Treatment Failure in Acute Streptococcal Tonsillitis in Children over the Age of 10 and in Adults

Autor: Roos, Kristian, Holm, Stig, Ekedahl, Claes
Zdroj: Archives of Physiology and Biochemistry; 1985, Vol. 17 Issue: 4 p357-365, 9p
Abstrakt: 13/169 outpatients (8%) with Streptococcal tonsillitis developed a new tonsillitis with the same strain within 2 weeks of completion of therapy (clinical treatment failures) and 24 (14%) remained carriers (bacterial treatment failures) after treatment with phenoxymethylpenicillin (penicillin V) 12.5 mg/kg body weight twice daily for 10 days. The mean serum concentration 60 min after penicillin V administration was 7.84μg/ml. Very large individual differences in serum concentration were found but these differences could not be correlated to treatment failure. About 60% of the patients showed salivary concentrations around 0.03 μg/ml. Three strains of streptococci (groups C and G) from patients with bacterial treatment failure had MIC values of 0.06 and 0.12 μg/ml. A majority of the patients with clinical treatment failures had contact with individuals with high carrier rates of beta-hemolytic streptococci. It therefore seems likely that some so-called treatment failures in reality are new infections. In clinical treatment failures group A streptococci were twice as common as groups C + G. In bacteriological treatment failures the ratio between A and C+G was 1: 1. Patients with non-streptococcal tonsillitis as well as carriers of groups C and G may appear among bacterial treatment failures.
Databáze: Supplemental Index