If you have a sore throat. How to treat a sore throat at home - the best and most effective recommendations

Duration lacunar tonsillitis about 6-8 days, when complications occur, the duration of the disease increases.
In other cases of tonsillitis, the clinical picture depends on the underlying disease.

Sore throat with diphtheria

Diphtheria - an acute infectious disease characterized by the development of an inflammatory process, as a result of which a dense, adjacent film is formed at the site of introduction of the pathogen. The causative agent is the diphtheria bacillus, which is transmitted by airborne droplets. Typically, the vocal cords are damaged. In some cases, bacteria affect the tonsils.
A severe form of tonsillitis is usually characterized by a sudden onset, after 2-5 days after contact with an infectious carrier. The following symptoms may be added to the general manifestations of intoxication:

• Choking cough
• Dyspnea
• Respiratory failure
• Symptoms of damage to the central nervous system (CNS)

The evolution of the disease is unfavorable; lethal outcomes are possible if treatment is not provided or not proper treatment.

Sore throat with flu

One of the most common viral infections is flu. Flu is transmitted by airborne droplets, so it is very easy to get infected.

Typically, sore throat is associated with:

• rhinitis (inflammation of the nasal mucosa)
• conjunctivitis (inflammation of the conjunctiva of the eye).

The clinical picture is similar to other forms and is blurred against the general background of influenza. With proper treatment it progresses favorably.

Sore throat with scarlet fever

Scarlet fever - an acute infectious disease characterized by an acute onset with symptoms of sore throat and pinpoint skin rashes. The main pathogenic pathogen is β - hemolytic streptococcus group A.
The clinical feature is:

• Gray plaque on the palatine tonsils, which, unlike plaque with diphtheria, is easily removed. Purulent plaque can spread to the soft palate, arches, and uvula.

• A pinpoint rash and peeling of the skin, but in the area of ​​the nasolabial triangle the skin remains unchanged.
• A crimson tongue is one of the signs of scarlet fever.
• Regional lymph nodes – enlarged
• Headache
• Chills

Children are most often affected by this form. younger age, and occurs with severe intoxication. Temperature up to 40°C, may be accompanied vomiting.

Sore throat with infectious mononucleosis

Infectious mononucleosis (monocytic tonsillitis) is a disease with airborne transmission and an acute onset. The cause of the origin of this disease has not been fully studied; there are viral and bacterial theories.

Clinical picture
The incubation period takes about 45 days. At the initial stage the following are noted:

• slight malaise
• sleep disturbance

There are several main symptoms:

• Angina
• Leukocytosis (increased white blood cells in the blood) with a large number of monocytes and lymphocytes
• Enlarged liver and spleen
• Heat.
• It is also accompanied by an increase in regional lymph nodes.

The palatine tonsils initially show changes of a banal sore throat, then the disease progresses with the formation of permanent dirty-gray plaques. In children, there is a significant enlargement of the palatine tonsils. Having increased in volume, they can converge along the midline, closing the lumen of the respiratory tract.

Bacterial or viral toxins penetrate the blood, spreading with current throughout the body, disrupting the function of other systems: the cardiovascular and central nervous systems.

Diagnosis of sore throat

It can be divided into three main points that are necessary to determine the form and stage of sore throat.

Clinical examination
Clinical examination is the main method in diagnosing almost all diseases; it allows the doctor to study the patient’s condition without auxiliary laboratory tests. This examination is very important as it provides most of the information about the patient. With its help, the doctor can develop a plan for further action (diagnosis and treatment) Includes:

• Finding out the reason for the patient’s request and complaints, that is, all the information about the disease. It is the first step to making a correct diagnosis. It is necessary to find out how long ago the first symptoms began, any treatment was undertaken, if any, what the effect was and other information that the doctor needs. When visiting a doctor, the patient must answer all questions - frankly, without hesitation.
• External examination and palpation of the neck, parotid and occipital areas.
• Pharyngoscopy – examination of the oral cavity and pharynx using a medical spatula. An examination of the mucous membrane is carried out by a general practitioner, pediatrician or ENT doctor.

The doctor examines the following areas under bright light:

• Mucous membrane of the soft palate
• Conditions of the cavity walls
• Gum
• The mucous membrane of the palatine tonsils.

With angina, changes are detected: the palatine tonsils are inflamed, may be increased in size, and depending on the form presented, they may have a purulent coating of a specific color on the surface. The folds in the tonsils can be filled with pus, which can be released into the oral cavity when pressed. In chronic tonsillitis, purulent plugs can be detected that cover the lacunae.
To determine the shape of a sore throat, the contents of the lacunae are isolated. Inflammation may spread to adjacent tissues, so the back wall of the pharynx is examined. Normally, small granules of lymphoid tissue can be seen. Thus , pharyngoscopy is a key method in determining the stage of angina and its form.

• Percussion and auscultation of the respiratory, cardiovascular and other systems at the discretion of the physician.

After carrying out the above clinical examination The doctor can make a preliminary diagnosis and prescribe additional laboratory and instrumental examinations to obtain the necessary information.
Laboratory diagnostics:

• CBC (complete blood count) to determine symptoms of inflammation, anemia . For example, mononucleosis tonsillitis is characterized by an increase in the level of monocytes (normal 5-10%), lymphocytes (25-40%)

• The bacteriological method consists of collecting material (pathogens from the mucous membrane) and inoculating it on a nutrient medium. The nutrient medium promotes the reproduction and growth of bacteria, it contains all the nutrients and other conditions necessary for this. After which a pure culture can be isolated for further study. May be uninformative, since the oral mucosa and all its components are normal Nutrient medium with a culture of bacteria grown.

Swab from the throat and nasal cavity to exclude diphtheria process. The contents are collected from the palatine tonsils, as well as from the wall of the pharynx using a spatula. As a result, samples are taken for identification hemolytic streptococcus, since in most cases it is a pathogenic agent. Specific forms of tonsillitis are characterized by the release of other pathogens. For example, for diphtheria - Corynabacterium diphteriae.

Diagnosis of complications of angina

Against the backdrop of an aggressive course of sore throat or its transition to a chronic form, complications often arise that require additional diagnostics.

Frequent studies performed when diagnosing complications of angina:
Laboratory blood tests (serological tests) - make it possible to determine the severity of the body’s inflammatory response and the presence of an autoimmune process.
The infectious process activates all immune processes of the body, and therefore the titer of antibodies to toxins And antigens ( unknown substances for the human body ) streptococcus - streptolysin O, hyaluronidase, streptokinase. Increase titer antistreptolysin O(antibodies) characteristic of:

• sore throat
• scarlet fever
• glomerulonephritis(inflammation of the renal glomeruli)

Very high numbers for rheumatoid fever. As a rule, the numbers increase impressively 7-10 days after infection and decrease after recovery. This study requires repeated blood sampling, as sometimes the numbers may decrease, giving hope for recovery.

Echocardiogram– allows you to identify the anatomical data of the heart
EchoCG is a research method that allows you to determine heart valve defects using ultrasonic waves.Since sore throat chronic course causes complications in the heart, namely its valve apparatus, an echocardiogram (EchoCG) is necessary before and after treatment.

X-ray of bones and joints
This examination is prescribed for suspected autoimmune joint damage in rheumatic diseases.
The clinical picture includes:

• high temperature
• joint pain and limitation of movement
• symmetrical joint damage
• swelling in the joints, which may last for about a week, then subsides for a period of time.

Modern methods of treating sore throat

To begin with, it should be noted that treatment should begin with improving the general condition and restoring the immune system. No medicine will help, how good dream, proper balanced nutrition, drinking plenty of fluids and avoiding stressful situations. Stress is an unfavorable factor, as it contributes to a decrease in immunity and a deterioration in the general condition of the patient. For recovery, the following points of non-drug treatment must be observed.

Non-drug treatment consists of following a diet, regimen, hygiene

• Bed rest, that is, the patient should not endure the disease physically exhausted. Exclude physical stress.
• Ventilate the room in which the patient is located at least twice a day.
• Proper nutrition, mainly plant-based and easily digestible foods high in vitamins (especially vitamin C)
• Various warming compresses (alcohol) in the area of ​​inflamed lymph nodes.
• Herbal inhalations: chamomile, sage.

Herbal infusion of sage used for inhalation and rinsing. In production in the following way: two tablespoons of crushed sage leaves are poured into 1 or 2 glasses of boiled water and heated for about 20 minutes. Then leave for about half an hour and remove the leaves. To reduce the concentration, add a glass of water. You can rinse several times a day. This solution can also be used for inhalation.

Herbal infusion of chamomile It is done as follows: 1-2 teaspoons of chamomile are poured into 1 glass of water. Boil, then leave for about half an hour, then strain and use for rinsing several times a day or orally one teaspoon after meals.

It is necessary to remember that warming compresses and inhalations can be carried out at normal temperatures.
Drug treatment
In some cases, without treatment with medications, it becomes impossible to avoid complications and recover within a reasonable time - in this case, doctors are forced to resort to prescribing medications that can help your body cope with infectious process.

Treatment with antibiotics

The need to prescribe antibiotics depends on many factors: the form of sore throat, concomitant diseases, and the presence of complications. Catarrhal sore throat is mild form sore throats, so local treatment is used in the form of rinses. Antibiotic treatment is prescribed for:

• Follicular and lacunar form, when purulent foci of infection are present.
• When β - hemolytic streptococcus of group A is isolated in a smear and other types of microorganisms with a characteristic clinic.
• Complicated forms of bacterial infection.

When antibiotics are prescribed in mild forms, resistant forms develop, which in the future will no longer respond to these drugs. Consequently, treatment will be much more difficult. Proper treatment is very important, so in any case you should consult a doctor.
First, broad-spectrum antibiotics are prescribed. There are different groups of antibiotics, the mechanism of action of which is different. The main importance of using antibiotics is to prevent the development of complications of streptococcal infection. The most common are the following:

Penicillins - amoxicillin, benzylpenicillin and others. Drugs in this series have best results in the fight against streptococcal infection.
Injectable forms of benzylpenicillin are used in the dose:

• for teenagers and adults - 1.5-4 million units per day
• for children 400,000-600,000 units.

Augmentin (Amoxicillin and Clavulanic acid) is one of the drugs of choice. This drug is more stable and protected from streptococcal toxin. The course of treatment should not exceed 14 days.
The dosage regimen is selected individually depending on
-masses
-age
-stages of the infectious process

Approximate destination scheme:

• In mild forms of the disease for children up to 2-6 years Prescribe 5 ml (body weight 12-20 kg), divided into 2-3 doses. Children over 6 years old - 10 ml (body weight - up to 40 kg)
• In severe forms, the dose is doubled, that is, for children from 2-6 years appoint 10 ml, children over 6 years old 20 ml. 2 times a day at intervals 12 hours.
• For adults calculated 40 mg/kg/day, if the reception is divided into 3 receptions and 45 mg/kg/day for 2 appointments.

This diagram is provided for internal use. It is recommended to use the drug before meals.

Cephalosporins - cefazolin, ceftriaxone and others
It is used parenterally (intramuscularly or intravenously). The dosage is selected individually and calculated by the doctor. The course of treatment should not exceed 14 days.
Dosage schedule:
Adults from 500 mg-2 g, 2-3 times a day (every 8-12 hours)
Children under 12 years old 30 mg/kg/day with an interval of 12 hours

Macrolides – erythromycin, clarithromycin and others
Used less frequently than the first two groups. Erythromycin is dosed individually. The course of treatment is up to 7 days. Treatment regimen:

• For adults 0.5-2 g 4-6 times a day.
• For children under 14 years old 20-40 mg/kg. Also 4-6 times a day.

Antibioticogram - identifying the most suitable antibiotic for a specific infectious agent that caused a sore throat is prescribed to speed up and reduce possible complications of the disease.

Antihistamines (antiallergic)

Due to the fact that antibiotics often cause allergic reactions, antiallergic drugs are prescribed in parallel. Eg:

• Diazolin
• Diphenhydramine

Preference is given to Suprastin, as it has fewer side effects. Prescribed to prevent allergic reactions. One tablet contains 25 g of active substance. Prescribed:

• 2-3 tablets for adults.
• For children from 1 month to 14 months, ¼ tablet 2-3 times a day
• For children 1 year to 6 years 1/3 tablet 2-3 times a day
• For children 7-14 years old ½ tablet 2-3 times a day

Antifungal drugs

Due to the fact that antibiotics suppress the development of normal positive microflora of the gastrointestinal tract. Digestive disorders (bloating, constipation, diarrhea) may occur. Immunity also decreases, which makes it possible to develop various types of fungal infections.
Antifungal drugs include:

• Nystatin
• Levorin

Fluconazole is available in tablets or capsules (50 mg or 150 mg)
Scheme for using fluconazole:
50 mg per day for 7-14 days, depending on how long the antibiotic therapy lasts.

