are given antibiotic injections. The same applies to persons with mental illness and prisoners of correctional institutions. The drugs prescribed in both cases are the same, only the release form and dosage regimen differ.

When it is not possible to monitor the patient’s strict compliance with the doctor’s instructions, bicillin can be used in the form of an injection. Intramuscular injection This antibiotic is very painful, so it is rarely used, but one injection per course is enough so that the patient does not pose an epidemiological threat to others.

Bicillin is prescribed when the doctor is not sure that the patient will be in the hospital for the entire course of treatment for sore throat and is unlikely to listen to the recommendations of a specialist outside the hospital.

Another popular problem among adequate adult patients is ignoring the presence of the disease. Thus, catarrhal and follicular tonsillitis in most cases is carried “on the legs”. Catarrhal tonsillitis has symptoms similar to ARVI, which is why correct diagnosis is possible only with a specialist, whom such patients usually do not reach. A sick person continues to go to work and infect others, and may experience slight discomfort, but prefers to ignore it.

Follicular tonsillitis occurs in a similar way in more than half of the cases. In fear of sanctions from management or because of their own workaholism, patients hide the disease, postponing a visit to the doctor indefinitely; this is facilitated by the mild course of the disease. Even if the patient finds time to visit the doctor, he rarely follows his recommendations exactly, adhering to the same rhythm of life as before the illness, and simply forgets to take the pill on time.

Treatment with antibiotics is more often carried out for the lacunar form of angina - the course of the disease is not so mild, so the patient remains at home and is forced to adhere to the regime, regardless of his plans and preferences.

Thus, the doctor’s task is to create the most comfortable treatment regimen for the patient, which will not be difficult to adhere to. One of the common antibiotics for sore throat in adults is azithromycin, it is taken in a course of three tablets, one per day.

Self-medication using recipes found on the Internet can lead to serious complications diseases. Some patients with sore throat prefer this option, since it is not as costly in terms of money and time as a visit to a specialist. However, treatment at home in most cases leads to the abuse of antibiotics, since sore throat is easily confused with viral pharyngitis. Viral diseases cannot be cured with antibacterial drugs; they only contribute to the formation of resistant strains of bacteria. Moreover, the risk of fungal infections of the larynx and oral cavity increases as a side effect of uncontrolled use of antibiotics.

A very common Internet request is “treatment of bronchitis and sore throat with antibiotics.” You should know that inflammatory diseases lower respiratory tract infections are most often caused by a viral infection, so treatment with antibacterial drugs in this case is useless. In this case, complications in the form of a fungal infection are almost inevitable; moreover, taking antibiotics for viral inflammations throat is ineffective, since sore throats in the classic form with similar symptoms No.

An irrational approach to the treatment of angina leads to complications and aggravation of the disease, its transition to a chronic form.

Chronic tonsillitis during the period of exacerbation has symptoms similar to sore throat, which creates difficulties for the doctor. Many patients resort to self-medication, which complicates diagnosis and treatment.

In case of chronic tonsillitis, which develops due to untreated sore throat, the specialist is faced with two problems:

Prescribing a specific type of antibiotic is quite difficult, since the causative agent of the disease may be resistant to any drug;

Complex therapy is required using additional measures– washing the lacunae and antiseptic treatment of the tonsils.

In most cases, chronic tonsillitis is a consequence of improper treatment of sore throat without the use of antibiotics. Symptomatic therapy eliminates the negative manifestations of the disease, without affecting its cause - the causative agent of the inflammatory process. Treatment of tonsillitis is a complex and lengthy process. With frequent exacerbations and ineffective conservative treatment the doctor may suggest surgery– removal of tonsils.

Surgery to remove tonsils and rehabilitation period takes two weeks, the same amount of time on average for a course of timely treatment with antibiotics, and the decision on this issue remains with the patient.

Interaction with other drugs

One of the main difficulties in treating sore throat with antibiotics in adult patients is the optimal combination of drugs. Patients in the older age group often have accompanying pathologies, and take other medications in parallel with antibiotics. Antibacterial drugs should not reduce the effectiveness of other medications or aggravate their side effects.

