Antibiotics For Pharyngitis - Which Ones Are More Effective?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Antibiotics for pharyngitis

The choice of treatment tactics is made by the doctor, only he decides whether or not it is advisable to prescribe antibiotics for pharyngitis. His decision is influenced by data on the etiology and course of the disease.

In the early stages, the following methods are practiced to treat inflammation of the pharynx:

• Neck compresses;
• Inhalation;
• Hot foot baths;
• Rinsing the throat;
• Compliance with vocal rest;
• Physiotherapy procedures.

The ineffectiveness of the measures taken, the lack of positive dynamics is the reason for the prescription of antibiotics.

First, antibiotics of the penicillin group are prescribed, in case of their ineffectiveness - drugs from the group of semi-synthetic penicillins:

• Ampicillin,
• Ospin,
• Augmentin,
• Oxacillin.

To prevent the infection from descending to the lower parts of the respiratory system, antitussive drugs are included in the treatment regimen, and to preserve the beneficial intestinal microflora - probiotics and prebiotics containing bifidobacteria and lactobacilli.

Content:

• Indications for the use of antibiotics for pharyngitis
• Release forms
• Pharmacodynamics of antibiotics for pharyngitis
• Pharmacokinetics of antibiotics for pharyngitis
• Use during pregnancy
• Contraindications to the use of antibiotics for pharyngitis
• Side effects of antibiotics for pharyngitis
• Antibiotics for pharyngitis in adults
• Antibiotics for pharyngitis in children
• The name of antibiotics for pharyngitis
• Method of application and dose of antibiotics for pharyngitis
• The best antibiotic for pharyngitis

Indications for the use of antibiotics for pharyngitis

In most cases, the doctor prescribes antibiotics to prevent and treat complications after the addition of a bacterial infection.

Indications for the use of drugs of this group in the treatment of inflammation of the pharynx:

• High risk of developing pneumonia;
• Subfebrile temperature lasting more than 5-6 days;
• Hyperthermia for more than 2 days;
• Obstructive bronchitis, concomitant pathology of the bronchi;
• Bacterial sore throat;
• Exacerbation of chronic pharyngitis;
• The risk of a purulent otitis media of the middle ear;
• The spread of the pathological inflammatory process into the nasopharynx;
• Prolonged course of the disease (longer than a month).

Release forms

Often, pharyngitis is combined with an acute rhinitis or other manifestations of the common cold, or, conversely, these diseases cause inflammation of the pharynx. Because of this, inflammation of the pharynx is usually treated with systemic antibiotics and topical agents in the form of applications, rinsing and irrigation of the pharynx.

Release forms:

• Aerosols containing combination products;
• Solutions for lubricating mucous membranes and processing granules on pharyngeal rollers;
• Ampoules for intramuscular injection;
• Tablets;
• Capsules;
• Powder for sprinkling the affected mucous membrane.

Pharmacodynamics of antibiotics for pharyngitis

To determine the clinical effect of antibiotic use, the following indicators are analyzed:

• The speed and area of drug spread;
• The ability to target the affected area of the mucous membrane of the respiratory tract.

Liver and kidney pathologies negatively affect the effectiveness of the drug. Individual characteristics of metabolism, the ability to establish connections with blood cells affect the properties of drugs. The higher the degree of absorption of the drug, the more successful the course of treatment of pharyngitis with antibiotics is. The connection of the components of the antibacterial drug with the enzymes of the digestive system can lead to the formation of ballast or toxic compounds.

After the antibiotic enters the human body, it dissolves, and its active ingredient is released and absorbed.

A decrease in the activity of the drug, a partial change in properties occurs after its interaction with the following elements:

• With leftover food
• With enzymes of gastric juice,
• With other medicines.

