According to new recommendations from the Infectious Diseases Society of America, most throat infections are caused by viruses and should not be treated with antibiotics.

The main objective of the recommendations published in the September issue of Clinical Infectious Diseases is to limit the use of antimicrobial agents for the treatment of viral infections of the posterior pharyngeal wall, as well as the rapid detection and adequate treatment for pharyngitis caused by group A streptococci (anginal streptococci). In accordance with these recommendations, penicillin and amoxicillin are the drugs of choice for the treatment of streptococcal infections.

According to a survey, up to 70% of Americans with sore throats take antibiotics. However, bacteria only cause 20-30% sore throat in children and 5-15% sore throat in adults.

According to American scientists, these recommendations are an important, timely guide for physicians to examine and treat patients with streptococcal tonsillopharyngitis. Strep throat is a common disease, however, in daily practice, viral infections are more common. According to the researchers, the doctor should be able to distinguish them, which will avoid unnecessary prescription of antibiotics that have side effects and will also increase the likelihood that a subsequent infection (in the same patient or in another) will become resistant antibiotic treatment. It will also help children to avoid surgery for recurrent tonsillitis.

Scientists note that although bacterial and viral throat infections often have a number of similar symptoms, other manifestations, such as coughing, runny nose, hoarseness, and mouth ulcers are the most common for viral infections.

On the contrary, the streptococcal nature of the disease should be suspected with an acute onset of the disease, the presence of severe pain during swallowing and fever. In such cases, independent analysis can be used to determine the causative agent to quickly detect the antigen. In children under 3 years of age, such an analysis is not necessary, since in this age group the development of strep throat is unlikely, except in special circumstances, such as infection of parents older.

Pap smears from the back of the pharynx should only be taken to confirm a negative test result for the streptococcal antigen in children and adolescents. You should refrain from doing this study in adults because of the low risk in this age group of streptococcal tonsillitis, as well as the lower risk of developing complications such as rheumatism.

In cases where the streptococcal nature of tonsillopharyngitis is confirmed, the therapy of choice is a 10-day course of penicillin (or its analogue amoxicillin), which has a narrow spectrum of activity, low cost and low risk of develop unwanted drug reactions.

American scientists recommend penicillin and amoxicillin for the treatment of streptococcal infections because they are the most effective and safest, except for patients with allergic reactions to penicillin antibiotics. At the same time, there is currently an increase in the resistance of streptococci to drugs of a wider spectrum (and, therefore, more expensive).

In these recommendations, it is also recommended to avoid tonsillectomy in children with recurrent throat infections, except in special cases (for example, in the presence of obstructive syndrome), because the relative benefit of surgery does not exceed his risk.

In the 13 recommendations developed, issued in the form of questions and answers, a lot of time is devoted to the doctor's strategy in the event that the patient suspects strep throat. According to the scientists, one of the objectives of creating these recommendations is to help a practitioner determine the tactics for managing patients with this common pathology. Patients need to explain that not all infections are bacterial in nature and therefore antibiotics should not be taken in all cases, which can sometimes do more harm than good.

Thus, clinicians must work closely with patients, provide them with detailed information about their disease, and provide appropriate assistance. Patients should be informed that antibiotics will not contribute to a viral infection, while there are other treatments.