The best antibiotics for angina for adults

Angina (acute tonsillitis) is an inflammation of the mucous membrane of the pharynx and lymph nodes.

The cause of angina in more than 65% of cases is group A β-hemolytic streptococcus, but it is also caused by viruses (adenovirus, parainfluenza, coronavirus), fungi, staphylococci, pneumococci.

Angina usually begins acutely. Her symptoms:

• increase in body temperature up to 38 degrees;
• sore throat that gets worse when swallowing (especially solid foods);
• soreness and enlargement of the lymph nodes under the lower jaw;
• enlargement and redness of the palatine tonsils, the appearance of a white coating is possible.

Since in most cases the cause of angina is group A β-hemolytic streptococcus, the patient needs antibiotic therapy.

It is impossible to say unequivocally without special laboratory tests which antibiotic is the best and which is the worst. The “gold standard” of diagnosis is sowing from the pharynx, which shows the sensitivity of the pathogen to antibacterial drugs. Only then can you be sure of the cause of acute tonsillitis. Unfortunately, sowing is performed within a few days, and treatment must be started immediately. We list the most popular and effective antibiotics for angina with a typical course of the disease.

List of top 10 inexpensive and effective antibiotics for angina according to KP

According to clinical guidelines, there are drugs of choice for the treatment of angina: antibiotics that are effective against group A β-hemolytic streptococcus in most people¹. There are also alternative drugs. We list the most effective and popular antibiotics that are regularly prescribed by practitioners.

1. Amoxicillin

The active substance is amoxicillin.

Available in the form of capsules, tablets, granules. It belongs to the group of penicillins. They act on the cell wall of the pathogenic microorganism and destroy it. Since the wall of the bacterium has a rigid structure, when it is destroyed, it dies.

Indications:

• infectious processes of the respiratory system (tonsillitis, otitis media, laryngitis, tracheitis, sinusitis, bronchitis, pneumonia);
• infections of the urinary tract and genital organs (cystitis, pyelonephritis, cervicitis);
• some infectious diseases of the gastrointestinal tract (H.pylori, enterocolitis, salmonellosis);
• infections of the outer integument, soft tissues, muscles.

Contraindications:

• hypersensitivity to beta-lactam antibiotics;
• serious kidney disease;
• during pregnancy and lactation only after consulting a gynecologist.

2. Flemoxin Solutab

The active substance is amoxicillin.

Available in the form of dispersible tablets, that is, the drug can be dissolved in water and drunk. Compared to conventional amoxicillin, this form has several advantages:

• greater bioavailability (up to 95% with 70-80% for conventional amoxicillin);
• has greater acid resistance, which allows it not to decompose under the action of hydrochloric acid in the stomach and immediately enter the bloodstream;
• the maximum dosage in the blood is reached faster;

Indications and contraindications for both drugs are the same. The differences are that Flemoxin Solutab contains saccharin as part of the excipients. This is important for people with diabetes (especially with uncontrolled course).

3. Amoxiclav

The active substance is amoxicillin in dosages + clavulanic acid 125 mg.

Produced in the form of tablets, granules and powder for suspension. It belongs to the group of penicillins in combinations. The drug acts on the cell wall of the microorganism and destroys it, and clavulanic acid enhances the effect of amoxicillin.

Indications:

• infectious diseases of the respiratory system;
• urinary tract infections (cystitis, pyelonephritis, cervicitis);
• some diseases of the gastrointestinal tract (H.pylori, enterocolitis, salmonellosis);
• soft tissue infections.

Contraindications:

• allergic reaction to penicillins, cephalosporins;
• serious blood diseases;
• with caution during pregnancy and lactation.

4. Ciprofloxacin

The active substance is ciprofloxacin

Available in the form of tablets, as well as solutions for injection, eye and ear drops.

Belongs to the group of fluoroquinolones of the 2nd generation. It affects the genes of the microorganism, which leads to disruption of DNA synthesis and death of the bacterial cell.

Indications:

• respiratory infections;
• urinary tract infections (cystitis, pyelonephritis, cervicitis);
• some infectious diseases of the gastrointestinal tract (H. pylori, enterocolitis, salmonellosis);
• infectious diseases in ophthalmology;
• infections of the skin, soft tissues, muscles, bones, joints.

Contraindications:

• allergy to fluoroquinolones;
• serious diseases of the cardiovascular system;
• pregnancy and lactation.

5. Suprax Solutab

The active substance is cefixime at a dosage of 400 mg.

Available in the form of dispersible tablets, that is, they can be dissolved in water and drunk as a suspension.

