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Upper respiratory tract infections in children: antibiotic treatment.
Drugs Exp Clin Res. 1987; 13(9):585-8.DE

Abstract

Upper respiratory tract infections, particularly pharyngitis and acute otitis media (AOM) are the commonest diseases in children. Although viruses are the main causative agents, bacteria may play an important role. With regard to antibiotic therapy, clinicians must solve two problems: differentiation between viral and bacterial aetiology and choice of the optimal drug for each bacterial disease. In patients with pharyngitis the identification of group A haemolytic streptococci as the causative agent may be very difficult if only clinical and haematological data are considered. Throat culture is time consuming and difficult to perform in ambulatory practice; the recent techniques for rapid detection of streptococcal antigens are a possible answer to this problem. In bacterial pharyngitis a single injection of benzathine penicillin is considered to be first choice. However local pain and the significant increase of the relative risk of allergic problems in comparison with the decrease of incidence of rheumatic fever may shift therapeutic preference towards macrolides. The recently marketed ones, especially miocamycin, seem to offer easier administration, fewer side-effects and better efficacy. With regard to AOM, the differentiation between bacterial and viral disease is less important because over 70% of cases are of bacterial origin. Besides, an exact aetiological diagnosis is possible only by tympanocentesis, an invasive method. In Italy amoxicillin is still the drug of choice: a twice-daily regimen has been demonstrated to be as effective as the traditional thrice-daily schedule.

Authors+Show Affiliations

Marchisio P
Paediatric Department IV, Sacco Hospital, Milan, Italy.
Principi N
No affiliation info available

MeSH

Anti-Bacterial AgentsBacterial InfectionsChildChild, PreschoolDiagnosis, DifferentialHumansOtitis MediaPharyngitisRespiratory Tract InfectionsStreptococcal InfectionsStreptococcus pyogenesVirus Diseases

Pub Type(s)

Journal Article

Language

eng

PubMed ID

3322754

Citation

Marchisio, P, and N Principi. "Upper Respiratory Tract Infections in Children: Antibiotic Treatment." Drugs Under Experimental and Clinical Research, vol. 13, no. 9, 1987, pp. 585-8.
Marchisio P, Principi N. Upper respiratory tract infections in children: antibiotic treatment. Drugs Exp Clin Res. 1987;13(9):585-8.
Marchisio, P., & Principi, N. (1987). Upper respiratory tract infections in children: antibiotic treatment. Drugs Under Experimental and Clinical Research, 13(9), 585-8.
Marchisio P, Principi N. Upper Respiratory Tract Infections in Children: Antibiotic Treatment. Drugs Exp Clin Res. 1987;13(9):585-8. PubMed PMID: 3322754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Upper respiratory tract infections in children: antibiotic treatment. AU - Marchisio,P, AU - Principi,N, PY - 1987/1/1/pubmed PY - 1987/1/1/medline PY - 1987/1/1/entrez SP - 585 EP - 8 JF - Drugs under experimental and clinical research JO - Drugs Exp Clin Res VL - 13 IS - 9 N2 - Upper respiratory tract infections, particularly pharyngitis and acute otitis media (AOM) are the commonest diseases in children. Although viruses are the main causative agents, bacteria may play an important role. With regard to antibiotic therapy, clinicians must solve two problems: differentiation between viral and bacterial aetiology and choice of the optimal drug for each bacterial disease. In patients with pharyngitis the identification of group A haemolytic streptococci as the causative agent may be very difficult if only clinical and haematological data are considered. Throat culture is time consuming and difficult to perform in ambulatory practice; the recent techniques for rapid detection of streptococcal antigens are a possible answer to this problem. In bacterial pharyngitis a single injection of benzathine penicillin is considered to be first choice. However local pain and the significant increase of the relative risk of allergic problems in comparison with the decrease of incidence of rheumatic fever may shift therapeutic preference towards macrolides. The recently marketed ones, especially miocamycin, seem to offer easier administration, fewer side-effects and better efficacy. With regard to AOM, the differentiation between bacterial and viral disease is less important because over 70% of cases are of bacterial origin. Besides, an exact aetiological diagnosis is possible only by tympanocentesis, an invasive method. In Italy amoxicillin is still the drug of choice: a twice-daily regimen has been demonstrated to be as effective as the traditional thrice-daily schedule. SN - 0378-6501 UR - https://www.unboundmedicine.com/medline/citation/3322754/Upper_respiratory_tract_infections_in_children:_antibiotic_treatment_ DB - PRIME DP - Unbound Medicine ER -