The use of antibiotics for tonsillitis

Forms of the disease

There are two main forms of the disease:

• compensated;
• decompensated.

Compensated - is a milder form and often occurs without serious complications, with rare cases of sore throat, in which the main discomfort for the patient is caused by plugs in the throat. It is due to these formations that the disease acquires a mild form, since they act as a protective mechanism for human organs and block the entry of harmful bacteria into the body.

The second form is more dangerous and, as a rule, is accompanied by frequent sore throats with various complications.

Is it possible to do without antibiotics?

The issue of using antibiotics to treat any disease is always accompanied by a number of dangerous issues. This is due to the fact that antibacterial agents destroy not only the causative virus, but also have a detrimental effect on the body as a whole: severe suppression of the immune system and disruption of the flora occurs. Therefore, many may have a question: “Is it possible to do without antibiotics?”

You can do without antibacterial drugs if the causative agent is not a bacterial infection, but a fungal one. Under such circumstances, patients are prescribed antiseptic and antifungal drugs for external use.

In the early stages of the disease with a small amount of the pathogen population, the use of antibiotics is inappropriate.

Treatment is carried out due to external influence on the surface layer of the tonsils by rinsing and washing with an antiseptic solution. The attending physician individually selects the form of the drug, but the most commonly used are: Furacilin, Rotokan, Miramistin. These products have proven themselves well in the fight against diseases of the tonsils (at an early stage of the disease) due to their high efficiency with regular use and the lack of toxic effects on internal organs.

If you do not seek help from a specialist in a timely manner, the likelihood of needing to use powerful antibacterial drugs increases. In this case, only an integrated approach will help cope with the exacerbation of tonsillitis.

Basic procedures in the treatment of chronic tonsillitis

A comprehensive therapeutic course for the disease in question involves the use of the following measures:

• using an antiseptic solution to gargle;
• physiotherapy (electrophoresis, heating, inhalation);
• use of antibiotics.

The last item on the list is the most significant in advanced stages of the disease. Antibiotics for chronic tonsillitis are prescribed intramuscularly by injection or orally . It is known for sure that it is impossible to get rid of the late stage of the disease without the use of antibiotics.

Criteria for choosing drugs

Chronic tonsillitis and treatment of chronic tonsillitis: antibiotics, as antibacterial agents to destroy infection, should easily and freely penetrate into the tissues of the tonsils, accumulate here in the amount necessary to affect microbes, creating there the necessary concentration of antibiotic to destroy or suppress the proliferation of bacteria.

Antibiotic (tablets) for chronic tonsillitis: must maintain its concentration in the blood for a long time. This is necessary for a reasonable number of times daily intake. Only antibacterial drugs can do this to these conditions; Antibiotics meet all these requirements.

It should be noted that antibiotics are prescribed only for exacerbations of chronic tonsillitis. During the period of remission, antibacterial agents are inappropriate and harmful. This is not justified because if the infection is latent, the antibiotic will not eradicate it.

Antibiotics for tonsillitis in adults

Let's look at the main groups of antibiotics:

• Pennicillins. This group of drugs is most widely used in the treatment of tonsillitis. These include the following medications: Amoxicillin, Flemoxina, Piperacillin, etc. By varying the dosages of these drugs, it is possible to treat acute sore throat in adults and children. The main features include a favorable price-quality ratio of drugs.
• Persistent penicillins. A modernized form of penicillins, which is characterized by a shorter period of fight against microorganisms and a guarantee of no relapse. The most famous of the drugs: Amoxiclav, Flemoklav, etc.
• Macrolides (Roxithromycin, Azithromycin, Spiramycin) and Cephalosporins (Cephalexin, Cefoxitin, Cefazolin). These are naturally occurring antibiotics that are often prescribed for chronic tonsillitis. Improvement in well-being is observed within two hours after using the first dose of the medicine. The active substance is difficult to leave the body, so the maximum permissible dose should not exceed that indicated in the annotation.
• Aminoglycosides. These are antibiotics of semi-synthetic or natural origin, which are very well tolerated by organisms without allergic reactions. These include: Streptomycin, Amikacin, Neomycin, Gentamicin, etc.