There are several rules for this:

Cyclosporines should not be taken together with azithromycin and penicillins, as this increases toxic effect;

Amoxicillin in combination with clavunalic acid should not be taken simultaneously with probenecid;

At renal pathologies Penicillin-based antibiotics should be used with extreme caution.

That is why, before prescribing antibiotics for a sore throat to an adult patient, the doctor must carefully study the medical history and obtain all the information about medicines that a person is currently using.

Side effects

The most common side effects of antibacterial drugs are dyspeptic disorders and allergic reactions. At the same time, the doctor’s approach to prescribing a particular drug must be individual; the drug is selected depending on the patient’s age and current state of health. Thus, children more often experience dyspeptic disorders as a side effect of antibiotic treatment, and negative reactions manifests itself more pronouncedly than in adults. In patients of the older age group, allergic reactions and side effects associated with incompatibility of medications taken simultaneously are more common. An allergy to antibiotics can be very dangerous, in some cases even causing the death of the patient as a result of anaphylactic shock.

Therefore, when the slightest sign If there is a non-standard reaction to the drug, it should be replaced with a more suitable drug.

A large number of drug forms

This feature of the use of antibiotics in the treatment of sore throat in adult patients, in contrast to the above aspects, does not complicate the doctor’s work, but, on the contrary, facilitates it. Thus, it is not always possible to prescribe antibacterial drugs in tablets to children, since chewing or swallowing may be difficult. The injectable form of antibiotics for sore throat is also better suited for adults than for children, since people of conscious age are not afraid of injections and understand the necessity of the unpleasant procedure.

The tablet form of the drug is convenient for use by adult patients, since there is no need to specifically calculate the dosage. The amount of active ingredient in an antibiotic tablet is initially designed for an adult, and powders must be measured depending on the patient’s body weight. Most often, the course of treatment of sore throat with antibiotics in adults involves taking the drug one tablet three to four times a day.

The specificity of the use of antibiotics implies the supervision of a doctor during the treatment process, since in the absence of the necessary theoretical training it is impossible to prescribe a suitable remedy.

And self-medication often leads to aggravation of the problem and creates unnecessary health risks. As a result, the money saved on consultation with a specialist is spent on treating the consequences of improper therapy.

Which antibiotic is best for a child or an adult to take for a sore throat?

Determine the most effective antibiotic in each individual case - the task of the doctor with special training. Does not exist universal remedy, which helps everyone and always. As a rule, a sore throat can be cured effectively and inexpensively using modern antibiotic penicillin series - amoxicillin. However, this remedy is not suitable for people who are allergic to penicillin, as well as for patients whose sore throat pathogen has developed resistance to this drug.

Most antibiotics have no contraindications for use in the treatment of sore throat in children, even in infants. Naturally, as in other cases, it is necessary to strictly adhere to the recommendations of the attending physician. Let's consider choosing the most appropriate antibiotic for children, starting with amoxicillin. The principles by which a doctor determines which drug to prescribe for a child are similar to the choice of drug for treating adults.

Why is amoxicillin the most effective antibiotic for sore throat?

Amoxicillin was originally developed as a replacement for the popular antibiotic penicillin. It was required that new drug would retain all the advantages of its “ancestor”, but would not have the disadvantages. Amoxicillin was invented in the early 70s, and within a few years it began to be widely used in medical practice. This antibiotic not only effectively treats sore throat and other bacterial diseases, but is also affordable for most patients.

The advantage of amoxicillin as an antibacterial drug:

Shows high effectiveness in the treatment of bacterial infections whose pathogens are not resistant to penicillin antibiotics, prevents the development of complications;

Does not have a depressing effect on beneficial microflora intestines, does not provoke dyspeptic disorders and other side effects;

It has high bioavailability and is almost completely absorbed by tissues (93% of the active substance). This distinguishes amoxicillin from other drugs of the penicillin group, even those with greater potency;

A variety of release forms - tablets, capsules, powders, suspensions, injections, which allows the product to be used to treat patients of all types age groups;

One of the most affordable antibiotics - a blister with 10 tablets costs about 40 rubles, which makes it accessible to all categories of the population.

