Antibiotics for adenoids: after removal, with inflammation

Medicinal treatment of adenoids is not always prescribed, but only in cases where surgery is contraindicated for some reason. In particular, antibiotics for adenoids are used only when a microbial infection occurs in the upper respiratory tract.

Antibiotics are selected and prescribed by a healthcare professional, usually based on a nasopharyngeal mucus culture and an assessment of the bacterial resistance to antibacterial drugs.

Are adenoids treated with antibiotics?

Doctors do not always prescribe antibiotics for the treatment of adenoids, since the use of such drugs is not always advisable and can negatively affect the state of the digestive and urinary systems.

Antibiotics may be appropriate:

• when a bacterial infection occurs;
• with a high probability of complications;
• at the preparatory stage before surgical intervention.

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Indications antibiotics for adenoids

Adenoids are the palatine tonsils, the main purpose of which is to filter incoming air from microbes and viruses. With frequent and severe viral or microbial infectious diseases, adenoids can increase in size or grow.

Often, with such growth, the ENT doctor prescribes antibiotic therapy. This is appropriate only in the presence of a microbial infection, which is detected by taking tests from the mucous membrane. If the tests show a positive result, then an analysis for the resistance of microbes to antibacterial drugs is necessarily taken. Based on all the results, a specific antibiotic is prescribed.

From this we can conclude: an antibiotic for inflammation of the adenoids can be prescribed only after a positive test result for the presence of bacteria. If the result is negative, then there is no particular sense in using antibiotics for adenoids.

In some situations, antibiotics are used at the stage of preparing the patient for surgical intervention to remove adenoids. Such prescription is appropriate in cases where the patient has foci of infection that can cause complications accompanied by the spread of bacteria.

An antibiotic after adenoid removal is prescribed to prevent complications of microbial etiology. In such a situation, the medication is taken for a maximum of five to six days.

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Release form

To treat adenoids, the doctor may suggest antibiotics in different dosage forms, even if the active component of the drug is the same:

• Lyophilisate is a powder for making liquid for injection. As a rule, it is produced in vials and is used for complicated and severe infectious lesions, when it is necessary to ensure the penetration of a high concentration of antibiotic into tissues in a short time.
• Tablets or capsules – used to treat children who can already swallow the drug on their own.
• Suspension for internal use - very convenient for giving to a small child. The suspension can be given with a spoon or mixed with water or compote.
• Children's suppositories for rectal administration - suitable for the treatment of both small children and older patients. They can also be used in cases where oral administration of medications is impossible for some reason.
• Syrup – this form is especially easy for children to accept. It can be produced in the form of granules for making syrup, or as a ready-made product.

External forms such as ointments or creams are not used to treat adenoids.

Names

If there is a need to prescribe an antibiotic for adenoids, it is necessary to take into account which of the drugs the patient used for treatment the day before, in order to avoid the development of "addiction". Most often, the doctor chooses from the following list of antibiotics:

• Penicillin antibiotics are most often the drugs of choice for adenoids, as they are considered the safest and most effective:

1. Amoxicillin;
2. Flemoxin Solutab.

• The macrolide series of antibiotics has broad antibacterial activity and can be prescribed in case of penicillin intolerance:

1. Azithromycin;
2. Macropen.

• The cephalosporin series of antibiotics is the drug of the third group of choice when there is no possibility of treatment with penicillins and macrolides:

1. Pancef (Cefixime);
2. Zinnat.

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Antibiotic Fluimucil for inhalation

It is worth noting right away that the use of steam inhalations for adenoids is prohibited. Hot steam can provoke further tissue growth, as well as lead to the appearance of purulent complications in the nasopharynx.

Among the pharmaceutical preparations for use in a nebulizer, the most suitable are regular isotonic sodium chloride solution and alkaline mineral water. In addition, on the recommendation of a doctor, you can also use an antibiotic - for example, Fluimucil IT, in case of a significant inflammatory reaction.

It is necessary to clarify: many people confuse the similarly named pharmaceutical drugs Fluimucil and Fluimucil Antibiotic IT. In fact, these are two completely different medications:

• Fluimucil is a mucolytic agent that does not have any antibacterial activity and is used as an expectorant for coughs;
• Fluimucil Antibiotic IT is a fundamentally different drug that belongs to amphenicols – systemic antimicrobial agents. It is this medication that can be prescribed for inhalation administration for adenoids. As a rule, it is used at 125-250 mg up to two times a day (1-2 ml of solution per procedure).

The antibiotic Fluimucil IT can only be prescribed by a doctor: self-administration can be dangerous.