Immunity Boosters

Imudon has a local anti-inflammatory effect and increases the protective properties of the oral mucosa. Possesses:

• Antifungal
• Antivirus
• Antibacterial

It is prescribed individually, depending on how much the immune system is damaged.

Antiseptic solutions

Mouth rinse solutions are used. The following can be used as antiseptic drugs:

• Furacillin solution Available in tablets of 0.02 g, 10 pieces.

- It is very easy to prepare the solution at home. It is necessary to crush two furacillin tablets, pour a glass of boiling water and stir thoroughly. It dissolves quickly in hot water.
-Then allow the solution to cool to an acceptable temperature. Afterwards the solution is ready for rinsing (5-6 times a day).
-This solution can be stored in the refrigerator, but must be reheated before use.

• A weak solution of potassium permanganate.

A 0.1% solution is used.
- Take 1 gram of powder and pour 1 liter of water at a temperature of 37 degrees. Then stir well and rinse through a thick layer of gauze. The solution should have a faint purple tint. It is necessary to ensure that the solution does not contain crystals.
- The throat is washed several times a day

• Sprays are used (Tantum verde, Cameton), which possess locally
• painkillers
• antiseptic
• anti-inflammatory effect

These sprays, created on herbal based. They alleviate the general condition and promote recovery.
Possess local antimicrobial effect.
Treatment acute sore throat lasts on average 7 days, in severe cases can last up to 14 days. To prevent the occurrence stable forms bacteria are carried out full course antibiotic therapy regardless of the patient's condition.

Tonsillectomy - removal of tonsils, when is surgery necessary?

With frequent occurrence of tonsillitis, the disease develops into chronic form, this creates conditions for local destruction of the tonsils. With time lymphoid tissue ceases to perform its functions, and the existing infection is able to penetrate into the general bloodstream, thereby affecting other organs and systems. To exclude complications associated with this phenomenon, it is necessary to remove pathologically altered tonsils.
Indications for surgery:

• Frequent repeated exacerbations of sore throat (at least 3 times a year)
• Lack of effect from conservative treatment (medicines)
• Chronic tonsillitis, complicated by the spread of infection to nearby areas

Contraindications for surgery:

• Heart defects of 2-3 degrees of severity
• Hemophilia - a bleeding disorder
• Severe diabetes mellitus

Prevention of sore throat

Considering all the possible consequences of a sore throat, it is easier to avoid recurrences by following some simple rules.

• Hypothermia should be avoided. As a result of local cooling of the oral cavity, a layer of mucus forms on the surface of the tonsils, which promotes the proliferation of bacterial agents (streptococci, staphylococci and others). Also, under the influence of cold, the blood supply to the mucous membrane decreases due to vasoconstriction, which contributes to the process of sore throat. Thus, it is necessary to limit the consumption of cold drinks and ice cream, especially when the body is heated. It is also necessary to avoid cold rooms, swimming in cold bodies of water, and dress appropriately for the weather conditions.
• Temper the body. To gradually accustom the body to temperature changes, it is necessary to take contrast showers. At the same time, reduce the water temperature gradually so that it is slightly cool. Systematic exercise also contributes to strengthening the body, morning exercises. Exercises may include running, swimming and others.
• Dental control. It is necessary to monitor the condition of your teeth. Dental caries is a breeding ground for pathogenic pathogens of sore throat. Therefore, independent control over dental condition is required. To remove food debris and bacteria from the mouth, rinse your mouth warm water, or furacillin solutions and other antiseptics, for those at risk of recurrent sore throat.
• Control by an otorhinolaryngologist. Nasal breathing affects the condition of the palatine tonsils. Therefore, curvature of the nasal septum and other damage, disrupting normal breathing, contribute to the development of sore throat. Also, patients who often suffer from rhinitis (inflammation of the nasal mucosa) are at risk. In such cases, an examination by a doctor (otorhinolaryngologist) should be performed at least 2-3 times a year.
• Balanced diet, including a variety of fruits and vegetables. It is necessary to eat food that does not irritate the oral mucosa. This diet includes soups, cereals, boiled meat, and the exclusion of spicy and salty foods.

In cases where there is a person with tonsillitis in the family, the following preventive measures must be observed.

• Using separate utensils for patients
• Periodic ventilation of premises
• Wearing a medical mask

How does angina occur in children?

Sore throat in children occurs with a sharp increase in body temperature. The temperature level can reach 39 – 40 degrees, and in some cases even higher. The temperature value can fluctuate from minimum to maximum limits. So, on the first day the temperature can be 40 degrees, and the next day it can reach 36.6, and then jump sharply again. Regardless of its form, childhood sore throat has a number of similar manifestations. Children complain of a sore throat, which gets worse when swallowing, refuse to eat, and are capricious. Patients are worried about headache, weakness, nausea. In some cases, stool upset or vomiting may occur. The inflammatory process affects the vocal cords, so a sick child may have a hoarse voice. When examining children, enlarged and painful lymph nodes are revealed ( cervical and submandibular). The tissues of the palate, palatine arches and tonsils swell and turn red. A purulent plaque forms on their surface.
The intensity of symptoms is determined by the stage of angina, which can be acute or chronic.

Manifestations of acute sore throat in children
Acute tonsillitis occurs with pronounced symptoms and is characterized by rapid development. Most often, no more than a day passes from the moment of infection to the appearance of the first symptoms. Against the background of infection, children develop intoxication of the body, which is accompanied by deterioration or lack of appetite, apathy, discomfort in abdominal cavity. Patients experience severe headaches that can radiate to the ears. With viral tonsillitis, the symptoms, in most cases, are milder than with bacterial tonsillitis.

Other signs of acute tonsillitis are:

• unpleasant taste in the mouth;
• coating on the tongue;
• hoarse or missing voice;
• sore throat;
• nausea;
• vomit;
• the presence of pus on the tonsils;

In some cases, children become irritable, nervous, and whiny. Often a sore throat occurs with a cough, in which the patient coughs up clots of pus. Sometimes tonsillitis is accompanied by diseases such as rhinitis and otitis media.
With adequate treatment, the child’s condition improves on days 5–7 ( depending on the form of sore throat).

Manifestations of chronic sore throat in children
During remission, chronic tonsillitis is manifested by periods of weakness, bad breath, often developing colds. The tonsils in children with chronic tonsillitis look swollen and their tissues are loose. In some forms of the disease, the lacunae of the tonsils are filled with plugs of secretion, which has an unpleasant odor. Exacerbation of chronic tonsillitis occurs in a milder form, and the child’s condition may improve after a few days. In some cases, relief occurs even without treatment.

Signs of relapse of chronic tonsillitis in children are:

• increased body temperature;
• feeling of discomfort in the throat;
• general deterioration of health;
• the formation of white plaque on the tonsils.

How does viral tonsillitis proceed?

Features of the course of viral sore throat depend on the specifics of the virus that caused the disease, as well as on the individuality of the organism.

The causes of viral sore throat are:

• herpes viruses;
• adenoviruses;
• rhinoviruses;
• coronaviruses;
• syncytial virus.

The main risk group for this disease is children. Cases of viral tonsillitis in adults are extremely rare. In 95 percent of cases, children from one to three years old suffer from sore throat of viral origin. This age range largely determines the subsequent course of the disease. A feature of this period is that, regardless of the location of the infectious focus, disorders are observed gastrointestinal tract. Thus, to the classical syndromes ( general intoxication syndrome and local manifestations syndrome) with viral sore throat, abdominal syndrome is associated.

Therefore, despite the fact that the child will have inflamed tonsils, he will complain of abdominal pain. Also, the first symptoms to appear are nausea, vomiting, and diarrhea. Local symptoms, such as sore throat and cough, will appear later and fade into the background in intensity.

Abdominal symptoms of viral sore throat are:

• nausea, vomiting;
• stomach ache;
• refusal to eat;
• bowel disorder ( often in the form of diarrhea).

Often this onset of the disease mimics a gastrointestinal infection. To avoid this, a nearby parent must look at the baby’s throat.
It is known that in young children preschool age (that is, up to 3 years) with any infectious disease, symptoms of general intoxication predominate. These are symptoms such as fever, weakness, body aches. However, its manifestations depend on the type of pathogen. If the source of the sore throat was rhinoviruses or adenoviruses, then the standard symptoms ( temperature) symptoms such as runny nose, cough, conjunctivitis are added.

The syndrome of general intoxication with viral sore throat is determined by the following criteria:

• temperature;
• body aches;
• lethargy, weakness;
• cough;
• runny nose;
• conjunctivitis;
• Possible convulsions due to fever.

As a rule, the temperature with viral sore throat reaches 38 - 39 degrees. It is accompanied by chills and muscle pain. Children who are unable to express all their complaints become lethargic and apathetic. They refuse to eat because of a sore throat.

Local symptoms of viral sore throat are:

• a sore throat;
• redness and enlargement of the tonsils;
• formation of small pink bubbles on the tonsils;
• redness of the back of the throat.

These symptoms are detected by a detailed examination of the throat. Often the blisters on the tonsils burst, and ulcers remain in their place.

If this is a secondary angina, that is, it occurs against the background of some other viral disease, then the symptoms of the underlying disease are added to the main symptoms. For example, with angina against the background of infectious mononucleosis, symptoms such as regional enlargement of lymph nodes and specific blood changes appear.

How does herpes sore throat occur?

Herpes sore throat occurs with vivid clinical manifestations that occur after completion incubation period. After contact with the virus, it takes 7 to 14 days until the first symptoms appear. During this period, nothing bothers a person, but he is already a spreader of the infection. At the end of incubation, the first sign that begins to worry the patient is a high temperature.

Other manifestations of herpes sore throat are:

• damage to the mucous membrane in the mouth;
• body aches;
• a sore throat;
• runny nose;
• cough;
• headache;
• gastrointestinal disorder;
• inflammation of the lymph nodes.

The temperature rise occurs sharply and can reach 38 - 40 degrees. In most cases, temperatures peak on the first and third days. The temperature is accompanied by general malaise, lethargy, and depression. In children, herpes sore throat is more severe than in adults.
If herpes sore throat is provoked by intestinal viruses, patients are bothered by severe abdominal pain and intestinal colic. Diarrhea, vomiting and other digestive disorders may occur. Against the background of these sensations, other symptoms appear less pronounced.

A distinctive sign of herpes sore throat is changes in the structure of the mucous membrane of the pharynx. The mucous tissue first turns red, after which small papules, the diameter of which reaches 1–2 millimeters, form on it within 1–2 days. The neoplasms turn into purulent blisters, which burst after 3–4 days. In place of the burst bubbles, erosions form, surrounded by a red border and covered with a grayish-white coating.

The areas where bubbles form are:

• language;
• palatal arches;
• solid sky;
• soft sky;
• tonsils.

In the larynx, mucosal lesions are smaller in size than in the area of ​​the palate and tonsils. In areas of greatest accumulation, the bubbles can join together, forming large areas of affected tissue. Erosion of the mucous membrane causes pain during swallowing and intense salivation. Because of the pain, patients refuse to eat and drink, which can lead to dehydration. This leads to indigestion, unpleasant sensations in the mouth, muscle spasms.

Painful sensations due to lesions of the mucous membrane are accompanied by a sore throat and cough. A runny nose may develop, which is accompanied by mucous-watery discharge, sometimes mixed with pus.
Herpes sore throat occurs with changes in the lymph nodes located in the mandibular and parotid zones. Palpation reveals an increase in size and tenderness of the lymph nodes. With timely and correct treatment, the symptoms of herpes sore throat begin to subside on the 7th to 12th day.

How to treat simple sore throat?

Treatment of angina should be comprehensive and aimed not only at eliminating pathogenic microorganisms, but also at preventing possible complications. It is known that angina itself is not as terrible as its consequences. Therefore, a wide range of drugs with different mechanisms of action are used in the treatment of angina.

The principles of treating angina are as follows:

• Etiotropic treatment– aimed at eliminating the source of infection. For this purpose, either antibacterial drugs or agents with antiviral effects are prescribed.
• Symptomatic treatment– aimed at eliminating symptoms. Antipyretics are prescribed to reduce the temperature.
• Local treatment – aimed at eliminating pathological plaque on the tonsils and restoring normal flora tonsils
• General restorative treatment– aimed at increasing the body’s resistance and preventing the development of complications.

