OPTIMUM TREATMENT OF STREPTOCOCCAL PHARYNGITIS

Streptococcal pharyngitis is a common infection in children and adoles cents. The great majority of these infections are caused by group A be ta-haemolytic streptococci. Although the use of penicillins for group A beta-haemolytic streptococcal pharyngitis has reduced the incidence of rheumatic fever, in the past decade several studies of pharyngitis treatment have reported penicillin failure. It has also been suggested that in comparison with the penicillins the cephalosporins are associ ated with a lower rate of clinical failure. Cephalosporins have drawba cks in cost, administration frequency or adverse effect profile. Moreo ver, there is the theoretical risk of cross-antigenicity to cephalospo rins in penicillin-allergic patients. Erythromycin is a traditional al ternative to penicillins, especially in penicillin-allergic patients, for the treatment of tonsillopharyngitis. However, increased resistanc e as well as failure rates as high as 24.7% have been reported for ery thromycin in the treatment of pharyngitis. Therefore oral penicillins, and alternatively oral cephalosporins, should be considered first-lin e agents for the treatment of culture-confirmed group A beta-haemolyti c streptococcal tonsillopharyngitis. Cephalosporins are useful especia lly for the treatment of recurrent streptococcal tonsillopharyngitis.