THERAPEUTICAL NOTES   

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

Copyright © 2000 EDIZIONI MINERVA MEDICA

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.