Drugs used in the treatment of sore throat

Treatment principle	Group of drugs	Representatives
Eliminating the source of infection	Antibiotics for bacterial sore throat. Considering that very often the source of sore throat is streptococcus, drugs from the group of penicillins and cephalosporins are prescribed. In case of viral sore throat antivirals are rarely prescribed. More often, interferons are prescribed, which also have an antiviral effect. They also increase the body's resistance.	oxacillin; ticarcillin; mecillam. Viferon; leukocyte interferon.
Eliminating symptoms	Antipyretic drugs – to eliminate fever. Antihistamines - to relieve swelling of the throat.
Local treatment	Irrigation of the throat and tonsils is carried out using special sprays or infusions, as well as homemade products.	inhalipt; givalex; stopangin; camomile tea.
Prevention of complications	Immunomodulatory drugs are prescribed that strengthen the body and reduce the risk of relapse ( repeated exacerbation of the disease). Also, in order to reduce the risk of complications to a minimum, it is necessary to observe bed rest. Strict bed rest must be adhered to during the acute period of illness, when the temperature persists.	immunomax; florin forte; lycopid; Echinacea tincture.

Physiotherapeutic procedures play an important role in the treatment of sore throat. This includes periodic inhalations, throat irrigation with special antiseptics and other procedures.

How to treat chronic sore throat?

Chronic sore throat must be treated based on the form of the disease, external manifestations, the general condition of the patient and the presence of concomitant pathologies. Taking these factors into account, the doctor may suggest conservative and/or surgical treatment.

Conservative treatment
Conservative treatment of chronic tonsillitis includes a large number of methods that can be used both individually and in combination.

Types of treatment are:

• washing the tonsils;
• injections into the tonsils and surrounding tissues;
• physiotherapy;
• complex treatment.

Because of chronic inflammation in some patients in the lacunae ( natural depressions) tonsils, purulent plugs form. They provide favorable conditions for the growth and development of pathogenic bacteria. Washing is carried out using a special instrument or medical equipment. The purpose of the procedures is to remove the contents and destroy harmful microorganisms using antiseptic agents.

Preparations for washing can be:

• furatsilin;
• boric acid;
• iodinol;
• sodium albucid in solution;
• penicillin solution.

Washing is carried out in a course of 7 – 10 procedures, which are carried out every other day. After 3 months, it is recommended to undergo this type of treatment again.

Injections into the tonsils and surrounding tissues
The introduction of drugs into the tonsils and adjacent tissues makes it possible to act directly on the sites of infection. As a result of this treatment, inflammatory processes are stopped, and the tonsils are reduced in size. Most often, not one, but several drugs are used, among which one is an antibiotic and the other is an anesthetic. The medication can be administered using a needle or a special nozzle with a large number of small needles. When choosing this type of therapy, the condition of the affected tissues has a great influence, since due to injections the possibility of developing abscesses in the tonsil area increases.

Physiotherapy
Physiotherapeutic treatment methods involve the impact of various physical and chemical factors on the affected tonsils.

Physiotherapy methods are:

• ultraviolet irradiation;
• inhalation therapy;
• ultrasound therapy.

All physiotherapeutic methods can be divided into three groups according to the type of influence used. The first group includes procedures that involve exposure to dry heat using light rays or electricity. Warming the tonsils allows you to destroy the pathogenic environment and reduce tissue swelling.
The second group includes physiotherapy methods that are based on the use of ultrasonic waves. Such conservative treatment methods are not recommended for young children. The third group includes treatment methods based on the effects of moist heat. Inhalation therapy is the optimal method of treatment, which has minimum quantity contraindications.

Complex treatment
Complex treatment is carried out using special medical equipment (most often using a tonsil machine) and a number of medications.

The stages of complex treatment are:

• washing– the doctor uses a specialized nozzle and antiseptic to rinse the tonsils;
• ultrasonic irrigation– the medicinal solution is broken up by ultrasound into a finely dispersed suspension, which is applied to the affected areas;
• tonsil treatment– carried out using drugs that contain iodine;
• laser exposure– aimed at reducing swelling of mucous tissues;
• wave action– allows you to improve tissue nutrition and oxygen supply;
• ultraviolet irradiation– carried out to suppress pathogenic microflora located on the tonsils.

Such treatment must be carried out in courses, for which the optimal number of procedures is determined by the doctor.

Surgery
Surgical treatment is prescribed in cases where other methods of therapy have not brought effective results. Surgical treatment involves removal of the tonsils and can only be performed during a period of stable remission. Surgery to remove the tonsils is called a tonsillectomy and may involve a complete or partial removal. For surgical intervention, strong indications are required.

Indications for tonsil removal are:

• recurring abscesses ( purulent inflammation );
• endocarditis ( inflammation of the lining of the heart);
• glomerulonephritis ( inflammatory process in the kidneys).

Tonsil removal can be performed using classic surgical instruments or using laser or ultrasound. Also, for small tonsils, a cryosurgical method can be used, which involves freezing the tonsils.

How to treat a sore throat at home?

It is necessary to treat a sore throat at home, regardless of the form of the disease, under the supervision of a doctor. The essence of home treatment is to provide conditions conducive to recovery and follow the recommendations given by the physician.

Treatment for sore throat is as follows:

• taking self-help measures before the doctor arrives;
• compliance with the instructions given by the physician;
• fight against intoxication ( poisoning of the body);
• providing a special diet;
• organization of certain living conditions.

Taking self-care measures before the doctor arrives
If your health worsens due to angina, the patient must be provided with bed rest. You should not fight fever on your own, because this creates favorable conditions for the development of infection. You can alleviate the patient's condition with cool compresses or wiping the body with cool water. It is not recommended to use alcohol-containing liquids for wiping. Alcohol vapor entering the body can cause nausea, headache, and fainting. Teas made from linden or raspberries will help improve your well-being at high temperatures.
To reduce a sore throat, you need to gargle every 3 to 4 hours.

Among the rinsing solutions are:

• herbal decoction ( chamomile, sage) – use 2 – 3 tablespoons of dry herbs per glass of water;
• beet juice with vinegar– add 20 milliliters of apple cider vinegar to a glass of freshly squeezed juice;
• solution of soda and salt– Mix 1 teaspoon each of baking soda and table salt with a glass of water.

Compliance with medical instructions
After starting medication, improvement is likely to occur within 2 to 3 days. This is not a reason to stop drug therapy. For adequate treatment, you must take the full course of medications prescribed by your doctor. It is necessary to observe not only the duration of treatment, but also the rules for using drugs. This applies to such items as the daily dose of medication, time of administration ( before or after meals), drug compatibility, and so on.

Fighting intoxication
Poisoning the body during a sore throat provokes headaches, weakness and other symptoms of the disease. Drinking plenty of fluids will help remove toxins, the optimal volume of which is determined according to the patient’s body weight. Drink sufficient quantity fluid is also necessary to restore the water balance, which is disturbed during sore throat due to increased sweating.
To calculate the daily requirement, you need to multiply your body weight in kilograms by 30 ( milliliters of liquid) and add 500 ( milliliters). So, for a patient weighing 60 kilograms, the recommended volume of fluid is 2300 milliliters. Preparing and drinking drinks during a sore throat follows a number of rules.

The rules for maintaining drinking regime are:

• the drinking temperature should be moderate; hot or cold liquid can worsen the patient’s condition;
• adding vitamin-containing ingredients to drinks will help speed up the healing process;
• it is necessary to ensure that juices and teas are not too acidic, as this can cause irritation of the mucous membranes;
• if the drink has a strong taste, it should be diluted with water;
• from drinking juices industrial production should be discarded, as they contain a large amount of flavor enhancers and other chemical components.

One of the recommended drinks for angina is berry juice. To prepare it, you need to grind 150 - 200 grams of berries, squeeze out the juice and combine with 2 glasses ( 500 milliliters) boiled water. If desired, you can add 1 – 2 teaspoons of natural honey. Cranberries, viburnum, raspberries, and currants can be used as the main component.

• Tea with lemon;
• milk with honey;
• Herb tea;
• dried fruits compote;
• rosehip decoction.

Security proper diet nutrition
Great importance in the treatment of angina, it is important to organize proper nutrition. Rough and hard foods should be avoided as they may have difficulty swallowing. You need to give preference to easily digestible foods to reduce the body’s efforts to digest food. Products with a high content of fat, hot seasonings and spices should be excluded from the diet. The best option for preparing food is to grind food using a blender. Of the species heat treatment Steaming or baking in the oven is most preferable.

• porridge ( oatmeal, buckwheat, rice);
• broth ( vegetable, meat, fish);
• dairy products ( kefir, yogurt, cottage cheese);
• puree ( potato, zucchini, pumpkin).

Organization of certain living conditions
Sore throat is a contagious disease, so the patient must be isolated from other family members. The patient should be provided with utensils and personal hygiene products. After each use, all items should be rinsed with boiling water if possible. In the room where there is a patient with a sore throat, systematic ventilation must be provided. The air must be moist, so wet cleaning should be done at least once a day.
With fever, which is the main symptom of tonsillitis, the patient sweats profusely. Therefore, the patient must be frequently changed and bed linen changed. If a child who wears a diaper has a sore throat, it must be removed, as this underwear retains heat.

How to gargle for a sore throat?

Gargling for a sore throat can cleanse the affected areas of germs and reduce pain. The procedure must be carried out 4 – 5 times a day ( unless otherwise indicated). The temperature of the solution should be average, and the duration of the procedure should be 3 – 4 minutes.

For gargling you can use:

• antimicrobial and antiseptic agents;
• pharmaceutical drugs herbal based;
• folk remedies.

Antimicrobial and antiseptic gargles for sore throat

Name	Release form	Effect	Mode of application
Furacilin	Pills	Has an antimicrobial effect. Reduces the inflammatory process.	Prepare a solution of 200 milliliters of water and 0.02 grams of the drug. Crush the tablets, then stir the solution intensively for 5 – 10 minutes. Before use, rinse your mouth with water or soda solution.
Hexoral	Spray Solution	Stops the activity of pathogenic organisms. Promotes healing of mucous membranes. Reduces the intensity of cough.	The spray is sprayed for 2 seconds onto the affected areas. The undiluted solution is used for rinsing, the duration of which should not exceed 30 seconds. Apply 2 times a day.
Miramistin	Solution	Fights microbes and viruses, reduces the resistance of pathogenic microorganisms to antibiotics. Eliminates plaque on mucous membranes, combats the feeling of dryness in the throat.	Adults can use an undiluted solution of the drug to rinse. For children under 14 years of age, the drug should be diluted with water in a ratio of 50 to 50.
Lugol's solution	Spray Solution	Glycerin, which is part of the drug, softens the affected areas of the mucous membrane, and iodine fights pathogenic microorganisms.	The solution is applied to a gauze swab, which is used to treat the palate and tonsils. The spray irrigates the inflamed areas. Use no more than 3 times a day.
Iodinol	Solution	Has a bactericidal effect against a large number of bacteria. Accelerates the healing of mucous tissues.	The solution is used in diluted form. For a glass of water ( 250 milliliters) 1 tablespoon of the drug is used.
Chlorhexidine	Solution	Actively fights both bacterial and viral infections. Has a long-term healing effect.	For rinsing, adults use undiluted solution in the amount of 1 tablespoon. Children under 14 years of age should dilute the drug halfway with water. Before use, rinse your mouth thoroughly. After rinsing, refrain from eating and brushing your teeth for 2–3 hours.
Rivanol	Pills	Has a disinfecting effect. It has the greatest effect on follicular tonsillitis.	To rinse, you need to prepare a solution at the rate of 0.2 grams of the drug per 200 milliliters of water.
Tantum verde	Aerosol	Fights inflammation and has an analgesic effect.	The solution is used in the amount of 1 tablespoon. The aerosol is sprayed in 5 to 7 sprays for adults and 4 sprays for children from 6 to 12 years old. Before using any form of the drug, you must rinse your mouth with water.

The drugs are purchased at the pharmacy and used an hour before or after meals.

Herbal pharmaceutical preparations
Such products contain extracts medicinal plants. To preserve the healing properties of the drug components, they should be mixed with water at room temperature.