Let's look at some of the commonly prescribed general antibacterial drugs for oral and intramuscular use.

Erythromycin

Perhaps the very first oral antibiotic that is able to protect the body from Staphylococcus aureus infections. The drug is suitable for patients with an allergic reaction to the penicillin group of drugs, since it has a similar mechanism of action.

Erythromycin is well absorbed from the gastrointestinal tract, but food intake may slow down this process. Therefore, it is recommended to take the drug one hour before meals or 2 hours after. Depending on the severity of the disease, the dosage of the drug may differ by 5 times. The average course of treatment is 1 to 2 weeks. It is not recommended to stop taking the drug earlier than 2 days before the onset of the last symptoms.

Amoxicillin

One of the most popular penicillin antibiotics.
The mechanism of action of the active substances of the drug is that the latter block the protein synthesis of bacterial tissues, which is why microorganisms are not able to divide. Over time, the number of harmful microorganisms on the surface of the tonsils decreases, and then the inflammatory process also decreases. If the causative agents of tonsillitis are streptococcal infections, then this drug will be the best option for treating the disease. According to the instructions, the dosage of the drug varies greatly and should be determined by the attending physician.

Augmentin

A drug with a strong antiseptic effect. It is taken even in extremely advanced stages of chronic tonsillitis. The product is effective in the fight against Staphylococcus aureus. The active ingredient of the drug is very well absorbed by the intestines and is excreted from the body just 6 hours after the first dose. The minimum time for using Augmentin is 5 days. Without appropriate instructions from the attending physician, the therapeutic course should not exceed 14 days.

Vilprafen

Quite an expensive Dutch macrolide antibiotic. Vilprafen has a number of advantages over the above-mentioned antibiotics. First of all, this is the effectiveness of the drug in the fight against many microorganisms. Secondly, its ability to pass through the cell membrane of human tissues, where most of the harmful bacteria can be concentrated. This is extremely necessary for severe forms of tonsillitis, which was caused by intracellular microorganisms. The course of treatment with the drug is planned only by the attending physician.

Bicillin

An injectable drug, which is available in powder form for the preparation of a solution for intramuscular administration. The medication has three forms (Bicillin 1, Bicillin 3, Bicillin 5), which differ in the amount of active ingredients.

All of them are slowly absorbed into the blood, but can remain in the body for up to 6-8 days, which may be enough to treat mild forms of chronic tonsillitis in adults. The drug, like any antibiotic, has a number of application features - the form, dosage and course of treatment should only be prescribed by a doctor.

Use of antibiotics

When prescribing antibiotics, the best option is to culture a smear and determine the sensitivity of the pathogen. But the analysis is done over several days, so doctors usually prescribe the drug empirically, taking into account the frequency of occurrence of the pathogen and the effectiveness of the most commonly used drugs.

The effectiveness of antibiotic prescription is detected within 72 hours; if there is no effect, the antibiotic (medicine) for chronic tonsillitis becomes subject to replacement with another, more effective and stronger one.

Among antibiotics, penicillins are becoming the first-line drugs. Then aminoglycosides, cephalosporins, macrolides, etc. are used. Penicillins are still in demand because streptococci have not yet developed resistance to them.

Today, inhibitor-protected penicillins are used, which are not destroyed by penicillinase. These include: Amoxiclav, Amoxicillin, Flemoclav; Augmentin; Ampicillin sulbactam: Ampiksid, Sultamicillin; Panclave, Flemoxin, Ticarcillin; Tazobactam, Ampiox, Unazin, etc.

Another advantage of penicillins is that they can be used during pregnancy; they have a bactericidal effect; have a preventive effect - by acting on hemolytic streptococcus, they prevent the development of the rheumatic process and glomerulonephritis.

Antibiotics for exacerbations of tonsillitis are prescribed for at least 10 days to ensure complete treatment and prevent complications. In addition, the sore throat itself lasts at least 10 days, even despite the normalization of the temperature.

