Antibiotics for pharyngitis

The choice of treatment tactics is made by the doctor, only he decides whether it is advisable or not 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;

• Inhalations;

• Hot foot baths;

• rinsing of the throat;

• Compliance with voice rest;

• Physiotherapeutic procedures.

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

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

• Ampicillin,

• Aspen,

• 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.

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 bronchial pathologies;

• bacterial sore throat;

• Exacerbation of chronic pharyngitis;

• The risk of purulent otitis media;

• The spread of the pathological inflammatory process in the nasopharynx;

• Prolonged course of the disease (more than a month).

Forms of release

Often, pharyngitis is combined with an acute runny nose or other manifestations of a 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, rinses and irrigation of the pharynx.

Forms of release:

• Aerosols containing combined products;

• Solutions for lubricating the mucosa and processing granules on the pharyngeal rollers;

• Ampoules for intramuscular injections;

• Tablets;

• Capsules;

• Powder for sprinkling the affected mucous membrane.

Pharmacodynamics of antibiotics in pharyngitis

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

• The speed and area of ​​distribution of the drug;

• The ability to purposefully influence the affected area of ​​the mucous membrane of the respiratory tract.

Pathologies of the liver and kidneys 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. 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 food leftovers

• With gastric enzymes

• With other medicines.

As a result of the combination of antibiotics with food in the gastrointestinal tract, the formation of poorly soluble or completely insoluble compounds with weak adsorption occurs. Antibiotics from the tetracycline 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 in pharyngitis

The degree of impact 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 it is eliminated, the antibiotic goes through the following stages:

1. Suction,

2. Distribution,

3. metabolism,

4. Withdrawal.

Intramuscular administration of the agent accelerates its transportation to the source of infection, as well as the impact on microorganisms. The rate of drug entry into 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 varies, lasting from several hours to several days.

Use during pregnancy

Uncomplicated pharyngitis in pregnant women is usually treated symptomatically.:

• steam inhalation,

• compresses,

• rinses,

• Drinking warm milk with honey.

If there is no critical change in the patient’s health status, systemic antibiotics are usually not prescribed. In extreme cases, the doctor may prescribe topical 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 knowing the contraindications:

• Hypersensitivity to drugs of this group, to antibacterial agents;

• Pregnancy (especially 3rd trimester);

• Lactation (possibly forced cessation of breastfeeding for the duration of antibiotic therapy);

• Liver and kidney 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 the use of antibiotics are:

• The development of candidiasis – fungal diseases, mycoses, thrush;

• Dyspepsia: pain in the epigastric region, flatulence, indigestion, intestinal inflammation, vomiting and nausea;

• Anemia, a decrease in the concentration of leukocytes and platelets in the blood;

• Articular pain, the appearance of petechial hemorrhages under the skin;

• Allergy manifestations: anaphylactic shock, allergic rhinitis, conjunctivitis, dermatitis, angioedema;

• Feverish conditions;

• Anaphylaxis with topical application: suffocation, spasm of the larynx, mucosal edema.

Antibiotics for pharyngitis in adults

Drugs with antibacterial activity are prescribed to adult patients suffering from pharyngitis, with the following purpose:

• Elimination of symptoms of infection;

• Normalization of the state;

• Prevention of primary and secondary complications.

For the appointment of antibiotics, there must be an important reason – the bacterial origin of pharyngitis. Prescribing drugs of this group without any reason causes such undesirable consequences as resistance to antibiotics 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 these results are obtained, guided by the clinical picture of the manifestations of the disease.

Antibiotics used for pharyngitis in adults:

• Preparations from the group of penicillins;

• Oral cephalosporins: Ceftriaxone, Cefazolin;

• Macrolide antibiotics (Azithromycin, Erythromycin), and lincosamide antibiotics (Clindamycin, Lincomycin) – for the treatment of people who are allergic to ?-lactams.

Factors to consider 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 appointment of antibiotic therapy is a guarantee of a quick recovery and the 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:

• Incorrect selection of drugs in the treatment of an acute form of the disease;

• Violation of the doctor’s recommendations: self-cancellation of the drug, dose reduction, change in the frequency of administration;

• Attachment of infection from existing chronic foci.

Rules of treatment 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 by 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, Geksoral). 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 systemic antibiotics, they are prescribed only when there is a risk of complications. Indications for their admission may be the addition of angina to pharyngitis. In this case, starting from the age of 4, children are prescribed antibacterial lozenges (Strepsils, Falimint).

When pharyngitis is complicated by the addition of microorganisms such as staphylococcus, streptococcus, Haemophilus 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 asthma attack 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. Refraining from drinking and eating for 1-2 hours after injection will help prolong the effect of the drug.

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 group of cephalosporins: Ceftriaxone, Cefadroxil;

• Macrolide antibiotics: Roxithromycin, Erythromycin, Azithromycin, Midecamycin, Spiramycin, Clariromycin;

• Lincosamide antibiotics: Clindamycin, Lincomycin.

Method of application and dose of antibiotics for pharyngitis

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

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

• Shows antimicrobial and anti-inflammatory activity;

• Regenerates damaged tissues of the mucous membrane;

• Protects the lower parts of the respiratory system from the penetration of infection into it.

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

The most commonly prescribed dosages are::

• Benzylpenicillin – 2,4 IU intramuscularly once. The antibiotic is used in difficult situations, in patients with negative living conditions and social environment, during epidemics;

• Cefadroxil – 5 mg 2 r / day;

• Azithromycin – 5 mg once on 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, in the treatment of children, the dose is adjusted depending on the age of the patient;

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

Overdose

Prolonged treatment with antibiotics 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 measures 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 drugs.

• Antibiotics from the cephalosporin group may show allergic cross-sensitivity in patients with a history of allergies;

• Semi-synthetic antibiotics of the penicillin series enhance the action of fibrinolytics, anticoagulants, antiaggregants;

• The combination of antibiotics and NSAIDs increases the chance of negative side effects;

• The combination of antibiotics from the group of tetracyclines and macrolides with penicillin preparations 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 a temperature of +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.

Preparations of the penicillin series (Benzylpenicillin) are prescribed when a bacterial infection (streptococcus, staphylococcus, anaerobic bacteria) is attached to the inflammation. Broad-spectrum penicillins (Carbencillin, Ampicillin) are used to treat group A streptococcal infections and pneumococci.

Pathologies of the respiratory system 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, inflammation of the middle ear, etc.

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

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

The low effectiveness of treatment with one antibiotic in complex cases and with moderate pharyngitis requires the appointment of complex agents:

• Antibiotics of the cephalosporin group, approximate in terms of the breadth of the range of action to semi-synthetic penicillins (Ceftriaxone, Cefazolin);

• Macrolide antibiotics (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 influence pathogenic bacteria that are resistant to other types of antibiotics and for hypersensitivity to penicillins. Absolute contraindications to their use are children under 8 years of age, pregnancy and lactation.

Such semi-synthetic tetracyclines as Metacycline, Morphocycline differ in less pronounced side effects. They are used in smaller doses, and side effects are not as significant as those of drugs from the same group.

Prolonged antibiotic treatment provokes the development of fungal infections, so the treatment of pharyngitis with these drugs is accompanied by the appointment of antifungal agents.

The information contained in this article is offered for informational purposes only. The use of antibiotics requires consulting a doctor and carefully following his recommendations and instructions for use.