Other antibiotics do not have such a number of advantages, but may be needed in cases where amoxicillin is powerless. Therefore, you should not doubt the qualifications of the doctor who prescribes you another drug for the treatment of sore throat: despite the fact that amoxicillin is the most effective remedy in standard cases, in some forms of the disease complicated by a resistant infection, it does not give the desired result. The specialist selects an antibiotic for a sore throat individually depending on the characteristics of the disease, medical history, and health status of the patient.

Amoxicillin effectively treats sore throat in adults, but is also prescribed for young children, including infants infancy, as it has a gentle effect on intestinal microflora without causing dysbacteriosis. For infants, amoxicillin is prescribed in the form of a powder from which a suspension is made.

The following drugs are made based on amoxicillin: Flemoxin Solutab, Augmentin, Amoxiclav, Ranoxil. All of them are suitable for the treatment of purulent tonsillitis, acute tonsillitis in children and adults, and have affordable price and a minimum of side effects. With a correctly prescribed drug, sore throat and its unpleasant symptoms eliminated in five days.

The drug Augmentin deserves special attention - a product that contains not only amoxicillin, but also clavulanic acid. That in itself excipient has a weak antibacterial activity, its main function in the complex is to protect the active substance from destruction by bacterial enzymes. Thus, Augmentin effectively fights even strains of microorganisms resistant to amoxicillin. The complex of active ingredients is safe to use and does not produce additional side effects. The only drawback of the drug in comparison with antibiotics, which only contain amoxicillin, is relatively high price, about 300-400 rubles per package. Other drugs based on this complex: Amoxilav, Bactoclav, Panclave, Ecoclave. To be on the safe side, doctors prescribe them immediately instead of regular amoxicillin.

The downside of this popular antibiotic is a number of problems that arose precisely because of its widespread availability and wide application. Since amoxicillin is often prescribed to treat bacterial diseases, including sore throats, in some cases even without accurate diagnosis, many microorganisms have become resistant to the active ingredient of the drug. And with frequent use of this drug, the patient may develop hypersensitivity and allergic rashes. At the same time, resistant strains of bacteria may not respond to treatment even with a complex of amoxicillin and clavulanic acid. This forces doctors to look for an alternative option.

If for some reason treatment with amoxicillin does not produce results, then a replacement drug is sought among other antibiotics from the penicillin group, provided that the patient is not allergic to them. If penicillin antibiotics provoke allergic reactions, the doctor prescribes cyclosporines, and only as a last resort, in case of allergies to drugs of both groups ( increased sensitivity to the beta-lactam ring), macrolides are used.

Groups of antibiotics used to treat sore throat in adults (in descending order of preference):

Penicillins. The most ancient and popular drug of this series is penicillin itself; it is usually used by injection if amoxicillin is not at hand. The same applies to other drugs of the penicillin group - ampicillin, phenoxylmethylpenicillin and benzathine benzylpenicillin. They are not as effective as amoxicillin, have less bioavailability and absorption, are less safe in terms of side effects, and provoke the same allergic reactions in patients sensitive to penicillin. They are still used in field conditions, if there are no other antibiotics, as well as in correctional institutions, when treatment is necessary a large number people in a short time - then penicillin is used in the form of intramuscular injections;

Cephalosporins. The drugs Cedrox, Duracef, Biodroxil belong to the group of cephalosporins based on the active substance cefadroxil. They are a worthy alternative to penicillin antibiotics, therefore they are prescribed to adult patients with sore throat with an allergy to amoxicillin or high resistance of pathogens to penicillin drugs. Other popular cephalosporins are cefaclor, cefazolin, cephalexin;