If the cause of a sore throat or exacerbation is chlamydia, penicillins do not act on them in any dosage; chlamydia is well treated with a group of tetracyclines. Some antibiotics today have a duration of action of more than a day; The medicine in this case is taken once a day. With such antibiotics, the course of treatment can last no more than 3-5 days.

List of drugs in this group:

• Clarithromycin, Roxithromycin;
• Erythromycin; Sumamed, Josamycin, Azitral - macrolides;
• cephalosporins – Cefuroxime (second generation cephalosporins);
• Ceftriaxone, Cefoperazone, Ceftibuten, Cefexime, Cefazidime are third-generation drugs;
• Cefepime, Cefadroxil (fourth generation) - they are taken once a day.

Cefadroxil is especially in demand today. It is taken once a day; the effect occurs within 1.5 hours. It is removed from the body slowly.

Aminoglycosides and fluoroquinolones work well against Staphylococcus aureus. Among penicillins, only Oxacillin affects them (causes lysis of bacteria). But more often these antibiotics are prescribed in a hospital setting. This type includes: Xenaquin, Lomacin, Levofloxacin, Oflo-, Cipro-, Gati- and other floxacins, Loxon, Quiroll, Zanoacin, Amikacin.

If an exacerbation occurs without pronounced general symptoms, some doctors limit themselves to local treatment with antibiotics, which is not always good, because the pathogen may develop resistance to it.

Take the medicine only with clean water, not milk, tea or coffee. You cannot stop the course of treatment without permission, despite the improvement in your health. Also, you cannot reduce the dose or frequency of administration. Children with chronic tonsillitis are prescribed penicillins (Oxacillin, FOM-penicillin), macrolides and cephalosporins.

Topical products

As mentioned above, to treat chronic tonsillitis it is necessary to follow an integrated approach. Therefore, along with general antibiotics, topical antibacterial drugs are often prescribed. The measure will help cope with the disease in a shorter period of time and with fewer complications for the body . Let's look at some of the representatives.

Furacilin

A drug with a wide spectrum of action.
Used as an antiseptic solution for gargling. The active substance reduces the activity of pathogenic bacteria, which is why the latter can no longer provide sufficient resistance to the patient’s immunity. The drug has almost no harmful effects on the body; it can be used up to 5 times a day with gargling for 2-3 minutes. You can increase the effect of Furacilin in the following ways:

• use freshly prepared warm solution;
• before use, gargle with a solution of baking soda to remove mucus;
• add a few drops of calendula tincture to the solution.

Imudon

Immunostimulating drug in the form of lozenges. When it enters the mucous membrane, the drug stimulates the immune system to produce more antibodies. The course of treatment is 10 days, and for the prevention of chronic tonsillitis it is no more than 3 weeks with a frequency of up to 3 times a year.

Hexoral

Antiseptic agent in aerosol form for topical use. Hexoral has a strong bactericidal effect (destroys most known bacteria). Once on the mucous membrane, the drug forms a thin film that can retain its properties for up to several hours. The spray is well tolerated by the body, but you should not use the drug more than 2 times a day. The duration of the course of treatment is 5-7 days.

IRS19

Immunomodulatory drug of bacterial origin. Includes more than 20 destroyed bacterial cells, which, when contacted with the mucous membrane of the mouth and pharynx, stimulate the functional activity of the local immune system. Without special prescriptions, take the drug for no more than 2 weeks.

Treatment for adults

Augmentin for angina in adults and children over 12 years of age is prescribed as follows.

1. The maximum period of taking the drug should not exceed 14 days.
2. In case of severe form of the disease, Augmentin is taken 3 times a day, 1 tablet weighing 674 grams, or injections are given every 6 to 8 hours. The maximum daily injection dose is 7.2 grams, the maximum single dose is 1.2 grams.
3. In case of moderate illness, the drug is prescribed in the form of tablets 325 grams 3 times a day.
4. The drug should be taken before meals.
5. Augmentin is a powerful antibiotic, so its use is strictly not recommended without consultation and prescription from a doctor.

