Problemi correnti
Una vecchia “conoscenza” (la faringotonsillite) e i nuovi dubbi: trattare, non trattare…
PHARYNGOTONSILLITIS: TO TREAT OR NOT TO TREAT?
MARCELLO BERGAMINI1, ROBERTO BUSSI1, ROBERTO BUZZETTI2, MATTIA DORIA1, STEFANO DRAGO1, VITALIA MURGIA1, FRANCO RAIMO1, PAOLO SCHIEVANO1, WALTER SPANEVELLO1, GIUSEPPE VENTRIGLIA3
1Pediatra di libera scelta
2Epidemiologo clinico
3Medico di medicina generale, formatore
Novembre 2006 - pagg. 570 -578
Abstract
Pharyngotonsillitis is a very common reason for people to seek medical care, but whether or not to prescribe antibiotics is controversial. This review provides an overview of the studies which assessed the appropriateness of treating Group A streptococcal pharyngitis. For this purpose we analysed guidelines, systematic reviews and primary studies. There is general agreement about the treatment of streptococcal pharyngitis, but the efficacy of the therapy in preventing rheumatic
fever is still questionable. Methodologically sound, large, and prospective trials are needed to determine the effectiveness and the side effects of the antibiotic treatment of pharyngotonsillitis in children.
Suggerite dall'AI
Classificazione MeSH
Bibliografia
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4. Denny FW, Wannamaker LW, Brink WR, Rammelkamp CH jr, Custer EA. Prevention of the rheumatic fever: treatment of the preceding streptococcic infection. JAMA 1950; 254(4):534-7.
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7. Scottish Intercollegiate Guidelines Network. Management of sore throat and indications for tonsillectomy, 1999; http://www. sign. ac.uk/guidelines/fulltext/34/index. html.
8. Institute for Clinical Systems Improvement (ICSI). Acute pharyngitis. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI), 2005.
9. Bisno AL, Gerber AM, Gwaltney JM Jr, et al. Practice Guidelines for the Diagnosis and Management of Group A Streptococcal Pharyngitis. Infectious Diseases Society of America. Clin Infect Dis 2002;35:113-25.
10. Hayes CS, Williamson H Jr. Management of Group A beta-hemolytic streptococcal pharyngitis. Am Fam Physician 2001;63(8): 1486-7,1493.
11. Bisno AL. Acute pharyngitis. N Engl J Med 2001;344(3):205-11.
12. Pichichero ME. Group A beta-hemolytic streptococcal infections. Pediatr Rev 1998; 19(9):291-302.
13. Gerber MA, Tanz RR. New approaches to the treatment of group A streptococcal pharyngitis. Curr Opin Pediatr 2001;13(2):215.
14. Anguilar A, Tinoco JC, Macias M, et al. Clinical and bacteriologic efficacy of amoxycillin b.d. (45 mg/kg/day) versus amoxycillin t.d.s (40 mg/kg/day) in children with group A streptococcal tonsillopharyngitis. J Chem 2000;12(5):396-405.
15. Leone V, Panizon F. Streptococco: tra il dire e il fare. Sulla conflittualità tra le raccomandazioni ufficiali e la pratica quotidiana. Medico e Bambino 2002;21(6):377-82.
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17. Gruppo di Lavoro sulle linee guida per la prescrizione ambulatoriale degli antibiotici nelle infezioni pediatriche delle vie respiratorie, Bologna. Prescrizione ambulatoriale degli antibiotici nelle infezioni respiratorie. Medico e Bambino 2000;19(7):431-47.
18. Adam D, Scholz H, Helmerking M. Shortcourse antibiotic treatment of 4782 culture-proven cases of group A streptococcal tonsillopharyngitis and incidence of poststreptococcal sequelae. J Infect Dis 2000;182(2):509-16.
19. Casey JR, Pichichero ME. Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children. Pediatrics 2004;113(4):866-82.
20. Associazione Culturale Pediatri - Centro per la Salute del Bambino. La sorveglianza della letteratura per il pediatra. Newsletter N.2, Apr.-Mag. 2004, pag. 10.
21. Stanford T, Shulman ST, Gerber MS. So what's wrong with penicillin for strepthroat? Pediatrics 2004;113:1816-9.
22. Lord RW Jr. Is a 5-day course of antibiotics as effective as a 10-day corse for the treatment of streptococcal pharyngitis and the prevention of poststreptococcal sequelae? Clinical Question. The Journal of Family Practice. http://www.jfponline.com/content/2000/12/ jfp_1200_1075e.asp
23. Francis D, Del Mar C, Thomas M, Glasziou P. Non-antibiotic treatments for sore throat (Protocol). The Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD
004557. DOI: 10.1002/14651858.CD004557.
24. van Driel Ml, Habraken H, De Meyere M. Different antibiotic treatments for group A streptococcal pharyngitis (Protocol). The Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD004406. DOI: 10.1002/
14651858. CD004406.
25. Buzzetti R, Bergamini M, Bussi R, et al. Svelare lo Streptococco, rapidamente. Area Pediatrica 2006;7:47-55.
26. Del Mar CB, Glasziou PP, Spinks AB. Antibiotics for sore throat. The Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD000023.pub2. DOI: 10.1002/14651858. CD000023.pub2.
27. Sharland M, Kendall H, Yeates D, et al. Antibiotic prescribing in general practice and hospital admissions for peritonsillar abscess, mastoiditis, and rheumatic fever in children: time trend analysis. BMJ 2005;331:328-9.
