当前位置： SCI文献检索 > ANNALS OF INTERNAL MEDICINE期刊下所有文献 > Principles of appropriate antibiotic use for acute pharyngitis in adults: background.

Principles of appropriate antibiotic use for acute pharyngitis in adults: background.

Abstract：

:The following principles of appropriate antibiotic use for adults with acute pharyngitis apply to immunocompetent adults without complicated comorbid conditions, such as chronic lung or heart disease, and history of rheumatic fever. They do not apply during known outbreaks of group A streptococcus.1. Group A beta-hemolytic streptococcus (GABHS) is the causal agent in approximately 10% of adult cases of pharyngitis. The large majority of adults with acute pharyngitis have a self-limited illness, for which supportive care only is needed.2. Antibiotic treatment of adult pharyngitis benefits only those patients with GABHS infection. All patients with pharyngitis should be offered appropriate doses of analgesics and antipyretics, as well as other supportive care.3. Limit antibiotic prescriptions to patients who are most likely to have GABHS infection. Clinically screen all adult patients with pharyngitis for the presence of the four Centor criteria: history of fever, tonsillar exudates, no cough, and tender anterior cervical lymphadenopathy (lymphadenitis). Do not test or treat patients with none or only one of these criteria, since these patients are unlikely to have GABHS infection. For patients with two or more criteria the following strategies are appropriate: a) Test patients with two, three, or four criteria by using a rapid antigen test, and limit antibiotic therapy to patients with positive test results; b) test patients with two or three criteria by using a rapid antigen test, and limit antibiotic therapy to patients with positive test results or patients with four criteria; or c) do not use any diagnostic tests, and limit antibiotic therapy to patients with three or four criteria. 4. Throat cultures are not recommended for the routine primary evaluation of adults with pharyngitis or for confirmation of negative results on rapid antigen tests when the test sensitivity exceeds 80%. Throat cultures may be indicated as part of investigations of outbreaks of GABHS disease, for monitoring the development and spread of antibiotic resistance, or when such pathogens as gonococcus are being considered.5. The preferred antibiotic for treatment of acute GABHS pharyngitis is penicillin, or erythromycin in a penicillin-allergic patient.

journal_name

Ann Intern Med

journal_title

Annals of internal medicine

authors

Cooper RJ,Hoffman JR,Bartlett JG,Besser RE,Gonzales R,Hickner JM,Sande MA,American Academy of Family Physicians.,American College of Physicians-American Society of Internal Medicine.,Centers for Disease Control.

doi

10.7326/0003-4819-134-6-200103200-00019

subject

Has Abstract

pub_date

2001-03-20 00:00:00

pages

509-17

issue

eissn

0003-4819

issn

1539-3704

pii

200103200-00019

journal_volume

134

pub_type

指南,杂志文章,实务指引

在线工具

Principles of appropriate antibiotic use for acute pharyngitis in adults: background.