The dosage of the drug does not depend on the gender of the patient. However, it can be changed by a doctor depending on body weight. This is especially true for children under 12 years of age, as well as people who are overweight or underweight.

special instructions

To achieve the maximum effect from taking antibacterial agents in the treatment of tonsillitis, you must follow some simple recommendations:

• You should not arbitrarily interrupt treatment, increase or decrease the prescribed dosage of medications if you suddenly feel better;
• while taking antibiotics, you should avoid alcohol, fatty and spicy foods, and smoking;
• if you feel worse or have an allergic reaction, you must immediately inform your doctor;
• bed rest is necessary during exacerbation of chronic tonsillitis;
• you should follow a diet to reduce the possibility of symptoms of dysbiosis;
• After completing the course of treatment, in order to return the immune system to its previous level, it is necessary to include pribiotics and fermented milk products in the diet.

Since any of the antibacterial drugs can cause significant harm to the body, there are a number of contraindications to the use of antibiotics for the treatment of tonsillitis in adults:

• the presence of allergic reactions to the active substance of the drug;
• liver and kidney failure associated with various diseases;
• peptic ulcers, inflammatory processes of the mucous membranes of the intestines or stomach;
• pregnancy and lactation period.

Common antibacterial drugs

Tonsillitis is a serious disease that can lead to a number of serious consequences. These include:

• inflammatory process in the tissues of the myocardium and pericardium with their subsequent destruction;
• renal dysfunction;
• inflammatory diseases of bones and joints.

The use of antibacterial drugs is justified only if the origin of tonsillitis is bacterial. Antifungal agents are used to treat fungal tonsillitis. If the causative agent of the disease is viruses, treatment is most often based on the use of local antiseptics. That is why the treatment of the disease should be entrusted to an experienced specialist who will prescribe the right drug after determining the type of pathogen.

Antibacterial therapy for angina involves the prescription of medications included in the following groups:

• penicillins;
• cephalosporins;
• macrolides.

Antibiotics from the penicillin group

Amoxicillin (Flemoxin solutab). This drug contains the active ingredient of the same name. Amoxicillin effectively destroys gram-positive and gram-negative strains of aerobes. It is used in the treatment of bacterial tonsillitis that develops against the background of damage to the body by streptococci and staphylococci. Ampicillin is not prescribed if the causative agent of sore throat is fungi, mycoplasma and viruses.

Bicillin. This drug is available in powder form for injection. The active ingredient is benzathine benzylpenicillin. The drug is effective against a number of gram-positive and gram-negative bacteria. It is not used if the causative agents of sore throat are fungi, viruses and bacteria that are insensitive to penicillin.

Flemoclav. This drug contains two active substances:

• ampicillin;
• clavulanic acid.

The antibacterial agent effectively destroys most bacteria. The spectrum of action of amoxicillin is expanded by the addition of clavulanic acid. Flemoclav is contraindicated for use if tonsillitis occurs against the background of infectious mononucleosis.

Augmentin, Amoxiclav. The composition of the drugs includes the following active substances:

• ampicillin;
• clavulanic acid.

Medicines are available in the form of tablets and powder for the preparation of suspensions. They are effective against most types of bacteria. Augmentin and Amoxiclav can be used in the treatment of children from 3 months. However, children under 12 years of age should take the drug in suspensions.

Antibiotics from the cephalosporin group

Cefazolin. The drug contains the active substance of the same name. The antibacterial agent is available exclusively in powder form for the preparation of intramuscular and intravenous injections. This feature is caused by the fact that cefazolin is destroyed in the gastrointestinal tract without having time to be absorbed into the blood.

The drug is used in the treatment of tonsillitis and purulent tonsillitis, as it is effective against most pathogenic microorganisms.

Cefadroxil. The active substance of the drug is cefadroxil. This drug is available in several dosage forms:

• pills;
• capsules;
• granules for preparing suspensions.

Cefadroxil has a broad spectrum of antimicrobial action and is successfully used in the treatment of bacterial tonsillitis.