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Pharmacodynamics

The pharmacological properties of antibiotics for adenoids can be considered using the example of the most popular drug in this area - Amoxicillin. This drug represents a group of semi-synthetic penicillins with a wide spectrum of antibacterial activity, being a 4-hydroxyl analogue of the well-known Ampicillin.

Amoxicillin exhibits a bactericidal effect against gram-positive and gram-negative aerobes (staphylococci, streptococci, Neucheria, Escherichia, Shigella, Salmonella, Klebsiella).

Bacteria that produce penicillinase are considered resistant to the drug.

Cross-resistance has been found between antibiotics such as Amoxicillin and Ampicillin.

The drug becomes more effective if it is combined with the β-lactamase inhibitor clavulanic acid. This combination leads to an increase in the activity of Amoxicillin against bacteroides, legionella, nocardia, pseudomonas.

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Pharmacokinetics

After oral administration, Amoxicillin is well absorbed in the digestive tract without being damaged by gastric acid. The maximum serum concentration is detected after 1-2 hours. If the dose is doubled, the concentration also doubles.

Total absorption does not depend on whether there is food in the stomach.

Following injection of an antibiotic, similar concentrations of the drug are found in the bloodstream.

The binding of Amoxicillin to plasma proteins is close to 20%.

The antibiotic spreads well throughout the tissues and fluids of the body.

The half-life can be 1-1.5 hours.

Approximately 60% of the total dose taken leaves the body unchanged in urine by glomerular filtration. A small amount of the antibiotic is found in feces.

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Dosing and administration

Penicillin antibiotics
Amoxicillin	It is used to treat children from the age of five at 250 mg three times a day. For children from 2 to 5 years old, the dose is calculated taking into account body weight: 20 mg of antibiotic per 1 kg.
Flemoxin Solutab	For the treatment of children from one year of age, 125 mg of antibiotic is used in the morning and evening. For children from six to 12 years old - 250 mg in the morning and evening.
Macrolide antibiotics
Azithromycin	For the treatment of children under 12 years of age, the dose is calculated using the formula 10 mg per kilogram of body weight.
Macropen	It is used to treat children from three years of age. The dose is calculated as 40 mg/kg per day (in three doses).
Cephalosporin antibiotics
Pancef	Prescribed at a rate of 8 mg/kilogram per day, in one or two doses. Not recommended for use in children under six months.
Zinnat	Prescribed for children from three years of age, 125 mg in the morning and evening. The drug is not used to treat children under three years of age.

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Antibiotics for adenoids in children

Of course, you shouldn’t rush to use antibiotics for adenoids: a regular antibacterial agent can cause too many side effects and negative reactions in the body.

The main indications for antibiotic therapy may be:

• addition of microbial infection;
• real risk of complications developing.

Thus, a doctor can prescribe antibiotics for secondary otitis, tonsillitis, and inflammatory processes in the respiratory system.

It is no secret that prolonged adenoiditis can be complicated by heart disease, endocarditis, digestive system damage, rheumatism. If not treated correctly, sinusitis, laryngotracheitis, bronchitis and even pneumonia can develop.

Taking this into account, the doctor may prescribe to the patient for the treatment of adenoids not only local procedures in the form of irrigation, physiotherapy and the use of nasal drops, but also antibiotics.

Antibiotics should not be used for adenoids solely for prophylactic purposes.

Penicillin antibiotics
Amoxicillin	It is used to treat children from the age of five at 250 mg three times a day. For children from 2 to 5 years old, the dose is calculated taking into account body weight: 20 mg of antibiotic per 1 kg.
Flemoxin Solutab	For the treatment of children from one year of age, 125 mg of antibiotic is used in the morning and evening. For children from six to 12 years old - 250 mg in the morning and evening.
Macrolide antibiotics
Azithromycin	For the treatment of children under 12 years of age, the dose is calculated using the formula 10 mg per kilogram of body weight.
Macropen	It is used to treat children from three years of age. The dose is calculated as 40 mg/kg per day (in three doses).
Cephalosporin antibiotics
Pancef	Prescribed at a rate of 8 mg/kilogram per day, in one or two doses. Not recommended for use in children under six months.
Zinnat	Prescribed for children from three years of age, 125 mg in the morning and evening. The drug is not used to treat children under three years of age.

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Use antibiotics for adenoids during pregnancy

As a rule, adenoids are detected in childhood - from three to seven years. Over the years, the size of the nasopharyngeal tonsil decreases, and the lymphoid tissues are almost completely transformed into connective tissue by about 15 years. However, in some cases, the tonsil can continue to exist in adults.