Pharmaceutical preparations based on herbs for gargling with sore throat

Name	Release form	Effect	Mode of application
Rotokan	Solution	Has a healing and anti-inflammatory effect. Helps reduce pain and resolve swelling.	The drug contains a large amount herbal ingredients which can cause allergies. Therefore, it is necessary to start using small doses. For the first rinse, 1 teaspoon of the drug is mixed with a glass of warm water. If after the first procedure no allergic reactions occur within 4–5 hours, the concentration must be increased to 3 teaspoons of the medicine per glass of water.
Chlorophyllipt		Accelerates the healing process of mucous tissues, destroys and prevents further development bacteria. The drug also improves the overall resistance of the body and improves the supply of oxygen to tissues.	The spray irrigates the tonsils ( 1 spray for each) 3 – 4 times a day. The drug in solution is mixed with water at the rate of 1 teaspoon per glass of liquid. Rinse the mouth with the solution 2 – 3 times a day.
Malavit	Solution	Using the drug can reduce the intensity of pain and swelling of tissues.	To carry out the rinsing procedure, 100 milliliters of water should be mixed with 5 - 10 drops of medicine.
Ingalipt	Spray	Has an antiseptic and anesthetic effect. Fights microbes and promotes rapid healing of the mucous membrane.	One session of irrigation of the affected areas includes 2 - 3 sprays.

Folk remedies
Rinses prepared according to folk recipes have a fairly mild effect on the affected mucous membranes. Therefore, it is recommended to combine them with medications recommended by your doctor. The effect of rinsing with folk remedies lasts less, so the procedure must be carried out every 2 to 3 hours.

Folk remedies for gargling with sore throat

Name	Ingredients and method of preparation	Effect
Sea water	Edible sea salt ( tablespoon) mixed in a glass of water.	Reduces pain.
A solution of iodine, salt and soda	For a glass of liquid, use 5 drops of iodine and 1 teaspoon each of baking soda and table salt.	Fights the inflammatory process, eliminates tissue swelling.
Lemon juice	Freshly squeezed lemon juice is mixed in an amount of 2 parts with 3 parts water.	Effectively fights the feeling of sore throat and suppresses the development of the inflammatory process.
Herbal tea number 1	Equal parts of calendula, chamomile and eucalyptus in a total amount of one tablespoon are brewed with a glass of boiling water.	Helps restore damaged tissues and fights infection.
Herbal tea number 2	Herbs such as wormwood, plantain and calendula are mixed in equal quantities. A tablespoon of the collection is steamed with 200 milliliters of hot water.	Has anti-inflammatory properties.
Clove decoction	Carnation ( spice) is steamed with boiling water at the rate of 10 - 12 granules per 1 glass. Ready solution should be dark brown in color.	Renders antiseptic effect.

What folk remedies exist for the treatment of sore throat?

There are a large number of folk remedies for the treatment of sore throat, which, depending on the type of effect, are divided into several categories.

Groups of traditional medicines used to treat sore throat are:

• antipyretics;
• restorative drugs;
• rinsing agents.

Antipyretics
The use of medicinal plants that have an antipyretic effect helps fight the main symptom of sore throat - high fever.

The following plants have an antipyretic effect:

• chamomile;
• cranberry;
• raspberries;
• rose hip;
• Linden.

Chamomile
In addition to lowering temperature, chamomile increases sweating, which reduces intoxication. Also, preparations based on this component normalize intestinal activity and stimulate appetite.
A decoction is prepared from chamomile, for which a tablespoon of the raw material is brewed with boiling water. After 2 hours of infusion, the decoction should be given to a patient with a sore throat throughout the day. In addition to using chamomile internally, this plant is used for enemas. Chamomile infusion prepared from a glass of water and 2 tablespoons of dry inflorescences, combine with sunflower oil (50 milliliters) and use a syringe to inject the solution into the anus. This procedure allows you to reduce the temperature by 0.5 - 1 degree.
Contraindications for the use of chamomile are intolerance to this component.

Cranberry
Cranberries not only help fight fever, but also have an antiseptic effect, inhibiting the activity of harmful microorganisms. Also, cranberry preparations enhance immune functions and improve the general condition of the body. To prepare a cranberry drink, crush 150 grams of berries and squeeze the juice out of them using a gauze cloth. Cake ( leftover berries) pour in a liter of water and bring to a boil over heat. Combine the resulting broth with cranberry juice and honey.
Cranberries are not recommended for those patients who suffer from liver disease or high acidity of gastric juice. You should drink cranberry drinks after meals, and after drinking you should rinse your mouth with water.

Raspberries
Raspberry drinks are used as a means to reduce the temperature and level of intoxication of the patient. This plant also has an analgesic effect. Raspberry jam You can add 1 - 2 teaspoons to tea, and make juice from fresh berries. For juice, you need to grind 150 - 200 grams of berries with sugar or honey and dilute the resulting pulp with 2 cups of boiling water. You can also prepare a medicine against sore throat from raspberry leaves. To do this, fresh leaves in the amount of 100 grams should be poured with hot water and steamed for 10 - 15 minutes. You need to drink the decoction throughout the day.
, heart failure . People who suffer from ulcers or gastritis should also refrain from drinking rosehip drink. The acids contained in rose hips can damage tooth enamel. Therefore, after consuming it, you should rinse your mouth with water.

Linden
Linden has an antipyretic, diaphoretic and expectorant effect. Linden contains a large amount of vitamin A and C, which allow you to better cope with sore throat. To make linden tea, brew a tablespoon of inflorescences with a glass of boiling water. Linden drinks put stress on the heart, so people with heart disease should limit themselves to one cup of linden tea per day.

General restorative drugs
The composition of such products includes plants that contain large amounts of vitamins, organic acids, and microelements. These substances strengthen the body's defenses, allowing it to fight sore throat.

Recipes for strengthening the body are (one part of the raw material is equal to a tablespoon, part of water is equal to one glass):

• Rowan tea. Pour 1 part dry berries with 1 part boiling water and leave to steep for several hours. Take one third of a glass three times a day.
• Radish with honey. You should take a black radish, cut off the top and pour honey into the resulting hole. Leave overnight, then take one teaspoon of honey infused in the radish. In the evening, repeat the procedure with honey and radish.
• Propolis. Propolis should be cut into small fractions and sucked after eating. You can also put a piece of propolis behind your cheek or under your tongue before going to bed.
• Fig decoction. Cut the dry berries into small pieces, then add 1 part of the raw material to 2 parts of water. Leave on fire for about 5 minutes, then divide the entire volume into several parts and drink throughout the day.
• Aloe with honey. 1 part aloe pulp must be mixed with 3 parts honey. Take the mixture one teaspoon after meals.
• Apple with onion. You should take an apple and a medium-sized onion and grate them or grind them in a blender. Add 2 parts honey to the apple and onion pulp. Take the product 3-4 times a day, one teaspoon.

Rinses
Gargling with preparations based on herbal ingredients can reduce tissue swelling, reduce pain and prevent the proliferation of bacteria on the mucous membrane. Procedures should be carried out 5–6 times a day.

Rinse aids are (one part of the raw material is equal to a tablespoon, part of water is equal to one glass):

• Beetroot juice. Grate the beets, squeeze out the juice and gargle with it. Using the same analogy, you can prepare carrot juice, either used alone or diluted with beet juice.
• Cranberry juice. Crush 3 parts fresh or thawed berries, mix with 1 part water. Add honey and carry out procedures, after which the mouth should be rinsed with water.
• Garlic infusion. Dilute 1 part chopped garlic with 1 part warm water. Leave for 5 – 10 minutes, strain and use for rinsing.
• Pine decoction. Spruce needles ( 100g) should be finely chopped, pour 2 parts water and keep on fire, avoiding strong boiling, for 20 minutes.

You can also use decoctions of St. John's wort, sage, chamomile, calendula, and thyme for rinsing.

How long does it take to treat a sore throat?

How long it takes to treat a sore throat depends on its form and the degree of reactivity of the body. For bacterial sore throat, the duration of treatment is determined by the course of antibiotic therapy. So, on average, a course of antibiotic treatment lasts from 7 to 10 days. The minimum course is 5 – 7 days, the maximum is 10 – 14 days. However, this does not mean that the treatment of sore throat ends here. After a basic course of antibiotics, local and restorative treatment continues. Thus, on average, the duration of treatment will take about two weeks. If it is a viral sore throat, then the time frame for its treatment is approximately the same. However, if a viral sore throat is complicated by the addition of bacterial flora, then its treatment is delayed. Attachment of purulent flora ( let's say staphylococcus) delays the treatment of sore throat up to three to four weeks.

Regarding treatment chronic forms sore throats, their duration increases. Courses of conservative treatment of chronic tonsillitis are carried out twice a year. This can be washing the tonsils, inhalation, irrigating the throat with antiseptics and other methods. All these methods work gradually, slowly increasing resistance ( resistance) organism. If relapses ( repeated exacerbations) chronic tonsillitis is very frequent, then courses of treatment are carried out four times a year. Each course lasts from 10 to 14 days.

Another parameter that determines the duration of treatment is temperature. As a rule, sore throat is accompanied by an increase in body temperature. Maximum temperature rises ( 39 degrees) are observed with purulent, bilateral sore throats. Most often, the temperature rises to 38 degrees and lasts 3 to 5 days. This temperature is typical for viral, fungal and unilateral bacterial tonsillitis. Antibacterial treatment should be continued for several more days after the temperature normalizes. It happens that the patient subjectively feels better, but the temperature continues to persist. This may indicate either the development of complications or the persistence of an infectious focus. In this case, the doctor may change the antibiotic, and treatment will continue until the temperature stabilizes. After the thermometer shows 36.6 degrees, it is necessary to continue antibiotic therapy for another 3 to 5 days. If treatment is interrupted at this point, the infection may reactivate after a few days ( resume again).

There are cases when an increase in temperature is not observed, or it is observed slight increase. For people with weakened immune systems ( for example, those suffering from immunodeficiency (HIV)), as well as for people old age Characterized by erased forms of sore throat with mild subfebrile condition. In such cases, the temperature ranges from 37 to 37.2 degrees, and sometimes it even remains within normal limits ( 36.6 degrees). In this case, the doctor is guided by the parameters of laboratory tests. If leukocytosis characteristic of angina ( increase in the level of blood leukocytes above 9x 10 9) disappears, which means that antibiotics can be discontinued, and treatment moves to the stage of restorative procedures.

What antibiotics are used in the treatment of sore throat?

Antibiotics from a wide variety of groups are used in the treatment of sore throat. Considering that in more than 50 - 70 percent of sore throats is caused by beta-hemolytic streptococcus, they are mainly used penicillin antibiotics. For tonsillitis of other etiology ( for example, in the case of staphylococcal sore throat) antibiotics from the group of cephalosporins and macrolides are also used.

Groups of antibiotics used in the treatment of sore throat

Group of drugs	Representatives	Mechanism of action
Penicillins	Naturally occurring penicillins: penicillin G; penicillin V; benzathine benzylpenicillin. Penicillins of synthetic origin: bicillin-1; bicillin-5. Semi-synthetic penicillins: oxacillin; ampicillin; amoxicillin.	They have a wide spectrum of action and are effective both for streptococcal sore throat and sore throat of other etiologies. A significant disadvantage is the high frequency of allergic reactions.
Cephalosporins	First generation: cephalexin; Second generation: cefuroxime Third generation: ceftazidime; ceftriaxone. Fourth generation: cefepime.	They have a wide spectrum of action and are effective against streptococci, staphylococci, and enterobacter.
Macrolides	Natural origin: oleandomycin; spiramycin. Synthetic origin: clarithromycin;	Drugs in this category are reserve drugs. They resort to extreme cases when there is intolerance to penicillins and cephalosporins.

In the treatment of sore throat, antibiotics are used systemically and locally. Systemic antibiotics are used both in tablet form and in injection form ( intramuscular and intravenous). Local antibiotics are used in the form of sprays that are sprayed onto the tonsil area.

The antibiotic therapy algorithm for angina is as follows:

• If there is extensive inflammation of the tonsils ( the doctor sees multiple purulent plaques), then treatment begins immediately with cephalosporins. It is preferable to start with representatives of the third generation.
• If a culture has been previously done and the exact pathogen has been identified, then a strictly specific antibiotic is selected. For example, if gram-positive flora has been identified, penicillin is prescribed.
• Antibiotic therapy is necessarily accompanied by the prescription of antifungal drugs. This is done in order to avoid candidiasis.
• In case of moderate and severe forms of sore throat, antibiotics are prescribed by injection.

What does a throat look like with a sore throat?

What the throat looks like with a sore throat depends on the form of the disease. There are quite a lot of forms of sore throat, and it is only possible to determine exactly which form of the disease a person is suffering from. qualified specialist. An incorrect diagnosis entails an incorrect treatment regimen and, consequently, all sorts of complications of the disease.