Cefixime. The active ingredient of the drug is cefixime. The product is available in two dosage forms:

• pills;
• powder for preparing suspensions.

The antibiotic belongs to the group of 3rd generation cephalosporins and is effective against most bacteria. Cefixime is not prescribed if tonsillitis occurs due to damage by group D streptococci and certain types of staphylococci.

Ceftriaxone. The active ingredient is ceftriaxone. The drug is available in the form of solutions for infusion. Refers to 3rd generation cephalosporin antibiotics. Effective against most gram-positive and gram-negative bacteria. Contraindicated for use if the development of tonsillitis is caused by staphylococci and group D streptococci.

Cefepime. The antibacterial agent contains the active substance - cephelim. Available in powder form for the preparation of intramuscular and intravenous injections. Belongs to the group of 4th generation cephalosporin antibiotics. Effectively destroys any type of bacteria resistant to 3rd generation cephalosporins.

Antibiotics from the macrolide group

Azithromycin, Sumamed, Zitrolide. The antibacterial agents contain azithromycin. Available in two dosage forms:

• pills;
• powder for the preparation of suspensions for internal use.

Azithromycin helps fight many pathogenic microorganisms. The exception is viruses and bacteria that are resistant to erythromycin.

Clarithromycin, Klacid. Antibacterial agents are available in the form of capsules and tablets, which contain the active ingredient clarithromycin. This effective remedy helps fight sore throat, which develops against the background of damage by various types of bacteria, including enterobacteria, and intracellular microorganisms.

Side effects of antibiotics

Even if there are no contraindications for taking the prescribed drug in a particular clinical case, the attending physician is unable to take into account all the characteristics of the human body, which may result in some side effects:

• allergic reactions (urticaria, local rashes);
• disturbances in the gastrointestinal tract (dysbacteriosis, nausea, vomiting, impaired taste buds);
• damage to the nervous system (insomnia, dizziness, headache, depression);
• disturbances in the functioning of the cardiovascular system (tachycardia, cardiac arrhythmia);
• structural and functional liver disorder in the form of hepatoxicity.

If you detect any of the above symptoms, which by their nature can be associated with the consequences of treating tonsillitis with antibiotics, you must stop taking the medications and promptly contact your doctor to formulate an alternative course of treatment.

In conclusion, we should once again emphasize the importance of the complexity of the therapeutic course for chronic tonsillitis. Since antibacterial drugs, even with their wide spectrum of action, are not able to affect all facets of the disease.

Symptoms and features of the course of acute and chronic tonsillitis

Symptoms of sore throat:

• sharp pain when swallowing;
• increase in body temperature to 38–39 °C;
• headache;
• chills, feeling of weakness, weakness;
• nasal voice;
• bad breath;
• copious secretion of saliva.

With tonsillitis, the palatine tonsils are affected, and surrounding tissues may be involved in the process

With sore throat, the inflammatory process can spread to surrounding tissues, leading to pharyngitis and laryngitis. Also often accompanied by inflammation of the mucous membrane of the nasal cavity and paranasal sinuses, which aggravates nasal breathing.

Upon examination, the doctor reveals enlargement and tenderness of the regional lymph nodes. Pharyngoscopy reveals hyperemia and swelling of the mucous membrane of the tonsils, on which fibrinous plaque often forms.

A blood test reveals leukocytosis, a shift in the leukocyte formula to the left, acceleration of ESR (erythrocyte sedimentation rate), and the appearance of C-reactive protein.

Chronic tonsillitis manifests itself as symptoms of chronic intoxication in the form of general weakness, increased fatigue, and irritability. There is often an increase in body temperature to 37.0–37.9 °C in the evenings. Autonomic-vascular changes are possible: acrocyanosis, pulse lability, orthostatic hypotension, discomfort in the heart area.

If active treatment of angina is not started in the first days, then on the fifth day a paratonsillar abscess may form, which is a limited abscess in the peritonsillar tissue.

During pharyngoscopy in patients with a chronic form of the disease, the adhesion of the tonsils to the arches and the presence of scars are determined; caseous plugs are visualized in the lacunae.