As a result of the combination of antibiotics with food in the digestive tract, poorly soluble or completely insoluble compounds with weak adsorption are formed. Antibiotics from the tetracyclines group are not recommended to be taken with milk, since the calcium of dairy products binds to the components of the drug. Certain types of food negatively affect the absorption of antibiotics from the group of penicillins, tetracyclines, Erythromycin, Rifampicin, etc.

Pharmacokinetics of antibiotics for pharyngitis

The degree of influence of the active substance of antibiotics on the causative agent of the disease differs markedly at different stages of its stay in the body. From the moment the drug enters the bloodstream until its elimination, the antibiotic goes through the following stages:

1. Suction,
2. Distribution,
3. Metabolism,
4. Excretion.

Intramuscular administration of the drug accelerates its transportation to the focus of infection, as well as the effect on microorganisms. The rate at which the drug enters the circulatory system directly depends on its ability to dissolve in water and fatty substances.

In some cases, it is more effective to administer antibiotics directly into the pharyngeal cavity in the form of sprays and aerosols. The duration of action of the antibiotic after administration in each case differs, lasting from several hours to several days.

Use during pregnancy

Uncomplicated pharyngitis in pregnant women is usually treated with symptomatic methods:

• Steam inhalation,
• Compresses,
• Rinsing,
• Drinking warm milk with honey.

If there are no critical changes in the patient's health, systemic antibiotics are usually not prescribed. In extreme cases, the doctor may prescribe local antibiotic therapy with minimal penetration into the circulatory system. This approach reduces side effects for the fetus and the body of a pregnant woman.

Systemic antibiotics for the treatment of pharyngitis are prescribed by a doctor only after a complete examination of the woman and an assessment of the likely consequences for the health of the mother and child.

Contraindications to the use of antibiotics for pharyngitis

It is impossible to start antibiotic treatment without getting acquainted with the contraindications:

• Hypersensitivity to drugs in this group, to antibacterial agents;
• Pregnancy (especially the 3rd trimester);
• Lactation (possibly forced cessation of breastfeeding during antibiotic therapy);
• Hepatic and renal failure.

Additional contraindications for each drug are noted in the instructions for its use.

Side effects of antibiotics for pharyngitis

The most common side effects from antibiotic use are:

• Development of candidiasis - fungal diseases, mycoses, thrush;
• Dyspepsia: epigastric pain, flatulence, indigestion, intestinal inflammation, vomiting and nausea;
• Anemia, a decrease in the concentration of leukocytes and platelets in the blood;
• Joint pain, the appearance of pinpoint hemorrhages under the skin;
• Allergy manifestations: anaphylactic shock, allergic rhinitis, conjunctivitis, dermatitis, angioedema;
• Feverish conditions;
• Anaphylaxis when applied topically: choking, laryngeal spasm, mucosal edema.

Antibiotics for pharyngitis in adults

Drugs with antibacterial activity are prescribed for adult patients with pharyngitis with the following purpose:

• Elimination of symptoms of infection;
• Normalization of the state;
• Prevention of primary and secondary complications.

There must be an important reason for the appointment of antibiotics - the bacterial origin of pharyngitis. Prescribing drugs in this group without any reason causes such undesirable consequences as antibiotic resistance and other side effects.

The basis for starting antibiotic therapy is the data of bacteriological analysis. The doctor is able to determine the origin of pharyngitis before obtaining these results, guided by the clinical picture of the manifestations of the disease.

Antibiotics used for pharyngitis in adults:

• Drugs from the penicillin group;
• Oral cephalosporins: Ceftriaxone, Cefazolin;
• Macrolide antibiotics (Azithromycin, Erythromycin), and lincosamide antibiotics (Clindamycin, Lincomycin) - for the treatment of people who are allergic to β-lactams.

Factors to be considered for effective treatment of the acute form of the disease:

• The course of antibiotic treatment cannot be shorter than 10 days, with the exception of the drug Azithromycin, designed for 5-day use;
• Timely prescription of antibiotic therapy is a guarantee of a quick recovery and absence of complications;
• As prescribed by the doctor, a repeated laboratory test is carried out to monitor the results of treatment.