Macrolides. If the causative agent of the disease is resistant to antibacterial drugs with a beta-lactam ring, treatment of angina in adult patients is carried out using macrolides. This group of drugs successfully fights streptococci and staphylococci, which most often provoke inflammatory processes in the upper respiratory tract. Macrolides form high concentration active substance in tissues, inhibiting pathogenic microflora. Their effect is so strong and effective that a seven-day course of treatment is usually sufficient to destroy the causative agents of sore throat and complete recovery. The most popular drug in this group is Azithromycin; clarithromycin, midecamycin, josamycin, roxithromycin and other drugs are also used to treat angina. But antibiotics of a number of macrolides have a significant drawback - a pronounced side effect in the form of digestive upset. This back side the high effectiveness of these drugs and the strength of their destructive effect on microflora. Macrolides inhibit not only pathogenic strains that provoke sore throat, but also beneficial intestinal microflora, so they are prescribed with great caution. Another disadvantage of macrolides is their high price, compared to penicillins;

Lincosamides are prescribed when it is impossible to use the above antibiotics. With their sufficiently high efficiency, main drawback– pathogenic microorganisms quickly get used to the drugs, developing resistance. Popular means This group includes lincomycin and clindamycin.

Interestingly, even the very first antibiotics can be successfully used to treat tonsillitis, which is why they are most often purchased for field work and various expeditions because of their low cost and ease of use. After the decline of the first wave of development of resistance to penicillin in bacteria, new antibiotics were invented, and penicillin itself almost ceased to be used. Therefore, now that the variety of drugs and strains of bacteria resistant to them is very large, resistance to the world’s first antibiotic in microorganisms is gradually being lost.

Return phenomenon high sensitivity to penicillin in many bacteria that infect the upper Airways, makes it possible to cure a sore throat with injections of this antibiotic, although this is very inconvenient, because the success of treatment depends on compliance correct doses and time of administration. But in the field, you have to put up with the lack of more modern drugs and endure a course of 60 injections over 10 days in order to maintain a high concentration of the antibiotic every 4 hours.

Sometimes in field first aid kits there is another ancient antibiotic– the first open representative of the group of macrolides – erythromycin. Like all modern macrolides, erythromycin can adversely affect the intestinal microflora, which is why therapy with this medicine is often associated with digestive disorders: nausea, diarrhea, bloating, lack of appetite and constipation. However, the effectiveness of erythromycin for angina leaves no doubt - after a 10-day course the disease goes away, in some patients even without side effects.

How to choose the best antibiotic for a sore throat?

Regarding antibiotics, it is difficult to talk about more or less preferable drugs for children compared to adults.

You cannot prescribe an antibiotic for a sore throat on your own!

After all, the essence of the work of an antibiotic is its action on pathogens, which in any case are represented by the same set of bacteria. Simply put, amoxicillin is the best antibiotic for a sore throat.

Macrolides (josamycin, azithromycin) can also be prescribed to children of any age, but subject to doctor's recommendations and measures to prevent side effects. Due to difficult absorption by the body and high probability manifestations of the same side effects, some antibiotics (for example, clarithromycin or cefadroxil) cannot be prescribed to infants under six months of age. Clarithromycin is a derivative of erythromycin, so it is almost guaranteed to provide the baby digestive disorder, which his body may subsequently not be able to cope with.

If amoxicillin does not produce the desired effect for a sore throat or causes an allergy, only a doctor can find and prescribe a replacement for it.

Among the factors that a specialist must take into account in order to make right choice, includes:

Patient's health status;

Age and weight;

The presence of allergic reactions to the components of the drugs of choice;

Data microbiological research(type, strain and degree of bacterial invasion).

Most parents make the common mistake of considering antibiotics too dangerous and resorting to them only when as a last resort. Tonsillitis is a rather serious disease even for adult patients, especially for a child, and it is better not to mention the consequences of sore throat during complications without reason. Home and folk remedies A child's sore throat can be cured with early stages, subject to sufficiently strong immunity and strict adherence to the regime. In most cases, these measures are not enough, and the disease develops to extreme stages. Children with tonsillitis are often brought to doctors because they have literally “cultivated” pathogenic bacteria in the body to such an extent that treatment must begin with the opening of purulent formations on the tonsils.