Characteristics of the throat in various forms of sore throat

Forms of sore throat	Throat view
Catarrhal sore throat	The throat appears red and swollen. The back wall is also bright red. The tonsils are enlarged either on one side or both. There is no pathological plaque. The tongue is dry and slightly coated.
Follicular tonsillitis	Redness of the throat, soft palate, and tonsils is noted. On the surface of the bright red tonsils, rounded yellow-white formations appear, which are nothing more than accumulations of pus.
Lacunar tonsillitis	There is redness and swelling of all the walls of the throat. The tongue is dry, with a brown coating. On the tonsils, pus takes the form of yellowish spots or plaque. Pus thus fills the crypts of the tonsils. Sometimes plaque in the form of films covers most of the tonsil.
Fibrinous tonsillitis	The tonsils are entirely covered with a gray-white coating. Plaque is a mixture of fibrin and dead cells. Plaque can not only cover the entire surface of the tonsil, but also extend beyond it.
Herpangina	Small pink bubbles are visible on the surface of the back wall of the pharynx, tonsils, soft palate, tongue and arches.
Fungal tonsillitis	The pharynx is red and swollen. The tonsils are sharply enlarged and covered with a white, loose, cheesy coating.
Sore throat with scarlet fever	The throat with scarlet fever looks bright red, even flaming ( “flaming pharynx” is a specific symptom of scarlet fever). At the same time, a clear boundary is visible between the flaming throat and the pale sky. The tonsils themselves are swollen and covered with a gray-dirty coating.

What complications can a sore throat cause?

Despite the fact that sore throat seems to be a minor disease and many people ignore its comprehensive treatment, it is fraught with numerous complications. Complications of angina are conventionally divided into local and general. Local complications are those that develop within the tonsils and surrounding tissues. General complications affect the entire body.

Local complications of angina are:

• peritonsillar abscess or cellulitis;
• swelling of the larynx;
• purulent lymphadenitis;
• otitis.

Abscess or cellulitis
An abscess is a localized collection of pus. In a peritonsillar abscess, pus accumulates around the inflamed tonsils. Cellulitis differs from an abscess in size and boundaries. It is somewhat more extensive than an abscess and affects not only the tonsils themselves, but also the surrounding tissues. The boundaries of phlegmon are more vague. Both abscess and cellulitis are very dangerous complications that require prompt resolution. Pus from an abscess or cellulitis can spread through the blood or lymphatic vessels, thus facilitating the generalization of infection.

Laryngeal edema
Laryngeal edema is extremely dangerous condition, which can lead to death. The larynx is not only an organ of speech production, but also part of the respiratory system. Through it, air penetrates from the external environment into the bronchi and lungs. Therefore, if the larynx swells, difficulty breathing occurs. Patients attempt to cough, but this does not bring results. As the larynx swells, breathing becomes more difficult, and oxygen deficiency occurs.

Purulent lymphadenitis
Purulent lymphadenitis is purulent inflammation of the lymph nodes. Develops due to the spread of pathogenic microorganisms from the tonsils to the lymph nodes. In this case, the lymph nodes become enlarged, tense and painful. The surrounding tissues also become tense and adherent to the lymph nodes. If the process is two-way ( that is, the lymph nodes of the right and left sides are affected), then the entire neck increases in volume. It becomes difficult for the patient to turn his head or make any movements. Due to compression of the lymphatic vessels, the outflow of lymph is disrupted, as a result of which the tissues swell even more. In addition to the lymphatic vessels, they are compressed and blood vessels. As a result, the blood does not circulate, but stagnates ( venous stasis), giving the neck a purple tint.

Otitis
Otitis is called acute inflammation of the middle ear. Due to the close proximity of the mouth and ear, otitis media is one of the most frequent complications tonsillitis. Through the Eustachian tube ( which connects the oropharynx and the ear cavity) bacteria easily penetrate from the tonsils into the middle ear. The first symptom of otitis media is moderate hearing loss. Hearing loss is followed by pain.

Common complications of tonsillitis are:

• glomerulonephritis.

Rheumatism
Rheumatism, or rheumatic fever, is systemic lesion connective tissue of an autoimmune nature. Its pathogenesis is based on the body’s specific response to the penetration of beta-hemolytic streptococcus. Thus, in response to the penetration of streptococcus ( the most common causative agent of sore throat) the human body begins to synthesize antibodies. These antibodies are produced to all components of streptococcus, namely streptolysin O and S, M protein, hyaluronic acid. These antibodies then bind to antigens ( components of streptococcus) and settle in the kidneys, on the heart valves, and joints. Next, the “antigen + antibody” complex triggers an inflammatory reaction, which unfolds where this complex settles. The main target organs for rheumatism are the heart, kidneys, and joints.

Myocarditis
Myocarditis is an inflammatory lesion of the heart muscle. This complication can develop both during the sore throat itself and after it. In the first case, the cause of myocarditis is specific damage to the muscle by the pathogenic microorganisms that caused the sore throat. Most often, myocarditis develops with viral tonsillitis, because viruses have the greatest affinity for heart tissue. Since viral sore throats most often occur in children, viral myocarditis is usually observed in children and adolescents. Since myocarditis affects the muscle fibers themselves, the heart, being muscular organ, becomes weak and ceases to perform its functions. The main symptoms of myocarditis are weakness, shortness of breath, rapid heartbeats, and cardiac arrhythmias.

Myocarditis can also be of an autoimmune nature. Such myocarditis develops a couple of weeks after suffering from a sore throat. The mechanism of development of this myocarditis is similar to rheumatism. Immune complexes settle on the heart muscle, triggering a cascade of inflammatory reactions.

Glomerulonephritis
Glomerulonephritis is a bilateral kidney disorder. The cause of the development of this complication is an autoimmune process that develops in response to the penetration of streptococcus into the body. As with rheumatism, in response to this the body produces antibodies, which specifically bind to antigens and form immune complexes. These complexes initially circulate in the blood. If rheumatic tests are done at this moment, they will reveal the presence of specific antibodies. The best known is the anti-streptococcal streptolysin antibody, abbreviated as ASLO.

These complexes then settle on the glomerular vessels of the kidneys. An inflammatory process develops, which gradually ( within 10 – 15 years) leads to kidney failure. Glomerulonephritis is difficult to treat, so its development should be feared in the first place. Symptoms of glomerulonephritis are high blood pressure, swelling, and blood in the urine.

Sore throat is commonly called acute tonsillitis. This insidious disease accompanied by infectious lesion palatine tonsils and can cause a lot of dangerous complications. Patients are often recommended to be admitted to a hospital, but in uncomplicated cases it is also possible to treat sore throat in adults at home. It is important to understand the principles of therapy and coordinate your actions with your doctor.

Basic principles of treatment of sore throat in adults

Since tonsillitis is an infectious disease, the main goal of treatment is the elimination of pathogenic flora from the tissues of the tonsils. The second goal of therapy is to eliminate intoxication of the body and restore immunity. To solve this set of problems, various methods are used.

What drugs and antibiotics help with the disease?

First of all, antibiotic therapy is prescribed for tonsillitis.

Treatment of sore throat with antibiotics is a radical step, but necessary.

Other tools and methods are auxiliary.

In addition to antibacterial drugs, it is advisable to prescribe antihistamines and non-steroidal anti-inflammatory drugs:

Group of drugs	Drug names	Application	Contraindications
Antibiotics	"Sumamed"	1 tablet 500 mg or 2 capsules 250 mg 1 time per day.	hypersensitivity to macrolides; severe dysfunction of the liver and kidneys.
	"Amoxiclav"	1 tablet 250 mg or 1 tablet 500 mg every 8 hours.	increased sensitivity to components; liver dysfunction; Infectious mononucleosis; lymphocytic leukemia; with caution - during pregnancy and lactation.
	"Amoxicillin"	1 tablet 500 mg or 2 tablets 250 mg 3 times a day.	gastrointestinal infections with vomiting and diarrhea; Infectious mononucleosis; lymphocytic leukemia; allergies and hypersensitivity.
Antihistamines	"Suprastin"	1 tablet 25 mg 3 times a day	peptic ulcers; glaucoma; arrhythmia; myocardial infarction; prostate dysfunction; individual intolerance.
Nonsteroidal anti-inflammatory drugs	"Ibuprofen"	1 tablet 200 mg 3 times a day	internal bleeding; peptic ulcers; hyperkalemia; III trimester of pregnancy.
	"Paracetamol"	1 tablet 500 mg 3 times a day	severe kidney and liver dysfunction; alcoholism; blood diseases; hypersensitivity.

Often when long-term treatment antibiotics, the development of fungal infections is observed, to suppress which an antifungal drug, Nystatin or Ketonazole, can be prescribed.

It is also important to supplement drug therapy with drugs to enhance immunity - vitamins or immunomodulatory drugs.

Gargling as a remedy for sore throat

The purpose of rinsing for a sore throat is to wash away pathogenic flora from the surface of the tonsils.

Antiseptic solutions are used for this:

• Furacillin solution. Grind 2 tablets into powder and dissolve in 1 glass of boiling water. Cool until warm.
• Soda-salt solution with iodine. Dissolve 1 teaspoon of salt and 1 teaspoon of soda in 0.5 liters of hot water. Add 3-4 drops of iodine into the solution.
• Lugol's solution. 1 teaspoon pharmaceutical solution dilute in 1 glass of warm water.
• Propolis solution. Dilute 2 teaspoons of alcohol pharmaceutical solution in 1 glass of warm water.
• Chlorophyllipt solution. Dilute 2 teaspoons of pharmaceutical solution in 1 glass of warm water.

For tonsillitis, you need to gargle at least 6 times a day. The product must be prepared in sufficient volume - about 0.5 liters per rinse. For each procedure it is better to use a fresh solution.

Throat sprays

The use of sprays is advisable after rinsing. Spraying them over the surface of washed tonsils has a local analgesic and anti-inflammatory effect.

• "Tantum Verde";
• "Hexoral";
• "Strepsils";
• "Inhalipt";
• Lugol spray.

You can also use lozenges that have the same effect as sprays - Faringosept, Septolete, Strepsils.

It is important to understand that neither sprays nor lozenges cure tonsillitis.

They alleviate some symptoms of sore throat and help relieve inflammation in the throat, but an infection that has penetrated deep into the tissue can only be destroyed with antibiotics.

Compresses for the throat

Warm compresses, once popular in the treatment of sore throats, are now causing controversy. On the one hand, they improve local blood circulation and relieve pain when swallowing. On the other hand, they contribute to the penetration of infection through the circulatory system into other organs, which leads to serious complications. For the same reason, inhalation is not recommended for angina.

It is strictly forbidden to apply compresses in the following situations:

• the presence of pus on the tonsils;
• heat;
• cerebrovascular accidents;
• cardiovascular pathologies;
• allergies and dermatitis;
• thyroid diseases.

However, compresses can alleviate the condition if a sore throat is accompanied by lymphadenitis - inflammation of the submandibular or cervical lymph nodes.

To do this, you can use the drug “Dimexide”, which penetrates well through the skin, anesthetizes and relieves inflammation:

• dilute “Dimexide” with warm water in a ratio of 1:3;
• soak a gauze compress in the solution and squeeze;
• apply a compress to the submandibular and side surfaces neck;
• secure it with a dry soft cloth;
• tie a wool scarf.

This compress should be kept for an hour, after which the skin should be wiped with clean water.

Folk remedies

Traditional medicine can offer many auxiliary means that complement drug therapy:

• Honey-vinegar rinse. Dissolve 1 teaspoon of 6% apple cider vinegar in 1 glass of warm water. Add 1 teaspoon of honey and gargle.
• Gargling with decoction oak bark. Pour 1 heaping tablespoon of raw material into an enamel bowl and brew 0.5 liters of boiling water. Simmer on the stove for 30 minutes, cool until warm and filter.
• Propolis peas. After rinsing, take pea-sized pieces of propolis and chew thoroughly until a characteristic burning sensation and numbness appears.
• Dry salt compress. Heat coarse salt in a frying pan or in the oven and pour it into a fabric bag. While warm, apply to the neck area in the submandibular area and secure with a scarf. Keep until cool.

In the treatment of sore throat, decoctions of rose hips, infusions of chamomile and linden color, tea with lemon, which you need to drink in large quantities. To soothe your throat, you can drink warm milk with a teaspoon of honey.

Treatment depending on the form of sore throat

Tonsillitis has many varieties and a complex classification. Depending on the form in which it occurs, treatment may have its own characteristics.

Catarrhal

In the catarrhal form of tonsillitis, the mucous membranes are superficially affected, without deep penetration of the infection into the tissues, so it is considered mild.

1. The tonsils turn red, become loose and increase in size.
2. Inflammation affects the adjacent arches and soft palate.
3. An increase in temperature to 380C is observed.
4. Pain when swallowing and headaches occur.
5. There is a general feeling of weakness.