The use of ineffective antibiotics requires changing the drug to drugs with a wider spectrum of action.

Reasons for the transition of acute pharyngitis to a chronic form:

• Wrong selection of drugs in the treatment of acute forms of the disease;
• Violation of the doctor's recommendations: self-withdrawal of the drug, dose reduction, change in the frequency of administration;
• Accession of infection from existing chronic foci.

Treatment rules that protect against the transition of the disease into a chronic form:

• Strict adherence to the dosage and regimen of taking antibiotics until complete recovery;
• Timely transition to systemic drugs in case of ineffective previous treatment;
• Control using bacteriological analysis.

Antibiotics for pharyngitis in children

For the treatment of inflammatory diseases of the pharynx in children, in most cases, the doctor adheres to the tactics of local treatment - irrigation of the oral cavity and pharynx with antibacterial solutions and aerosols (Orasept, Miramistin, Hexoral). They are selected taking into account the age of the patient and the possibility of side effects in the form of allergies and other side effects.

Uncomplicated forms of pharyngitis do not require oral administration of systemic antibiotics; they are prescribed only when there is a risk of complications. The indications for their admission may be joining sore throat pharyngitis. In this case, starting from the 4th year of life, children are prescribed anti-bacterial lozenges (Strepsils, Falimint).

When pharyngitis is complicated by the addition of microorganisms such as staphylococcus, streptococcus, hemophilus influenzae, the doctor prescribes antibiotics that are sensitive to a certain type of pathogenic bacteria.

Treatment with antibacterial aerosols in children under 2 years of age requires special care. Unexpected sensations with a sudden injection of the agent can cause an attack of suffocation with a reflex spasm of the larynx. To avoid such a reaction, the aerosol is sprayed onto the inner surface of the child's cheeks, and not into the throat. Abstaining from food and drink for 1-2 hours after injection will help prolong the effect of the drug.

The name of antibiotics for pharyngitis

The following types of antibiotics are used to treat inflammatory processes in the pharynx:

• Penicillin antibiotics: Phenoxymethylpenicillin, Amoxicillin, Benzylpenicillin;
• Antibiotics from the cephalosporin group: Ceftriaxone, Cefadroxil;
• Antibiotics from the macrolide group: Roxithromycin, Erythromycin, Azithromycin, Midecamycin, Spiramycin, Clariromycin;
• Antibiotics from the lincosamide group: Clindamycin, Lincomycin.

Method of application and dose of antibiotics for pharyngitis

Treatment of pharyngitis is carried out locally with drugs aimed at pathogenic microorganisms that have led to inflammation of the pharyngeal mucosa.

So, for example, Fyuzafyunzhin aerosol has the following properties:

• Shows antimicrobial and anti-inflammatory activity;
• Regenerates damaged tissues of the mucous membrane;
• Protects the downstream parts of the respiratory system from infection.

Regimens for the use of systemic drugs are different, they are used in different combinations.

The most commonly prescribed dosages are:

• Benzylpenicillin - 2.4 IU intramuscularly once. The antibiotic is used in difficult situations, in patients with negative conditions of life and social environment, during epidemics;
• Cefadroxil - 5 mg 2 r / day;
• Azithromycin - 5 mg once per day 1 of treatment, then 0.25 mg once an hour before meals for 4 days;
• Midecamycin - 4 mg 3 r / day one hour before meals;
• Amoxicillin - 5 mg 3 r / day;
• Phenoxymethylpenicillin - 5 mg 3 r / day one hour before meals, when treating children, the dose is adjusted depending on the patient's age;
• Clarithromycin - 0.25 g 2 r / day;
• Roxithromycin - 0.15 g 2 r / day for 10 days;
• Clindamycin - 0.15 g 4 r / day for 10 days;
• Erythromycin - 5 mg 3 r / day (the drug has a large number of side effects);
• Cefuroxime - 0.25 g 2 r / day immediately after meals for 10 days.