28. Zwart S, Rovers MM, de Melker RA, Hoes AW. Penicillin for acute sore throat in children: randomised, double blind trial. BMJ 2003;327:1324.
2. Coburn AF. The factor of infection in the rheumatic state. Baltimore: Williams & Wilkins, 1931.
3. Collis WRF. Acute rheumatism and hemolitic Streptococci. Lancet 1931;1:1341-5.
4. Denny FW, Wannamaker LW, Brink WR, Rammelkamp CH jr, Custer EA. Prevention of the rheumatic fever: treatment of the preceding streptococcic infection. JAMA 1950; 254(4):534-7.
5. Wannamaker LW, Denny FW, Perry WD, et al. The effect of penicillin prophylaxis on streptococcal disease rates and the carrier state. N Engl J Med 1953;249:1-7.
6. American Academy of Pediatrics. Red Book (Edizione Italiana). Pacini Editore, 2003:489- 91.
7. Scottish Intercollegiate Guidelines Network. Management of sore throat and indications for tonsillectomy, 1999; http://www. sign. ac.uk/guidelines/fulltext/34/index. html.
8. Institute for Clinical Systems Improvement (ICSI). Acute pharyngitis. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI), 2005.
9. Bisno AL, Gerber AM, Gwaltney JM Jr, et al. Practice Guidelines for the Diagnosis and Management of Group A Streptococcal Pharyngitis. Infectious Diseases Society of America. Clin Infect Dis 2002;35:113-25.
10. Hayes CS, Williamson H Jr. Management of Group A beta-hemolytic streptococcal pharyngitis. Am Fam Physician 2001;63(8): 1486-7,1493.
11. Bisno AL. Acute pharyngitis. N Engl J Med 2001;344(3):205-11.
12. Pichichero ME. Group A beta-hemolytic streptococcal infections. Pediatr Rev 1998; 19(9):291-302.
13. Gerber MA, Tanz RR. New approaches to the treatment of group A streptococcal pharyngitis. Curr Opin Pediatr 2001;13(2):215.
14. Anguilar A, Tinoco JC, Macias M, et al. Clinical and bacteriologic efficacy of amoxycillin b.d. (45 mg/kg/day) versus amoxycillin t.d.s (40 mg/kg/day) in children with group A streptococcal tonsillopharyngitis. J Chem 2000;12(5):396-405.
15. Leone V, Panizon F. Streptococco: tra il dire e il fare. Sulla conflittualità tra le raccomandazioni ufficiali e la pratica quotidiana. Medico e Bambino 2002;21(6):377-82.
16. Feder HMJ, Gerber MA, Randolph MF, Stelmach PS, Kaplan EL. Once-daily therapy for streptococcal pharyngitis with amoxicillin. Pediatrics 1999;103:47-51.
17. Gruppo di Lavoro sulle linee guida per la prescrizione ambulatoriale degli antibiotici nelle infezioni pediatriche delle vie respiratorie, Bologna. Prescrizione ambulatoriale degli antibiotici nelle infezioni respiratorie. Medico e Bambino 2000;19(7):431-47.
18. Adam D, Scholz H, Helmerking M. Shortcourse antibiotic treatment of 4782 culture-proven cases of group A streptococcal tonsillopharyngitis and incidence of poststreptococcal sequelae. J Infect Dis 2000;182(2):509-16.
19. Casey JR, Pichichero ME. Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children. Pediatrics 2004;113(4):866-82.
20. Associazione Culturale Pediatri - Centro per la Salute del Bambino. La sorveglianza della letteratura per il pediatra. Newsletter N.2, Apr.-Mag. 2004, pag. 10.
21. Stanford T, Shulman ST, Gerber MS. So what's wrong with penicillin for strepthroat? Pediatrics 2004;113:1816-9.
22. Lord RW Jr. Is a 5-day course of antibiotics as effective as a 10-day corse for the treatment of streptococcal pharyngitis and the prevention of poststreptococcal sequelae? Clinical Question. The Journal of Family Practice. http://www.jfponline.com/content/2000/12/ jfp_1200_1075e.asp
23. Francis D, Del Mar C, Thomas M, Glasziou P. Non-antibiotic treatments for sore throat (Protocol). The Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD
004557. DOI: 10.1002/14651858.CD004557.
24. van Driel Ml, Habraken H, De Meyere M. Different antibiotic treatments for group A streptococcal pharyngitis (Protocol). The Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD004406. DOI: 10.1002/
14651858. CD004406.
25. Buzzetti R, Bergamini M, Bussi R, et al. Svelare lo Streptococco, rapidamente. Area Pediatrica 2006;7:47-55.
26. Del Mar CB, Glasziou PP, Spinks AB. Antibiotics for sore throat. The Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD000023.pub2. DOI: 10.1002/14651858. CD000023.pub2.
27. Sharland M, Kendall H, Yeates D, et al. Antibiotic prescribing in general practice and hospital admissions for peritonsillar abscess, mastoiditis, and rheumatic fever in children: time trend analysis. BMJ 2005;331:328-9.
28. Zwart S, Rovers MM, de Melker RA, Hoes AW. Penicillin for acute sore throat in children: randomised, double blind trial. BMJ 2003;327:1324.
Corrispondenza: robuzze@tin.it