Treatment catarrhal form Tonsillitis occurs according to the usual pattern and is often avoided without the use of antibiotics.

But if the disease is neglected, it can progress to a more severe stage - lacunar tonsillitis.

With it appears on the tonsils white coating, exudate collects in the gaps. The temperature can rise to 390C and higher. Treatment of lacunar tonsillitis should be carried out under the strict supervision of a doctor, since the disease is fraught with serious complications.

Follicular

Follicular tonsillitis is characterized by deep tissue damage to the tonsils. Yellow-white lesions resembling grains—festering follicles—become noticeable on them. This form is considered severe and often requires hospitalization.

1. As with lacunar angina, the temperature can be high - from 390C and above.
2. The patient experiences increased salivation.
3. Present sharp pains, it becomes very difficult to swallow.
4. Sometimes there is pain in the heart area.

Follicular tonsillitis can be treated at home, but constant medical supervision is required.

This form of the disease requires high doses antibiotics, monitoring blood tests and subsequent rehabilitation.

Purulent

Purulent tonsillitis is commonly called either lacunar or follicular tonsillitis. Both forms are characterized by the presence of suppuration. Feature of therapy purulent forms tonsillitis – mandatory use of antibiotics. If necessary, they are prescribed not only in tablets, but also intramuscularly.

In some cases, treatment of purulent tonsillitis requires a special procedure - mechanical cleaning of the tonsils. It is prescribed if rinsing does not bring results. Cleaning at home is very difficult; it requires some skill. In addition, if done incorrectly, erosions may appear or an abscess may develop. Therefore, it is better to entrust the manipulation to a doctor, who will carefully remove the purulent plugs with a spatula and treat the throat with an antiseptic.

Phlegmonous

The phlegmonous form develops as a complication of purulent tonsillitis. Otherwise it is called “paratonsillitis”. In this case, the tissues adjacent to the tonsils are deeply affected.

Phlegmonous tonsillitis develops rapidly and is characterized by the following symptoms:

• temperature increase to 400C and above;
• severe hoarseness or complete loss of voice;
• increased salivation and bad breath;
• reduction (contracture) of the jaws;
• severe swelling of the soft and hard palate;
• severe pain, manifestations of general severe intoxication.

Treat phlegmonous form You can’t get a sore throat on your own.

If such symptoms appear, you should immediately call an ambulance.

Ulcerative-necrotic

Ulcerative-necrotic tonsillitis is a separate form of the disease, which is called Simanovsky tonsillitis. It develops differently than all those described above. Its cause is not the entry of an external infection into the body, but the activation of its own opportunistic microflora, which under normal conditions does not cause any inconvenience.

Simanovsky's tonsillitis can occur against the background of a general weakening of the immune system - after long-term illnesses, exhaustion, immunodeficiency, chronic infections.

The symptoms of the disease are as follows:

• temperature up to 37.50C;
• slight sore throat;
• manifestations of stomatitis with bad breath;
• grayish-white plaque and ulcers on the tonsils, usually on one side.

Advanced ulcerative necrotic tonsillitis leads to necrosis of the tonsils, palate, larynx and tongue. Adequate treatment is possible only after complete laboratory diagnostics. It usually includes antibiotic therapy and treatment of ulcers with hydrogen peroxide, irrigation of the throat with antiseptics, and lubrication of the tonsils with iodine.

Sore throat is an inflammation of the tonsils, which is infectious in nature. The virus can begin to progress due to the slightest hypothermia: cold drinks, ice cream, air and other reasons. The causative agents can be a variety of bacteria and viruses: staphylococci, streptococci, pneumococci. The disease develops both against the background of ARVI and independently, without other disorders in the body.

The onset of pathological processes is indicated by a sore throat, which over time develops into severe pain. In addition, the patient’s body temperature rises, lymph nodes enlarge, weakness and nausea appear. If the disease is noticed at the first stage of development, you can do without medical help - traditional medicine offers many remedies to eliminate the disease.

What symptoms bother a person?

1. Aches in the joints, heaviness in the muscles.
2. Inflammation of the lymph nodes.
3. Redness of the throat, tonsils, uvula and back wall are inflamed, the color is bright.
4. Body temperature, depending on the type of disease, can rise to 38-39 degrees.
5. Acute pain, much stronger with normal inflammation of the mucous membrane of the throat, can be observed both when swallowing and in a relaxed state.
6. General deterioration in health due to infection, fatigue and malaise.
7. The appearance of plaque or ulcers on the tonsils, the formation of follicles, a dense coating on the root of the tongue.

All these symptoms signal the presence of inflammation caused by microorganisms, which progresses in the pharynx.

How to treat a sore throat at home

There is a proven treatment regimen that includes certain medications. If you follow all the instructions, you can get rid of the disease relatively quickly.

Remember that all medications have contraindications, so they should be prescribed by your doctor. Self-administration potent drugs can cause the development of resistance in pathogenic microorganisms and, as a result, complicate further treatment of angina.

• To relieve symptoms, drugs such as Analgin, Aspirin, paracetamol, Citramon are used. One drug from this list is used, but not more than 5 days.
• Antibiotics. Although they can cause many side effects, taking them for sore throat is necessary. As a rule, they are prescribed by a specialist for lacunar and follicular tonsillitis. Common antibiotics are Ampiox, Tsifran, Axacillin, Macropen. If severe complications are observed, injectable drugs are used - Penicillin, Cefazolin.
• Bed rest. It must be observed not only at the moment high temperature, but also in the next few days. Remaining rest is mandatory, since sore throat often affects many organs negatively. This point must be supplemented with plenty of fluids. For this, fruit drinks, jelly, and juices are used. By drinking fluids, toxic products will be eliminated from the body much faster.
• Following a special diet. When a person has a sore throat, food should be such that it does not irritate the mucous membrane of the larynx. Cooked food should not be spicy, hot or overly salty. It should also be soft and liquid. At the same time, the products should contain many vitamins and minerals. Doctors often recommend eating chicken broth soup, mashed potatoes and vegetables, steamed cutlets and fish, porridge with water or milk.
• Sulfonamide drugs. If we talk about how to quickly cure a sore throat, then it is simply impossible not to mention these drugs. Biseptol or Sulfalen are often prescribed. Medicines are used for catarrhal sore throat, independently, and are almost always only additions to antibiotics. The instructions describe the dosage of the drug, which is calculated based on the patient’s age.
• Aerosol preparations. To quickly get rid of the disease, it is recommended to irrigate the throat several times a day with the following aerosols - Kameton, Ingalipt, Yox, Kolustan. Medicines have antimicrobial and analgesic effects.
• It is recommended to take antihistamines - Diphenhydramine, Suprastin. They relieve throat swelling well.

Such measures, with any method of treatment, make it possible to eliminate a sore throat much faster and go through the recovery process. Therefore, doctors believe that it is better to take sick leave and rest at home for a week.

Folk remedies for sore throat

The main condition for treatment methods alternative medicine is the absence of allergic reactions to all components included in the formulations. The following folk remedies are considered highly effective:

1. Lemon and honey. The juice squeezed from 1 fruit is stirred in 350 ml of warm water. Salt (1/4 tsp) and honey (3 tsp) are added to the resulting drink. Take twice a day.
2. Honey, butter and milk. In 200 ml of warm boiled milk, you need to dissolve butter and honey (1 tablespoon of each ingredient). Allowed to replace regular oil cocoa butter The frequency of reception is not limited.
3. Lemon juice and ginger. 1 tsp. Pour ginger crushed to a powder into boiling water (700 ml) and simmer over low heat for 10 - 12 minutes. Dissolve 4 tsp in the cooled broth. honey, add black ground pepper(1 pinch). The resulting volume of medication is divided into 3 doses and consumed throughout the day. Duration of treatment is up to 5 - 7 days.
4. Cranberry tea. 2 tsp. berries ground with sugar are poured with a glass of boiling water. Use warm up to 3 times a day. This method can also reduce the temperature.

These drugs make it possible to alleviate the course of the disease, since they have antiviral, antibacterial, and restorative effects. They help activate the immune system and speed up recovery. Treatment of any type of sore throat in children folk recipes requires consultation with the treating pediatrician.

Gargling for the treatment of sore throat in adults

Gargling - this method of treatment plays one of the main roles in the healing process. Thanks to daily rinsing, all harmful bacteria and pus are washed out of the mouth and larynx. Pain in the throat also decreases, resulting in an improvement in the overall condition of the body.

• a mixture of natural beet juice and table vinegar considered a unique remedy against germs and infections. This solution, when rinsed, has an anti-inflammatory effect and relieves pain when swallowing.
• Honey water (warm) is good for rinsing drinking water and a few spoons of honey), mix, use to gargle several times a day;
• medicinal mixture: squeeze the juice out of carrots and add a few cloves of garlic, grated on a fine grater. Take the mixture before meals for two or three days;
• handle sore tonsils a mixture of onions and honey. Grate a small onion, squeeze out the juice, add a teaspoon of natural honey to it. mix everything thoroughly. The healing composition is ready!
• medicinal mixture: a teaspoon of honey and the same amount of aloe juice, mix. Take several times a day before meals;
• Beetroot, which is rich in vitamins and microelements, has a beneficial effect on the body and on the source of inflammation. Extract fresh beet juice or boil it in a small amount of water, natural juice or gargle with beetroot broth. Beets perfectly eliminate swelling on the mucous membranes of the throat, pain and are effective against purulent phenomena in the tonsils;
• Warm honey-milk composition is a well-known way to get rid of sore throat, inflammation in the larynx, colds and coughs. Dissolve a little honey in a glass of warm milk and add butter for a more softening effect.

An important condition is the optimal temperature of the prepared solution: it should be within 35 - 40 degrees. It is not recommended to consume drinks or food after the end of the treatment session. Their reception is allowed half an hour after the procedure.

Compresses

Moist compresses for warming the chest and neck are very effective in treating sore throat. They help stop the development of the inflammatory process, reduce sore throat and increase blood circulation. An important condition for using compresses is normal body temperature (36.6?). At a late stage of disease progression, when ulcers appear on the tonsils, warm compresses cannot be used.

The compress can be applied to the throat, excluding the thyroid gland area. A cloth soaked in a specially prepared solution is applied to the skin. Then it is covered with plastic film. For insulation, everything is covered with a layer of flannel, and then tied with a warm scarf.

There are many recipes for medicinal and warming compresses that can be used to treat sore throat.

1. Cabbage leaf with honey also warms well and stops the inflammatory process. In order to cabbage leaf has become a little softer, you need to pour boiling water over it and leave for a couple of minutes. after this, the warm sheet should be blotted with water, greased with honey and applied to the neck with this side. Cover the top with film and tie it with a scarf.
2. A compress from boiled potatoes is prepared as follows: wash the potatoes and boil them with their skins on, then knead them, add a few drops of an alcohol solution of iodine and a spoonful of any vegetable oil. The resulting mass is placed in a gauze bag. When the temperature of the potato becomes tolerable for the skin, it is applied to the throat and wrapped around the neck. This compress can be left on even overnight.
3. An alcohol compress is easy to prepare. To do this you need to take 70% medical alcohol and dilute it with cold boiled water in a 1:1 ratio. To achieve a greater effect, take not simple alcohol, but an alcohol tincture with herbs. You can drop a few drops of some essential oil there, for example, eucalyptus or lavender. This compress should be used with caution by those with sensitive skin to avoid getting burned.
4. A compress of raw potatoes with vinegar is prepared as follows: you need to grate 2-3 medium tubers on a fine grater, add 1 tablespoon of 6% vinegar, place in a bag of thick fabric and apply it to your throat. This remedy perfectly relieves inflammation.

Children can apply compresses 1-2 times a day, and it is better to do this before bed. At the same time, it is desirable that your feet are also warm. Adults can apply warm compresses to a sore throat for 3-4 hours, taking two-hour breaks in between.

Inhalations

For sore throat, inhalation is an effective method of treating a sore throat - during inhalation, tissues are heated, medicinal extracts go directly to the site of the disease. Home inhalations are often carried out based on herbal decoctions; several are given below sample recipes preparations.

1. Prepare a decoction of dry St. John's wort and chamomile - pour 3 tablespoons of herbs into a liter of water, bring to a boil, cool - you can get a burn from the steam. To enhance the effect, add a few drops essential oils any conifers. Inhalation is carried out as in the previous recipe - for 20 minutes.
2. Take 2 tablespoons of crushed dry chamomile, mint, sage, pour in a liter of warm boiled water. Bring the mixture to a boil over low heat, then remove from heat and allow to cool slightly. The patient bends over a vessel with a decoction, his head is covered with a towel. You need to breathe through your mouth - this is how steam with healing extracts reaches the affected areas.