Suprax Solutab belongs to the 3rd generation cephalosporins. Unlike the 2nd generation, it is more active against gram-negative bacteria (rods, vibrio, spirilla). Also, the Solutab form has an acid-resistant shell, high bioavailability and has a pleasant taste (in contrast to the classic bitter taste from conventional ceftriaxone).

6. Azithromycin

The active substance is azithromycin in dosages of 125, 250, 500 mg.

Available in the form of tablets and capsules. Belongs to the group of macrolides. This group of drugs inhibits protein synthesis in a bacterial cell, which leads to its death. It also slows down the growth and reproduction of a pathogenic microorganism.

Indications:

• infections of the respiratory tract, ENT organs (tonsillitis, otitis media, sinusitis, bronchitis, pneumonia);
• urinary tract infections (urethritis, cervicitis);
• infections of the skin, soft tissues.

Contraindications:

• allergy to macrolides;
• serious liver disease;
• during pregnancy with caution;
• lactation period.

7. Sumamed

The active substance is azithromycin in dosages of 125, 250, 500, 1000 mg.

Available in the form of tablets, capsules, soluble tablets.

Belongs to the group of macrolides. Contraindications and indications are the same as those of Azithromycin. Sumamed is an original drug, however, its price is higher than that of the generic (Azithromycin). This is due to the fact that significant amounts are required for research and testing. In addition, Sumamed causes fewer side effects and allergic reactions and has greater bioavailability.

8. Vilprafen Solutab

The active substance is josamycin at a dosage of 1000 mg.

Available in the form of soluble tablets. Belongs to the group of macrolides. This group of drugs inhibits protein synthesis in a bacterial cell, which leads to its death. It also slows down the growth and reproduction of a pathogenic microorganism. Resistance to josamycin rarely develops, therefore, with insensitivity to erythromycin, Vilprafen Slutab may be the drug of choice.

Indications:

• infections of the respiratory tract, ENT organs;
• urinary tract infections (prostatitis, gonorrhea, urethritis, cervicitis);
• infectious diseases in ophthalmology and dentistry;
• soft tissue infections.

Contraindications:

• allergy to macrolides;
• serious liver disease;
• pregnancy and lactation – with caution.

9. Clarithromycin

The active substance is clarithromycin in dosages of 250, 500 mg.

Available in the form of tablets and capsules. Belongs to the group of macrolides. This group of drugs inhibits protein synthesis in a bacterial cell, which is why it dies. It also slows down the growth and reproduction of “invaders”.

Among macrolides, it has the widest antimicrobial spectrum. Side effects are rarely noted.

10. Macropen

The active substance is midecamycin in dosages of 400 mg.

Available in the form of tablets and granules for the preparation of a solution. Belongs to the group of macrolides.

Indications:

• infectious diseases of the respiratory system, ENT organs;
• some diseases of the genitourinary organs (urethritis, cervicitis);
• diphtheria;
• soft tissue infections.

Contraindications:

• allergy to macrolides;
• hypersensitivity to aspirin;
• serious liver disease;
• pregnancy – with caution;
• lactation period.

How to choose antibiotics for angina for an adult

Basic rules of antibiotic therapy:

• identify the pathogen (bacteria, viruses, fungi);
• identify the sensitivity of the microorganism to antibacterial drugs;
• start treatment as early as possible;
• first of all, an antibiotic with a wide spectrum of action is prescribed;
• the dose and duration of administration must be selected individually so that resistance does not occur.

Penicillins – drugs of choice in the treatment of angina, that is, they are usually prescribed in the first place. The advantage of penicillins is:

• low toxicity;
• broad antimicrobial spectrum;
• often used in combinations (clavulanic acid, sulbactam), which enhances the antimicrobial effect;
• resistant to acid in the stomach.

Cephalosporins – alternative drugs for the treatment of angina. Appointed for:

• resistance to other groups of antibacterial drugs.

Macrolides – effective antibiotics in the treatment of angina. Their features:

• effective for allergies to penicillins;
• good tolerance (except for erythromycin) and low toxicity;
• active against most pathogens, including atypical ones;
• prescribed 1-2 times a day².

The doctor should choose an antibacterial drug taking into account the clinical picture and examination data.

Popular questions and answers

We discussed important issues related to the prescription of antibiotics for angina, with therapist Tatyana Pomerantseva.

Sources:

1. Clinical guidelines “Acute tonsillitis and pharyngitis (Acute tonsillopharyngitis)”. 2021
2. Register of Medicinal Products of Russia ® RLS®2000-2021.
3. “Antibiotic resistance in the modern world” Namazova-Baranova Leila Seymurovna, Academician of the Russian Academy of Sciences, Professor. 2017