The experience of many parents shows that at the first signs of a sore throat (which is very easy to diagnose in a child, since the first thing he will do is report that it hurts to swallow and doesn’t want to eat), you need to visit a doctor and boldly use the antibiotic he prescribed. Most often, this is a drug based on amoxicillin: Amoxiclav, Augmentin, Ranoxil, Flemoxin Solutab. The most important thing is to adhere to the prescribed doses and observe full course treatment, otherwise a relapse of the disease may occur, the pathogens of which will be resistant to the antibiotic already used.

New generation antibiotics for sore throat: how good are they?

New generations of antibiotics rarely have any revolutionary properties in the treatment of a particular disease. the main objective their creation is the fight against microorganisms that have developed resistance to existing antibiotics and have spread among the population. That is, they act on bacteria in a similar way, which means there is no point in choosing a new generation drug without any particular reason.

Among those “special reasons” for choosing treatment with new generation antibiotics, there are only two factors:

Resistance of the pathogen of tonsillitis to the most common antibiotics in the presence of sensitivity to a new, recently invented drug (situations are possible in which a bacterium that has successfully developed resistance to one antibiotic becomes invulnerable to all antibiotics of this type, including new ones and not even those that have not yet been invented) ;

Hypersensitivity or allergy to traditional drugs.

When you get a sore throat and the first unsuccessful attempts to cure it with traditional antibiotics, you turn to new generation drugs: ticarcillin, roxithromycin, telithromycin, cefpirome, etc. They will cope with the disease as quickly as regular ampicillin or amoxicillin.

A logical question arises: if there is no difference in the action of these drugs, but new generation antibiotics are capable of affecting any bacteria, including those strains that have managed to develop resistance to traditional drugs, then why not always use only the most modern drugs? The answer is very simple - pharmaceuticals new generation ones always cost several times more than traditional ones.

This is especially true for antibiotics, regardless of class. For example, for a course of Timentin (a ticarcillin derivative) consisting of four bottles of injection solution, you will have to pay about 3 thousand rubles. This is 15-20 times more cost conventional drugs. Therefore, new generation pharmaceuticals are used only in hopeless situation when therapy with proven antibiotics does not produce any results.

The above-mentioned reasons for the use of new generation antibiotics must be supplemented by fairly common cases of provoking allergies or resistance in bacteria when antibiotics are used independently. Due to interruption of the course of treatment for sore throat traditional medicine most often there is a relapse, which, in the case of tonsillitis, gives complications, but can no longer be cured with a simple and inexpensive antibiotic. In the end, when the unfortunate patient comes to the doctor, he has no choice but to shell out his monthly salary (or even more) for a full course of a newly invented drug that can cure a sore throat.

If you have never used antibiotics and do not know the consequences of interrupting the course of this type of medication, do not under any circumstances try to save money by choosing a specific drug on your own or on the advice of a friend and taking it only until the symptoms of the disease disappear. Today you will underpay a hundred or two rubles for a few tablets, and in a few days you will pay a thousand or two for similar tablets and similar treatment, but using modern means.

Also, all new generation antibiotics have one common contraindication: pregnant women and nursing mothers should not take them due to the lack of data on the effect of a particular drug on the condition of the fetus or infant fed breast milk with the components of the drug. This information appears in the instructions and in the public domain usually after six months or even several years of sales and use of the drug.

Education: In 2009, he received a diploma in General Medicine from Petrozavodsk State University. After completing an internship in the Murmansk regional clinical hospital received a diploma in the specialty “Otorhinolaryngology” (2010)

The best time to attack the body with infectious agents is when the immune system is weakened. The causative agents of the disease can not only enter from the outside, but also become active, being part of the opportunistic human microflora. These include staphylococci, streptococci, which are the main causative agents of tonsillitis, and since the infection has bacterial nature, tonsillitis must be treated with antibiotics.

The choice of one drug or another depends on the patient’s age, type of sore throat, the presence of allergic reactions, and the ability to combine several drugs during complex therapy. The doctor must take all factors into account when prescribing antibiotics for tonsillitis.

