Treatment of angina and acute pharyngitis in children
Last reviewed: 23.04.2024
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Treatment of angina and acute pharyngitis varies depending on the etiology of acute tonsillitis and acute pharyngitis. With streptococcal tonsillopharyngitis, antibiotics are shown, when viral, they are not shown, with mycoplasmal and chlamydia - antibiotics are shown only in cases when the process is not limited to tonsillitis or pharyngitis, but descends into the bronchi and lungs.
Indications for consultation of other specialists
With mild and uncomplicated forms of acute tonsillitis and acute pharyngitis, there is no need to consult other specialists, but in severe and complicated forms, consultations of the otolaryngologist are indicated.
Indications for hospitalization
- The severity of the child's illness: hyperthermia, severe intoxication, respiratory failure, suspected systemic infectious disease (diphtheria, severe scarlet fever, tularemia, HIV infection, etc.).
- Development of complications of acute tonsillitis and pharyngitis - paratonzillitis or zaglugal abscess.
Non-pharmacological treatment of angina and acute pharyngitis in children
The patient is shown bed rest in the acute period of the disease on average 5-7 days. Diet is normal. Rinsing of the throat with 1-2% Lugol solution is shown. 1-2% solution of hexathedia (hexoral), etc., a warm drink (milk with Borjomi, milk with soda - 1/2 teaspoon of soda for 1 glass of milk, milk with cooked figs, etc.).
Drug treatment of angina and acute pharyngitis in children
Acute viral tonsillitis (tonsillitis) / tonsillopharyngitis is treated according to the same principles as acute rhinopharyngitis (see "Acute Rhinopharyngitis"). The main directions are anti-inflammatory and antiviral therapy. According to the indications are antipyretic and antitussive therapy. When choosing antipyretic therapy, preference should be given to ibuprofen, which, along with antipyretic, also has an analgesic and anti-inflammatory effect.
Systemic antibacterial therapy for viral tonsillitis / tonsillitis is not indicated. However, it is often recommended that children who are ill over the age of 2.5 years be prescribed a plant-specific antibiotic agent fusafungin (bioparox, which is prescribed in an aerosol for 4 injections in the mouth for 7 days, a non-steroidal anti-inflammatory drug benzidamine (Tantum Verde) or local antiseptics containing hexiethidine (hexoral). Ambazone (pharyngosept) or a mixture of bacterial lysates (imudon) .Tantum Verde, a dosed spray, is administered at 4 doses every 1.5-3 hours, children under 6 years of age - 1 dose for every 4 kg of body weight. Ethidin is prescribed in the aerosol for 1 injection in the mouth 3-4 times a day Ambazone and a mixture of lysates prescribed 1 tablet 3 times a day Assign also adaptogens that are phytopreparations, for example tonsilgon H, which includes the root of the althaea, chamomile flowers , horsetail, walnut leaf, oak bark, yarrow, medicinal dandelion.
In the complex therapy of acute viral tonsillitis (tonsillitis) / tonsillopharyngitis children are recommended to prescribe medicinal herbal preparations such as Tonzilgon H, which includes the althaea root, chamomile flowers, horsetail herb, walnut leaves, oak bark, yarrow herb, herb dandelion grass . Tonsilgon H has a complex anti-inflammatory, anti-edematous, local enveloping and analgesic effects. Active components of chamomile, althea and horsetail contribute to the increase of nonspecific protective factors of the body, which allows to appoint Tonsilgon H often and long-term sick children from infancy. Tonsilgon H is available as a drop in a 100 ml bottle for ingestion, as well as as a dragee for children from 6 years of age.
Treatment of acute streptococcal tonsillitis (tonsillitis) / tonsillopharyngitis and pharyngitis, on the contrary, includes mandatory antibiotic therapy with systemic antibiotics to avoid the development of such severe complications as glomerulonephritis and rheumatic fever. Thus, the indication for the administration of systemic antibiotics in acute tonsillitis (tonsillitis) and tonsillopharyngitis is streptococcal etiology, which is indicated by purulent exudation, the appearance of purulent yellowish deposits on the tonsils and the posterior wall of the pharynx and streptococcus out of the pharynx.
- The drug of choice - phenoxymethylpenicillin inside at 50-100 mg / kg per day in 3 doses for 10 days.
- Often ill children are recommended amoxicillin inside 25-50 mg / kg per day in 2 doses or Amoxicillin + clavulanic cot inside by 0.625 g 3 times a day or 1 g 2 times a day for 7-10 days.
- If penicillins are intolerant, one of the following drugs is prescribed: macrolides; cephalexin inside children under 12 years 25-50 mg / kg per day in 3-4 injections; children over 12 years of age, 1 g in 2-3 doses; cefadroxil inside at 30 mg / kg 2 times a day for children under 12 years, children over 12 years for 1 g in 2 doses for 7-10 days.
- With intolerance of beta-lactams and macrolides, lincosamines (lincomycin) are prescribed. Lincomycin is administered orally at 60 mg / kg in 3 injections.
Of the registered amoxicillin preparations, Flemoxin Solutab has the most optimal pharmacokinetic characteristics. Absorption of the drug with oral intake is 93% and significantly exceeds that with amoxicillin in capsules (= 70%).
The drug is available in the form of dispersible tablets Solutab. Innovative technology Solutab allows you to conclude the active substance in microspheres, from which a tablet is formed. Each microsphere consists of an acid-fast filler, which protects its contents from the action of gastric juice. The release of active components begins with an alkaline pH value in the upper intestine, i.e. In the zone of maximum absorption.
Tablets Flemoxin Solutab can be taken in many ways: take whole, divide into parts, prepare a syrup or suspension with a pleasant fruit taste. A variety of dosages (tablets contain 125, 250. 500 and 1000 mg of active ingredient) allow the use of Flemoxin Solutabu in children of different ages, starting from 1 month. The form of release of 1000 mg allows to reduce reception of amoxicillin up to 2 times a day at the same level with standard mode (500 mg 3 times a day) of efficiency and safety.
With mycoplasmal and chlamydial etiology of tonsillitis and pharyngitis, systemic antibiotic therapy is also shown, but the drugs of choice are macrolides.
[Surgical treatment of angina and acute pharyngitis in children
It is not shown, with the exception of complications - paratonzillitis and zaglugal abscess. In this case, the child is hospitalized in the otolaryngology department, where he is uncovered with abscesses, with recurrence of paratonsillar abscesses, tonsillectomy is indicated.
Prognosis of angina and acute pharyngitis in children
Favorable.