Document Detail

Macrolides in the management of streptococcal pharyngitis/tonsillitis.
MedLine Citation:
PMID:  9109157     Owner:  NLM     Status:  MEDLINE    
The most frequent bacterial cause of pharyngitis/tonsillitis, a common infection in children, is group A beta-hemolytic streptococci. Prevention of acute rheumatic fever is the principal goal of treatment, although antibiotic therapy may also relieve the signs and symptoms of infection, shorten the infective period and prevent suppurative complications. Penicillin is the drug of choice. Alternatives are required, however, for patients allergic to penicillin and may be needed if the rate of bacteriologic failure with penicillin observed during the past decade continues. Erythromycin is generally effective in this infection, but its use, especially in children, is complicated by the need for multiple daily doses, a lengthy treatment period and a high rate of gastrointestinal side effects. The newer macrolides clarithromycin and azithromycin offer lower rates of gastrointestinal complaints and more convenient dosing. Clarithromycin is recommended for twice daily and azithromycin for once daily administration. Because of its prolonged tissue half-life, the recommended duration of azithromycin therapy is 5 days, compared with 10 days for penicillin, erythromycin and clarithromycin. Newer macrolides are rational alternatives to erythromycin for streptococcal pharyngitis/tonsillitis in penicillin-allergic patients.
M J Tarlow
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  16     ISSN:  0891-3668     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-07-09     Completed Date:  1997-07-09     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  444-8     Citation Subset:  IM    
Department of Pediatrics, Birmingham Heartlands Hospital, Bordesley Green East, UK.
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MeSH Terms
Anti-Bacterial Agents / administration & dosage,  adverse effects,  therapeutic use*
Azithromycin / administration & dosage,  adverse effects,  therapeutic use*
Child, Preschool
Clarithromycin / administration & dosage,  adverse effects,  therapeutic use*
Erythromycin / administration & dosage,  adverse effects,  therapeutic use*
Penicillins / administration & dosage,  therapeutic use
Pharyngitis / drug therapy*
Streptococcal Infections / drug therapy*
Tonsillitis / drug therapy*
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Penicillins; 114-07-8/Erythromycin; 81103-11-9/Clarithromycin; 83905-01-5/Azithromycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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