It is important to know - inhalations are contraindicated when elevated temperature– they are usually carried out on last stage treatment like additional procedure to restore the mucous membrane of the throat.

It is possible to eliminate a sore throat not only on an outpatient basis. The disease is complex, but can be treated at home. Should choose effective methods, effective medications, the right healing regimen, and after a few days your throat will say goodbye to the annoying misunderstanding in the form of a sore throat. What home treatment regimen should I use to make the process go faster?

Medications

You cannot do without medications, since sore throat can cause complications. Without them, achieving a painless recovery is more difficult and takes longer. For sore throat, it is recommended to take antibiotics according to the strict instructions of the doctor and the instructions on the package. You cannot prescribe treatment for yourself or follow television advice. For a throat affected by disease, medical specialists prescribe:

1. "Bicillin"– a one-time intramuscular injection of the medicine actively fights against sore throat and sore throat.
2. « » – adult daily dose is 1.5 g, divided by 3 times, for children – 0.75 g/day. The course of treatment for sore throat is 10 days.
3. "Phenoxymethylpenicillin"– designed for 10-day use, three times a day, 60 minutes before meals. The dosage is selected strictly according to the instructions.
4. "Flemoxin"– the drug is taken in a convenient way: chewed, dissolved in water, swallowed. The dosage is written on the medicine at intervals of 2-3 hours.
5. "Amoxil"- between by oral administration an interval of 8 hours is maintained. The medicine is swallowed whole, since the action of the antianginal antibiotic occurs after it is dissolved in the stomach.
6. "Gramox"– intake for the treatment of angina is limited to 1 capsule, repeated three times, interval – from 5 hours.
7. – designed for a 3-day course of throat healing, for which you should take 1.5 g of the drug.
8. "Midecamycin"– the antibiotic is prescribed for one to two weeks, with a maximum dosage for adults of 1.6 g/day. The daily dosage for children is based on weight, amounting to 30-50 mc/kg.
9. "Sumamed"– the medicine is presented in capsule, tablet, and suspension form. Strict dosages are indicated on the packaging.
10. "Hemomycin"– limited to one daily dose, one hour before meals or 2 hours after. The instructions will tell you the appropriate dosage of the antibiotic.
11. "Erythromycin"– the medicine is administered by drip, intravenously, at low speed. The daily dose is limited to 1-2 g, divided into 2-4 appointments, with an interval between antibiotic injections of 6 hours.

In addition to the indicated medications, many others are available for sale, which are recommended to be alternated in the process of healing the throat. Sore throat is extremely insidious because it can create an addiction in the body to the effects of drugs. If the usual treatment does not give results, contact medical specialist. Be sure to tell the new doctor what medications you took last time. Antibiotics should be accompanied by the use of antihistamines and lactobacilli for the intestines.

Folk remedies

Traditional medicine preparations against sore throat present themselves at their best. There are a lot of methods for treating throat problems. different efficiency, however, we have selected the fastest ones. It is especially recommended to use them in the initial stages, when tonsillitis shows the first signs of its appearance and does not yet require antibiotics. So it’s possible to avoid going to the pharmacy for a potent drug if you stop the throat disease in time.

To eliminate pain, apply bandages:

1. Fold the gauze into 6 layers, wet it with a 10% saline solution, and apply it to the throat and neck area. Wrap tightly with a dry natural cloth on top and leave overnight.
2. Rub a dry bandage and gauze thickly with laundry soap and apply to the throat. It is better to fix the compress with a warm cloth with good air exchange. The pain will go away by morning.
3. Cut lard without salt into thin slices, apply to the throat, secure with parchment, cotton wool, a scarf, and on top with a scarf. It is done all night.
4. Soaked cold water The bandage is secured to the neck with a dry shawl. Left until morning, it effectively relieves pain.

1. Dry potato flowers, poured boiling water, leave until a not hot, warm solution is formed. After straining, gargle. To get rid of the pinching sensation and pain after the procedure, it is recommended to rinse with butter.
2. Create a mixture of a tablespoon of peroxide (3%) and a glass of water. Rinsing helps eliminate plaque on the tonsils, pain, helps reduce intoxication, and makes the course of the throat disease less painful.
3. Mix a glass of water with 0.5 tablespoons of tea soda, salt, iodine. All ingredients are taken in equal quantities, but the iodized part can be reduced to avoid a throat burn.

Eating simple foods that work well against sore throats:

1. Beet– add 6% vinegar (1 tbsp) to vegetable juice (1 glass), mix thoroughly. It is permissible to gargle with the solution up to 6 times a day; sometimes you are allowed to swallow a little of the mixture, no more than a sip. Effective for sore throat.
2. Potato– when boiled in its uniform, it is ideal for throat inhalation.
3. Onion– a fresh teaspoon of juice taken three times a day helps quick deliverance sore throat, pain relief.
4. Propolis– slow chewing and resorption of the product afterwards helps eliminate germs and sore throat.
5. Honey– great in tandem with lemon. It is recommended to mix equal parts of both products in such an amount that it is comfortable to take into the mouth. 1 tablespoon is enough. The mixture is kept in the mouth for 10 minutes and then carefully swallowed.

Watch the video from easy recipes home treatment. Have a sheet of paper ready with a pencil to mark the methods you are interested in. Pay attention to the described gargling techniques, which allow the prepared medicines to exert maximum force in the fight for a healthy throat. How to properly use lemon against a sore throat? What is the secret of consuming honey? Which dosage form should antianginal drugs be preferred? You will find answers and detailed instructions for treating a throat in the video. Find out the most effective folk secrets that declare war on sore throat.

Local therapy

Light shape sore throats can be treated with local antiseptics, which are freely available in nearby pharmacies. Their beauty is the instantly felt relief of throat pain, so there is a desire to constantly suck on some kind of lollipop. However, even candy-shaped drugs are medical drugs, having their maximum daily dose.

Preparations for topical use - lozenges and lozenges - have proven themselves well in the treatment of sore throat, and the drugs are more effective complex composition. For example, the drug Anti-Angin® Formula tablets/lozenges, which include vitamin C, as well as chlorhexidine, which has a bactericidal and bacteriostatic effect, and tetracaine, which has a local anesthetic effect. Due to its complex composition, Anti-Angin® has a triple effect: it helps fight bacteria, relieve pain and helps reduce inflammation and swelling. (1,2)

Anti-Angin® is available in a wide range of dosage forms: compact spray, lozenges and lozenges. (1,2,3)

Anti-Angin® is indicated for manifestations of tonsillitis, pharyngitis and the initial stage of sore throat; this may be irritation, tightness, dryness or sore throat. (1,2,3)

Anti-Angin® tablets do not contain sugar (2)*

*With caution in case of diabetes mellitus, it contains ascorbic acid.

1. Instructions for use of the drug Anti-Angin® Formula in lozenge dosage form.

2. Instructions for use of the drug Anti-Angin® Formula in the dosage form of a lozenge.

3. Instructions for use of the drug Anti-Angin® Formula in the dosage form of a dosed spray for topical use.

There are contraindications. You need to read the instructions or consult a specialist.

Take them according to the instructions:

1. "Septolete"– Limit 8 pieces of candy for adults, 4 for kids. Maintain an interval of a couple of hours between resorption of the medicine.
2. "Falimint"– a maximum of 10 pieces of throat medicine per day is allowed.
3. "Strepsils"– no more than 8 lozenges per day, with a break between doses of 2-3 hours.
4. "Sebidin"– the medicine is taken no longer than a week, 4 tablets per day.

Treatment regimen for angina

An effective working scheme for eliminating sore throat includes 7 indispensable rules. Maximum implementation, a combination of official and home medicine, and the correct regimen contribute to a successful healing process. Therefore, adhere to the following rules for treating sore throat and sore throat:

1. Bed rest with increased fluid intake, a simplified plant-dairy diet, and limited bad habits. It is strictly forbidden to endure a sore throat in the usual rhythm of life, since the body needs strength to fight a sore throat.
2. Taking antibiotics specifically selected by a professional who prescribes a treatment regimen for sore throat. Do not interrupt the course if you feel deceptive relief in your throat. If antibiotics are prescribed for 5 days, take them for 5 days; if 10, take 10. The beauty of such drugs is their effect on temperature; there is no need to take antipyretics separately.
3. Regular rinsing with antiangin infusions that relieve sore throat, destroy germs, and remove plaque from the tonsils. This is an excellent background treatment for sore throat, complementing drug methods.
4. Resorption of local tableted antiseptics, which work well in the fight against the initial stage of sore throat. Keep a few lollipops with you to prevent the disease from developing before active treatment begins, and to quickly relieve pain.
5. Treatment of the throat with aerosols that kill germs, relieve pain from sore throat, and reduce inflammation. They show instant results, so they are good as a local anesthetic.
6. The use of night compressors, which enhance the effect of antianginal drugs, eliminate pain discomfort, eliminate harmful microorganisms. Some dressings actively relieve pain overnight without requiring reapplication.
7. Fulfillment of all doctor's orders, no amateur activities, compliance with strict instructions for the use of drugs for sore throat.

How to avoid complications after a sore throat

This insidious disease that affects the tonsils can cause complications not only local, but also general. The heart, blood vessels, liver, joints, and kidneys are strongly affected by angina. Simple methods can help you avoid the annoying consequences of a sore throat:

• Complete the course of treatment. The absence of painful discomfort from a sore throat does not mean that the throat disease has given up or receded. Always bring the treatment process to its logical conclusion - absolute recovery, which can only be established by the doctor.
• At first, limit yourself to sports so that your body can fully restore its reserves. It only creates the appearance that the throat disease has nothing to do with the physical condition of the body. Sore throat greatly depletes the body's strength, so it is important to replenish it with rest, calmness, and positive emotions.
• Carefully take care of your body’s heat exchange, do not allow it to become overcooled, wet, or catch a cold. The process of treating a sore throat allows the intake of ice-cold drinks and ice cream, but during rehabilitation their intake should be sharply limited. ­ ­ ­ ­ ­ ­­

Home treatment for sore throat demonstrates noticeable effectiveness, but the process must be supervised by a specialized specialist. Avoid self-indulgence in treatment, since the disease can have serious consequences that complicate the general condition of the body. To prevent illness, train your body to resist sore throat, increase protective barriers, work on your immunity, and harden yourself.

Sore throat (acute tonsillitis) is an acute infectious disease with inflammation of the palatine tonsils, the same ones that many call tonsils. The tonsils trap bacteria and viruses that a person inhales, and the immune cells and antibodies in the tonsils help kill them and prevent infections from reaching the throat and lungs.

Mostly children of preschool and school age from 3 to 14 years old, as well as adults up to 35-40 years old, suffer from tonsillitis. In infants and in early childhood up to 3 years of age, as well as in people over 50 years of age, sore throat is rarely observed.

Causes of sore throat

The main causes of the development of sore throat in children over 3 years of age and adults are microorganisms - Group A β-hemolytic streptococcus. Staphylococcus can be a common causative agent of sore throat. Much less commonly, the causes of sore throat are adenoviruses, Coxsackie A viruses, Candida fungi and other microorganisms.

Penetration of the pathogen into the mucous membrane of the tonsils (they are located on the sides of the entrance to the pharynx and are clearly visible if you look into the open mouth) occurs through airborne droplets or alimentary routes (through water and/or food).

In some cases, microbes located in the throat and not causing diseases, are activated under the influence of certain unfavorable conditions, for example, during cooling or sudden temperature fluctuations environment. For some children, it is enough to wet their feet, drink a glass of cold milk or eat ice cream, and they immediately get a sore throat.

In adults, frequent sore throats can be associated with purulent inflammatory processes in the nasal cavity and paranasal sinuses, in which nasal breathing is impaired, for example, with sinusitis, as well as in the oral cavity (carious teeth). Also, the cause of sore throat in an adult can be caused by bad habits(smoking, alcohol abuse), other unfavorable conditions - work in hazardous industries, poor diet, vitamin deficiencies.

In addition, there are a number of infectious and systemic diseases, one of the manifestations or complications of which may be tonsillitis (specific tonsillitis): diphtheria, scarlet fever, infectious mononucleosis, tuberculosis.

Symptoms of a sore throat

There are several forms of sore throat, each of which has its own distinctive characteristics: symptoms, signs and methods of treatment. Clinical manifestations tonsillitis depends on the degree of tissue damage and the type of pathogen. Local and general symptoms are distinguished. To local symptoms, common to all forms of sore throat, include discomfort or pain in the throat, usually quite sharp, aggravated by swallowing, enlarged lymph nodes that can be felt under lower jaw closer to the neck. General symptoms of sore throat– malaise, weakness, increased body temperature to 39-40°C, chills; Possible pain in muscles, joints, and heart area.

