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A Journal on Internal Medicine and Pharmacology

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2000 December;159(6):231-5

language: Italian

Clinical and epi­dem­i­olog­i­cal ­study of pha­ryn­go­ton­sil­litis in­fec­tions, ­caused by β-hae­mo­lyt­ic Streptococcus of ­group A, in the pe­di­at­ric pop­u­la­tion of Molfetta and Giovinazzo (Southern Italy)

Balducci O. 1, De Laurentiis L. 1, Facchini I. 1, Spadavecchia M. 1, Spano M. 1, Zanzarella C. 1, Lorusso L. 2, Portoghese A. 2, Pranzo C. 2, Traetta G. 2, Mezzina G. 3, Grasso G. 4, Mezzina M. 4

1 AUSL BA/2 - Molfetta;
2 AUSL BA/2 - Giovinazzo;
3 Ospedale Civile di Molfetta, Laboratorio Centrale d’Analisi;
4 Ufficio d’Igiene - Giovinazzo


Aims. Acute pha­rayn­go­ton­sil­litis is one of the ­most com­mon in­fec­tions of the res­pir­a­to­ry ­tract and 95% of cas­es of bac­te­ri­al or­i­gin are ­caused by β-hae­mo­lyt­ic Streptococcus of ­group A (SBE­GA). In or­der to ­face a pa­thol­o­gy ­with ­such a ­wide-rang­ing so­cial im­pact, we ­found it nec­es­sary to use com­mon strat­e­gies.
Methods. In ­this ­open ­study 122 pa­tients ­were en­rolled, ­aged 3-14 ­years, suf­fer­ing ­from ­acute pha­ryn­gitis or pha­ryn­go­ton­sil­litis ­with a clin­i­cal ­score ac­cord­ing to mod­i­fied Breese great­er ­than 23. The pa­tients ­were giv­en anti­bi­o­tic ther­a­py in the ­form of sus­pen­sion (amox­y­cil­lin-clav­u­lan­ic ac­id, cef­a­clor, rok­i­tam­y­cin). The fol­low-up ex­am­ina­tion was car­ried out ­between 7 and 10 ­days af­ter the end of ther­a­py. In or­der to eval­u­ate re­cov­ery, the clin­i­cal ­score of mod­i­fied Breese and the pos­i­tiv­ity of pha­ryn­geal ­swab for SBE­GA and Staphylococcus au­re­us ­were con­sid­ered. Antibiograms ­were car­ried out for all pos­i­tive ­swabs.
Results. Clinical re­cov­ery was ­achieved in 100% of cas­es ­with amox­y­cil­lin-clav­u­lan­ic ac­id and ­with rok­i­tam­y­cin. The ­best re­sults as re­gards anti­bi­o­grams ­were al­so ­found ­with amox­y­cil­lin-clav­u­lan­ic ac­id and ­with rok­i­tam­y­cin.
Conclusions. In the treat­ment of pha­ryn­go­ton­sil­litis it is nec­es­sary act ear­ly. In the ar­ea of anti­bi­o­tic treat­ment amox­y­cil­lin-clav­u­lan­ic ac­id and rok­i­tam­y­cin al­low treat­ment of ­these ­young pa­tients achiev­ing suc­cess­ful clin­i­cal re­cov­ery. It is de­sir­able to ob­tain re­spons­es to cul­tures and to anti­bi­o­grams as quick­ly as pos­sible in or­der to ­choose a ther­a­py ­which is not on­ly ra­tion­al, but al­so in­creas­ing­ly spe­cif­ic.

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