Antibiotics should not be regarded as a panacea for any infection that develops in the throat. Even the best drugs broad spectrum of action may be powerless. The reason is that not only bacteria can cause disease.

Sore throats are:

Viral etiology. They are distinguished by their ease of flow and short duration. Risk of complications with viral tonsillitis minimal. Most often, these forms affect children aged 1–3 years. Pathogens are transmitted from an infected person by airborne droplets. These include viruses: influenza, Epstein-Barr, measles, herpes, adenovirus, enterovirus, rhinovirus, coronovirus. Viral sore throats are not treated with antibiotics. Complex therapy with the use of antiviral drugs will be required.
Bacterial etiology. The most common causative agent is group A beta-hemolytic streptococcus. The disease is characterized by an increase in temperature up to 40˚, accompanied by intense sore throat and signs of general intoxication of the body. The main danger of bacterial tonsillitis is the high risk of complications. In addition to the pathogens mentioned above, they can be diplococci, pneumococci, and enterobacteria. If the causative agent is bacteria, treatment of sore throat with antibiotics is mandatory.
Fungal. These are rare forms of tonsillitis, occurring mainly in children under 1 year of age. They occur when immunity decreases, against the background long-term use antibacterial drugs.

Fungal tonsillitis is characterized by mild symptoms and the presence of a plaque resembling cottage cheese on the mucous membrane of the tonsils. Usually the causative agents are fungi of the genus Candida. Treatment of such forms is carried out with antimycotic drugs, and the use antibacterial agents can only prolong the recovery period.

IN separate form ulcerative film sore throat of Simanovsky-Plaut-Vincent was isolated. Its causative agents are a spindle-shaped rod and a spirochete, which are in symbiosis.

Streptococcal sore throats are the most common and cause complications due to the fact that the causative bacteria contain proteins similar to connective tissues person. Cells immune defense destroy not only infectious agents, but also healthy organs. This is especially reflected in the functioning of the heart, kidneys, and the condition of the joints.

Read also: Giving injections for sore throat

As a result of the fight between lymphocytes and bacteria, pus is formed, filling the lacunae and follicles of the tonsils. This explains why bacterial acute tonsillitis is called purulent.

Antibiotics for streptococcal sore throat- a mandatory element of therapy.

How to recognize bacterial tonsillitis?

Acute tonsillitis caused by bacterial infection, differs in symptoms:

the presence of mucus with pus in the recesses of the tonsils;
severe pain in the throat, radiating to the ear;
a sharp jump in temperature to 39-40˚;
discomfort when palpating the lymph nodes;
no runny nose, cough.

Based on these signs and based on your medical history, you can suspect acute tonsillitis, and the results of laboratory tests will help you choose the most effective antibiotic for a sore throat.

How many days should you take antibiotics for a sore throat?

The ultimate goal of using antibacterial drugs is to destroy the source of infection and prevent the development of complications.

Important! If after 3 days the patient’s well-being has improved, it means that the drug was selected correctly and the treatment does not need to be changed. A positive result is not a reason to stop therapy.

It is necessary to complete a full course of antibiotics to treat a sore throat. On average, its duration is 7-10 days. If the course is shortened, in 7 out of 10 patients the disease recurs within 1 month.

When visiting a doctor, you may have doubts about the etiology of the disease. Then a smear culture and blood donation are carried out. Test results usually come in 3-4 days. During this period, sore throat will not cause complications, so you should not take antibiotics without direct indications.

Antibiotics for sore throat

Antibiotic therapy is the use of tablet forms of drugs orally, their intravenous administration, use in the form of drops, syrups.

There are several groups of antibiotics that neutralize pathogens of sore throat with pus: penicillins, cephalosporins, macrolides.

What antibiotics should be taken for sore throat in adults?

It is often more difficult to cure an adult than a child. There are several reasons:

High likelihood of an allergic reaction. Development negative consequences possible if the adult previously took the prescribed drug. Before reaching the age of 18 years, there is a high probability that the medicine has been taken previously, which means that it is entered as a stranger in the “database” of immunity, and with each new encounter with it the body will react allergic manifestations. If a patient has an allergic reaction to a prescribed antibiotic, an analogue is prescribed.
Uncontrolled unauthorized taking of medications without consulting a doctor. As a result, when really needed drug therapy, drugs are powerless in the fight against infection.