Symptoms of a sore throat in a child. In children early age In addition to redness of the tonsils and the back of the throat, symptoms such as refusal to eat, ear pain, nausea and abdominal pain, loose stools, and seizures are also typical. The child cries, is capricious, has problems sleeping, the child is either lethargic or has increased excitability. Very often, sore throat in children is accompanied by manifestations of otitis and rhinitis.

The symptoms of a sore throat are very similar to the common cold, but a sore throat is more severe, the sore throat is more acute, and the duration of the illness is longer, usually 5-7 days.

Depending on the degree of damage to the palatine tonsils, there are several forms of sore throat:

• catarrhal(damage to the mucous membrane of the tonsils), the most light form tonsillitis;
• purulent lacunar(involvement of the lacunar apparatus with the formation of plaque and pus in the lacunae);
• purulent follicular(inflammation of lymphoid follicles);
• fibrinous, phlegmonous, ulcerative-necrotic and mixed forms.

There are several types of sore throats, which are characterized by different pathogens. So, for example, if the causative agent of purulent sore throat is streptococcus, then the sore throat is called streptococcal, with staphylococcus - staphylococcal, and so on.

Depending on whether one or both tonsils are inflamed, tonsillitis can be unilateral and/or bilateral. In many cases, tonsillitis is combined with pharyngitis - inflammation of the posterior wall of the pharynx; the lingual tonsil, palatine ridges, etc. can also be involved.

Sore throat is contagious to others, especially small children, so it is necessary to isolate the patient and provide him with separate cutlery and care products.

Diagnostics

A bacteriological examination of a throat smear is necessary to identify the causative agent of a sore throat, but the problem is that the result often has to wait from 3 to 5 days. And in order not to delay treatment with antibiotics (especially in children), doctors use certain criteria to assess the likelihood of a streptococcal infection, so if the body temperature is above 38°C, there is no cough or runny nose, the tonsils are swollen, bright red or have plaque on them, and regional lymph nodes, especially under the lower jaw, are enlarged and painful on palpation, then antibiotic treatment is carried out without waiting for culture results.

More often than other forms, catarrhal tonsillitis occurs, which manifests itself predominantly as superficial damage to the palatine tonsils. Catarrhal sore throat flows more gently and independent disease occurs infrequently. In this form of tonsillitis, the inflammatory process is limited to damage only to the mucous membrane of the palatine tonsils and the edges of the palatine arches - their swelling and redness are noted. General symptoms are expressed moderately: the general condition may be satisfactory, but it may also worsen, which is manifested by intoxication, lethargy, increased fatigue, an increase in body temperature to subfebrile levels (37-37.5°C), in children it can rise to 38.0°C. There is pain when swallowing, soreness and dryness in the throat. The tongue is usually dry, coated, and there is a slight enlargement of the lymph nodes. In rare cases, catarrhal tonsillitis is more severe. In childhood, clinical phenomena are most often more pronounced than in adults.

A clinical blood test reveals mild neutrophilic leukocytosis (7-9 · 10 9 /l) and a slight band shift to the left, ESR - up to 18-20 mm/h.

The duration of the disease is 3-5 days, after which two options are possible: either the inflammation in the pharynx will subside, or the sore throat will develop into another, more severe severe form- follicular or lacunar. Although catarrhal tonsillitis differs from other clinical forms of the disease in its relatively mild course, we must not forget that severe complications can develop after it.

Follicular tonsillitis is also called purulent and begins acutely, with an increase in temperature to 38-39 ° C, but sometimes it can be subfebrile. There is a severe pain in the throat when swallowing, which radiates to the ear. Increased salivation may occur - this is due to severe pain in the throat and the inability to swallow saliva because of this. Enlarged lymph nodes can be felt under the lower jaw and on the back of the head; they are painful on palpation. Intoxication, headache, weakness, fever, chills are pronounced, and sometimes there is pain in the lower back and joints.

Follicles (plugs) form on reddened and swollen tonsils. Follicles– these are yellowish or whitish dots (grains, the size of a pinhead up to 3 mm) rising above the surface in the tonsil area, filled with gray-yellow pus. These purulent follicles are clearly visible when examining the throat and form a “starry sky” picture on the surface of the palatine tonsils. Three to four days after the onset of the disease, the plugs are opened, after which the temperature drops and the condition improves. Small wounds (erosions) remain in place of the abscesses.

In adults, stool retention is possible, tachycardia and heart pain may appear. In children - loss of appetite, nausea, vomiting, loose stools. People with poor health and children may experience fainting.

From the blood side, neutrophilic leukocytosis, stab shift to the left, increase in ESR, traces of protein may appear in the urine.

The disease lasts about a week.

The symptoms of the lacunar type of tonsillitis are similar to the symptoms of follicular tonsillitis: the disease begins acutely, high temperature up to 38–39.0 ° C, headache, swollen lymph nodes, difficulty swallowing, joint pain, but the form has a more severe course. The inflammatory process occurs as if on the surface of the tonsil tissue, and the purulent discharge is localized in the lacunae. The main difference between the symptoms of follicular and lacunar tonsillitis is the localization of purulent plaque on the enlarged tonsils. In the follicular form, purulent plugs appear in the follicles of the tonsils; in the lacunar form, the ducts of the palatine tonsils are affected.

Lacunar tonsillitis in children is especially dangerous, as it is often accompanied by severe inflammation of the tonsils, which can complicate breathing and sometimes completely block it. The main reasons for this process are the special structure of the upper respiratory tract. Also, due to high temperature and intoxication, the child may experience convulsions. The cervical lymph nodes are enlarged and painful.

The blood test showed an increased content of leukocytes and an increased ESR.

Fungal tonsillitis

Often found in young children. More often recorded in autumn and winter. It begins acutely, the temperature rises to 37.5–38 °C, but more often it is subfebrile. Upon examination, enlargement and slight redness of the tonsils, bright white, loose, curd-like deposits that are easily removed are revealed. The plaque disappears on the 5th–7th day. The smears reveal accumulations of yeast cells, mycelium of thrush fungi and bacterial flora.

Sore throat with scarlet fever

A connection has been established between the incidence of sore throat in adults and scarlet fever in children. In years of rising incidence of scarlet fever, there is an increased incidence of sore throat. Inflammatory changes in the pharynx usually develop even before the rash appears. The causative agent of scarlet fever is group A hemolytic streptococcus. Transmission of the infection occurs mainly by airborne droplets; children aged 2 to 7 years are most susceptible.

The disease begins acutely with a rise in temperature, malaise, headache and sore throat when swallowing. With severe intoxication, repeated vomiting occurs. Sore throat with scarlet fever is a constant and typical symptom. It is characterized by bright hyperemia of the mucous membrane of the pharynx (“flaming pharynx”), spreading to the hard palate, where sometimes there is a clear boundary of the inflammation zone against the background of the pale mucous membrane of the palate. The palatine tonsils are swollen, covered with a grayish-dirty coating, which, unlike that in diphtheria, is not continuous and is easily removed. Plaques can spread to the palatine arches, soft palate, uvula, and floor of the mouth.

If the disease is caused by viruses, then usually children with sore throat have the following symptoms: cough, runny nose, tonsils are red, mucus is visible on the back of the throat, and conjunctivitis is often observed. For viral sore throat soft palate, palatine arches, uvula, less often on the tonsils and the back wall of the pharynx reveals small, pinhead-sized, reddish bubbles. After a few days, the blisters burst, leaving behind superficial, quickly healing erosions, or undergo reverse development without previous suppuration. The cause of viral sore throat is influenza, parainfluenza, rhinovirus, coronavirus, adenovirus.

The causative agents of purulent sore throat are bacteria: streptococci and staphylococci. Streptococcal sore throat differs from viral sore throat in the absence of cough and runny nose. The main difference from viral is the presence of plaque white on the tonsils.

The incubation period for sore throat, whether viral or bacterial, is the same 5-7 days.

Complications of sore throat

Complications are more often observed with streptococcal sore throat and include local phenomena that develop on the 4-6th day of illness, and general ones that usually develop after 2-3 weeks:

• local complications - sinusitis, otitis media, cervical lymphadenitis;
• general complications – acute glomerulonephritis(kidney damage), hemorrhagic vasculitis.

Sometimes, even with mild catarrhal tonsillitis, heart damage (rheumatism of the heart, myocarditis) can be observed. In this case, symptoms such as heart pain, shortness of breath, and arrhythmia may occur. These complications usually appear in most cases when a person has suffered from the disease “on his feet”. Therefore, an extremely important point in the treatment of sore throat is compliance with bed rest.

Prevention consists of timely and adequate treatment of sore throat.

Treatment of sore throat

Treatment of sore throat is usually carried out at home, and only in case of severe disease - in an infectious diseases hospital.

The principle of treatment for all forms of sore throat is different. For example, treatment of catarrhal tonsillitis caused by a virus consists of alleviating the symptoms of the disease, since viral tonsillitis usually goes away on its own. In this case, to relieve the symptoms of the disease, it is recommended to: gargle with salt water, or furatsilin solution, drink plenty of warm fluids. If the cause of a sore throat is streptococcus, then antibiotics are necessary to treat purulent sore throat.

Non-drug treatment. In the first days it is prescribed strict bed rest, and subsequently - a home regime with limited physical activity. This is necessary to prevent complications.

A sick child or adult must be given separate dishes and a towel, and contact with others must be limited as much as possible. Recommended plenty of warm drinks(non-acidic fruit juices, tea, rosehip infusion, dried fruit compote, still mineral water, jelly). From food, everything is allowed that does not injure the inflamed tonsils; gentle, non-irritating food, mainly dairy-vegetable, is best suited. rich in vitamins, for example, pureed vegetable puree, vegetable or chicken broth, thin porridge, steamed cutlets, etc. Spicy, rough, hot or cold foods should not be given.

Antibiotics for sore throat

Treatment of purulent sore throat begins with a prescription antibacterial drugs. The choice of antibacterial drugs depends on the severity of the disease and the threat of complications. Antibiotics are used for treatment in age-specific doses. For various forms of bacterial tonsillitis, antibiotics are used, taking into account the sensitivity of the pathogen to antibiotics. In emergency cases, broad-spectrum antibiotics (Amoxicillin, Flemoxin-Solutab) are prescribed.

For infants, penicillin antibiotics are chosen, which are produced in the form of syrups with fruit additives. For acute streptococcal sore throat, Phenoxymethylpenicillin and Ospen are prescribed. If you are allergic to penicillins, choose cephalosporins or macrolides (Azithromycin, Sumamed).

To reduce the temperature and eliminate pain in a child, drugs based on paracetamol or ibuprofen are used. For young children, it is preferable to use these products in the form of rectal suppositories. In this case, the risk of allergic reactions is reduced, since syrups and tablets contain aromatic additives.

Improvement usually occurs with a decrease in intoxication and an improvement in general condition. However, antibiotic treatment must be continued for another three to five days.

A purulent sore throat in a child is a serious test for the baby and his parents. Treatment of the disease must be timely and appropriate to the age of the patient.

Systemic antibacterial therapy should be combined with local administration of antimicrobial drugs with a broad spectrum of action. In older children with sore throat, you can use absorbable tablets and lozenges - Faringosept, Stopangin, Strepsils, Grammidin, as well as sprays such as Hexoral, Ingallipt, Hexasprey, Tantum Verde and others. Most sprays and lozenges are approved for use in children only after three years of age.

Frequent gargling with antibacterial solutions, the use of antiseptic and anti-inflammatory inhalations, aerosols speed up the healing process and reduce local symptoms diseases.

Adults and older children can gargle. Suitable for rinsing pharmaceutical herbs(chamomile, eucalyptus, plantain, calendula), medications - (furatsilin solution, Miramistin, 1% alcohol solution of chlorophyllipt, Lugol), and gargling with solutions with soda, salt, iodine, which you can prepare yourself at home. Iodine-based rinses should be used with caution in children to avoid allergic reactions.

You can also gargle beet juice, diluted with lemon juice, diluted apple cider vinegar, strong tea.

In order for the medicine to reach the deep parts of the pharynx, when rinsing, the head must be tilted back strongly.

Previous tonsillitis, especially with inadequate treatment, is a predisposing factor to the formation of a chronic inflammatory process in the tonsils. Chronic tonsillitis is spoken of in cases where sore throats recur more than 2 times a year, which in turn increases the risk of developing severe complications. Treatment of purulent tonsillitis, especially in a child, must be comprehensive and must be carried out under the strict supervision of a doctor.