Even after stabilization of the patient's condition, disappearance of the characteristic symptoms of pharyngitis, restoration of lymph nodes and cessation of hyperthermia, the course of using the antibiotic prescribed by the doctor should not be interrupted.

Overdose

Long-term antibiotic treatment without calculating the optimal dosage leads to the following changes in blood composition:

• Neutropenia
• Hemolytic anemia
• Leukopenia
• Thrombocytopenia.

The consequences of an overdose are stopped by symptomatic treatment, excluding peritoneal dialysis and hemodialysis, as activities that do not bring results.

Interaction with other drugs

Antibiotics and drugs from other pharmacological groups interact with each other to varying degrees. This effect depends on the composition, pharmacodynamics and pharmacokinetics of the drugs.

• Antibiotics from the cephalosporin group may exhibit allergic cross-sensitivity in patients with a history of allergies;
• Semi-synthetic antibiotics of the penicillin series enhance the effect of fibrinolytics, anticoagulants, antiplatelet agents;
• The combination of antibiotics and NSAIDs increases the likelihood of negative side effects;
• The combination of antibiotics from the group of tetracyclines and macrolides with drugs of the penicillin series reduces the antibacterial activity of the latter.

Storage conditions

Proper storage of antibacterial drugs:

• Antibiotics produced in the form of tablets and powders are stored out of sunlight, out of the reach of children, at a temperature not exceeding + 25 ° C for 2 years.
• Antibiotics, produced in the form of solutions and aerosols, are stored in a dry and dark place at temperatures from + 8 ° C to + 15 ° C for 1-2 years.

The best antibiotic for pharyngitis

The choice of antibiotic depends on the individual characteristics of patients, the degree of development of the inflammatory process, and the characteristics of the course of the disease.

Penicillin drugs (Benzylpenicillin) are prescribed when a bacterial infection (streptococci, staphylococci, anaerobic bacteria) joins the inflammation. Broad-spectrum penicillins (Carbencillin, Ampicillin) are used to treat group A streptococcal infections and pneumococci.

Respiratory system pathologies in children and adults caused by infection with gram-negative bacteria, Proteus and Escherichia coli are treated with Ampicillin. It is used in the treatment of not only pharyngitis, but also tonsillitis, otitis media, etc.

Carbencillin, an antibiotic that effectively affects the bacterial flora, has a similar effect on Pseudomonas aeruginosa and all types of proteas.

Oxacillin, Dicloxacillin - penicillinase-resistant antibiotics of semisynthetic origin stop the infection caused by staphylococcus. Dicloxacillin is more active than the above drugs, therefore it is used in smaller doses in the treatment of pharyngitis of the same course.

The low efficiency of treatment with one antibiotic in difficult cases and with moderate pharyngitis requires the appointment of complex remedies:

• Antibiotics of the cephalosporin group, close in the breadth of the range of action to semi-synthetic penicillins (Ceftriaxone, Cefazolin);
• Antibiotics from the macrolide group (Oleandomycin, Erythromycin).

The use of antibiotics from the tetracycline group is no longer as relevant as it was several decades ago. They are used to target pathogenic bacteria resistant to other types of antibiotics and hypersensitivity to penicillins. Absolute contraindications to their use are children under 8 years of age, pregnancy and lactation.

Semi-synthetic tetracyclines such as Metacyclin, Morphocyclin differ in less pronounced side effects. They are used in smaller doses, and the side effects are not as significant as with drugs from the same group.

Long-term antibiotic treatment provokes the development of mycoses, therefore, the treatment of pharyngitis with these drugs is accompanied by the appointment of antifungal agents.

The information contained in this article is provided for informational purposes only. The use of antibiotics requires consultation with a doctor and careful adherence to his recommendations and instructions for use.

The author of the article: Lazarev Oleg Vladimirovich | ENT

Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)