Important! Do not use topical antibiotics for sore throats intended for internal use, use them for the purpose of prevention, reduce the course of admission. This leads to a decrease in the sensitivity of bacteria to the active components of the drugs, and further treatment takes longer and requires a search for similar medications.

Penicillins

The best antibiotics against sore throat are penicillins. Their action is aimed at suppressing the synthesis of protein - peptidoglycan, necessary for the construction of the bacterial cell wall. As a result, infectious agents die. There is such a small amount of peptidoglycan in the human body that the effect of the drug will in no way worsen the condition.

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The bacteria, in turn, adapt to the effects of the drugs and produce a substance - beta-lactamase, which resists the action of penicillin. This led to the need to create synthetic analogues of the drug.

For purulent sore throat in adults, natural, semi-synthetic antibiotics are used. The best antibiotic for sore throat is Amoxicillin, a drug of semi-synthetic origin. Its distinctive features:

effectiveness against many pathogenic microorganisms, preventing the development of complications;
gentle effect on intestinal microflora;
rapid absorption by tissues and prompt elimination of the source of infection;
the possibility of using antibiotics for the treatment of sore throat in adults and young people due to the variety of release forms;
accessibility for any category of the population, thanks to its wide distribution in pharmacy chain and low cost.

Antibiotics in tablets for sore throat are prescribed to adults, and in the form of syrups to young children.

Preparations containing only amoxicillin as an active ingredient: Amoxicillin, Hiconcil, Amosin, Ospamox, Flemoxin Solutab.

Combined preparations with amoxicillin and clavulanic acid: Amovycombe, Amoxiclav, Arlet, Augmentin, Bactoclav, Medoclav, Novaclav, Panclave, Trifamox, Flemoclav Solutab, Ecoclave. Clavulanic acid in the composition of the drugs prevents the destruction of amoxicillin by enzymes.

The drugs in this group are used for 5-7 days as prescribed by a doctor. If a person is allergic to these drugs, you can replace them with others of the same name active ingredients(DV):

Ampicillin trihydrate;
Phenoxymethylpenicillin;
Benzathine benzylpenicillin (analogs: Bicillin-5; Retarpen).

Antibiotics for purulent tonsillitis can be used after the exacerbation is eliminated. The procedure is called “bicillin prophylaxis”. A long-acting drug - Bicillin-5 is administered once every 21-28 days for six months. The antibiotic is effective for chronic tonsillitis in adults.

For allergies, individual intolerance penicillins, another group of drugs is prescribed.

Cephalosporins

The medicine is based on cefadroxil. They act similarly to penicillins and help when the latter are unable to cope with the infection.

Antibiotics have a positive effect for follicular tonsillitis, since they are active against many gram-positive cocci.

Cephalosporin antibiotics for tonsillitis in adults are used from representatives of the 1st and 2nd generations.

These include:

1st generation: Cephalexin, Cefazolin, Cefadroxil;
2nd generation: Cefaclor (Ceclor), Cefuroxime (Zinacef, Ketocef), Cefuroxime Asketil (Zinnat).

Important! Cefepime is very effective - an antibiotic for purulent sore throat, belonging to the 4th generation drugs. He has wide range actions, but is used only under medical supervision, since the side effects from its use have not been studied.

Macrolides

Antibiotics from the macrolide group are potent. 5 days of use are enough for the disease to subside.

Their main advantage is their effectiveness against streptococci, staphylococci, and at higher doses - pneumococci, diphtheria viruses, and whooping cough. Low toxicity of the drugs is also noted. A significant drawback is the negative impact on the digestive organs, increased risk of dysbacteriosis.

The most common antibiotic for angina in adults in tablet form, belonging to the macrolide group, is Azithromycin. The duration of treatment with the drug is minimal - only 3 days, but in some cases the doctor may extend treatment up to 6 days.