If adenoids were detected in a woman during pregnancy, then most often the doctor takes a wait-and-see attitude: the most radical method of treatment is the removal of adenoids, which is not practiced in the acute period. Most likely, the doctor will recommend immunostimulating treatment, a diet to support and strengthen the body's defenses. Antibiotics for adenoids for the treatment of pregnant women can be prescribed only in extreme and very severe situations.

Contraindications

Antibiotics are not used for adenoids unless there are clearly defined indications for this.

In addition, antibiotics are inappropriate:

• in severe infections of the digestive tract, in case of hypersensitivity to penicillins and/or cephalosporins;
• in case of disorders of hematopoietic processes, lymphocytic leukemia, infectious mononucleosis;
• in severe liver damage;
• during pregnancy and breastfeeding.

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Side effects antibiotics for adenoids

Antibiotics for adenoids can cause a number of negative symptoms:

• Allergy (skin rash, skin redness, swelling, allergic rhinitis or conjunctivitis, joint pain).
• Development of superinfection, most often with low resistance of the body.
• Dizziness, fatigue, convulsions, worsening mood, peripheral neuropathy.
• Nausea with bouts of vomiting, weight loss, diarrhea, difficulty in defecation, abdominal pain, stomatitis, inflammatory processes in the intestines.
• Jaundice, dermatitis.

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Overdose

Overdosing on antibiotics for adenoids is most often accidental, and usually in children. This situation occurs when the dosage of the medication is not calculated correctly, or when the doctor's instructions are not followed.

Almost all doses of antibiotics used in pediatrics are calculated "per kilogram of body weight". Therefore, self-medication in particular can lead to the most unfavorable consequences due to an incorrectly selected antibiotic or due to an incorrectly calculated amount.

What could be the signs of an antibiotic overdose for adenoids?

• Signs of general intoxication: fever, headaches, joint and muscle pain, dyspepsia, blood pressure surges, tachycardia, increased sweating, impaired consciousness.
• Intoxication damage to the kidneys: urination disorders, signs of renal failure.
• Intoxication liver damage: liver pain, jaundice, itchy skin.

In case of an overdose in a child, it is necessary to call an ambulance, empty the victim's stomach, give sorbents and a large amount of water (in case of an overdose of oral medications).

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Interactions with other drugs

Drug interactions of antibiotics for adenoids may vary. For example, when aminoglycosides, cephalosporins, Cycloserine, Vancomycin, Rifampicin are used together with Amoxicillin, synergism is observed. When macrolides, Chloramphenicol, lincosamides, tetracyclines, sulfonamides are combined with Amoxicillin, an antagonistic effect is observed.

Amoxicillin can enhance the effect of indirect anticoagulants by inhibiting the development of intestinal microflora, as well as impair the production of vitamin K and lower the prothrombin index.

Amoxicillin reduces the effectiveness of drugs that are metabolized to form PABA.

The concentration of Amoxicillin in the bloodstream may increase under the influence of diuretics, Allopurinol, Probenecid, Phenylbutazone, non-steroidal anti-inflammatory drugs.

The absorption of Amoxicillin is improved by vitamin C and is impaired by antacids or laxatives, aminoglycosides, and glucosamine.

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Storage conditions

Antibiotics used for adenoids are recommended to be stored in rooms with a temperature of no more than +25°C, in places difficult for children to reach.

If the antibiotic is a prepared suspension, it is stored only in a refrigerator, maintaining a temperature regime of +2 to +8°C.

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Shelf life

Antibiotics are traditionally stored for three years under appropriate conditions, but it is best to check this term in the instructions that come with the specific medication.

The self-prepared suspension can be stored for no more than a week in the refrigerator.

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Reviews

Should antibiotics be used to treat adenoids? Only a doctor can answer this question, and only on the basis of test results. Such tests may include nasopharyngeal smear cultures and an assessment of the sensitivity of bacteria to antibacterial drugs. The patient or his parents cannot decide on antibiotic therapy on their own.

Of course, if there is a bacterial infection of the upper respiratory tract, then you cannot do without taking antibiotics. And, if you believe the reviews, such treatment really helps in most cases. But the antibiotic should be selected by a doctor, and the patient's task is to take the drug, strictly following the doctor's prescription.

If antibiotics for adenoids are taken incorrectly or inappropriately, then such treatment can lead to the exact opposite effect: adenoid growths will only increase, and the problem can only be solved surgically.