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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A questionnaire, sent to a 10% random sample of Dutch general practitioners (n = 635) included descriptions of four cases of upper respiratory tract infections (acute tonsillitis, recurrent tonsillitis, acute otitis media and sinusitis). This was used to study the general practitioners' management of upper respiratory tract infections. A total of 376 doctors responded (59%). The majority of general practitioners would prescribe antibiotics for sinusitis (80% of respondents) but only 29% would prescribe antibiotics for acute otitis media. For acute tonsillitis and recurrent tonsillitis the proportions were 52% and 59%, respectively. The low prescription rate for acute otitis media was in accordance with national standards, such as the standard of the Netherlands college of general practitioners. A penicillin (phenoxymethylpenicillin or phenethicillin) was most likely to be selected for the two types of tonsillitis, amoxycillin for acute otitis media and doxycycline for sinusitis. Other antibiotics such as erythromycin, other tetracyclines and ampicillin, were seldom selected. Most respondents would prescribe antibiotics for seven days, but there was considerable variation. The influence of the characteristics of the general practitioners and their practices on their antibiotic prescribing was small. Only type of practice correlated with antibiotic treatment, in that general practitioners in single-handed practices would prescribe antibiotics more often than their colleagues in health centres. Among those who would prescribe symptomatic treatment nearly all would prescribe nosedrops for acute otitis media and sinusitis. Eighty five per cent of the respondents would refer the patient with recurrent tonsillitis, while 10% would refer the patient with acute otitis media. The results suggest that some aspects of the prescribing behaviour of Dutch general practitioners might be improved.
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PMID:Management of upper respiratory tract infection in Dutch general practice. 158 60

Respiratory tract pathogens (beta-haemolytic streptococci groups A, C and G, Haemophilus influenzae, Branhamella catarrhalis or pneumococci), were isolated from nasopharyngeal and/or throat swabs in 73/138 (53%) patients greater than 10 years of age with a clinical diagnosis of acute sinusitis, acute tonsillitis, purulent nasopharyngitis or acute bronchitis. Serological evidence of a viral infection (influenza A and B, parainfluenza 1, 2 and 3, respiratory syncytial virus, adenovirus) or Mycoplasma pneumoniae infection was found in 10% of the patients. The serum content of C-reactive protein (S-CRP) was increased (greater than 12 mg/l) in 26/33 (79%) patients with streptococci and in 22/59 (37%) patients without respiratory tract bacteria. In patients with a serological evidence of a virus tonsillitis, the S-CRP was also high (32-64 mg/l). At follow-up 10-12 days after the first visit, the clinical effect of erythromycin and penicillin V was judged to be similar (90% clinical effect). Relapse or re-infection with group A streptococci were seen in 7 patients (4 on erythromycin, 3 on penicillin). In another 6 patients (3 on erythromycin, 3 on penicillin), antibiotic treatment was switched owing to persisting symptoms, probably due to H. Influenzae infection in 3 cases. The patients' own estimates of their symptoms suggested treatment with erythromycin to have a more rapid effect than treatment with penicillin.
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PMID:Erythromycin and phenoxymethylpenicillin (penicillin V) in the treatment of respiratory tract infections as related to microbiological findings and serum C-reactive protein. 190 52

The efficacy and tolerability of morniflumate suppositories used together with phenoxymethylpenicillin were studied in a placebo-controlled, double-blind trial in 101 children with acute tonsillitis. Patients received a suppository containing 400 mg morniflumate or placebo twice daily for 4 days; all patients also received 1,500,000 IU/day phenoxymethylpenicillin. Response to treatment was assessed by clinical examination before and after 2 and 4 days' treatment. Efficacy was evaluated by resolution of oropharyngeal pain, congestion, fever, size and sensitivity of adenopathies, quality of life and duration of sleep. Body temperature fell rapidly after the start of treatment. There was also resolution of pharyngeal pain, earache, dysphagia and adenopathy. Spontaneous pharyngeal pain was present after 4 days in significantly (P = 0.03) fewer patients receiving morniflumate than receiving placebo. It is suggested that morniflumate combined with antibiotic therapy is an effective and well-tolerated treatment for tonsillitis in children.
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PMID:Double-blind, placebo-controlled multicentre trial of the efficacy and tolerance of morniflumate suppositories in the treatment of tonsillitis in children. 211 May 37

No other infectious diseases in the field of otolaryngology cause rapid and lethal course than cervical abscess. A case of cervicomediastinal abscess secondary to acute tonsillitis was presented. The patient was a 43-year-old male with liver cirrhosis and primarily had the treatment of tonsillitis. The complication of duodenal perforation caused marked general deteriotation, and cervical abscess occured. Immediately after transfer to our department, he was treated by cervical drainage, laparotomy and chemotherapy. However, hepatic failure occured, and he died of sepsis on the 16th day after the onset of tonsillitis. Cervicomediastinal abscesses were classified according to severity in Stage 1-4. 34 cases of advanced cervical abscess were reported in Japan from 1976 to 1989. These cases were analyzed statistically in terms of primary focus of infection, surgical procedures, clinical isolates and chemotherapy, etc., and following results were obtained. 1) Primary focus; approximately 50% was due to the infection of the tonsills and the pharynx occupied about 50%, and the odontogenic infections, approximately 40%. 2) Surgical procedures; the neck doranaige approaching through the vertical incision resulted more effective. 3) Clinical isolates; aerobes and anaerobes accounted for 50% each of all strains. alpha-Streptococcus was predominant among aerobes, and Peptostreptococcus and Bacteroides were predominant among anaerobes. In order to confirm pathogenic bacteria of cervical abscess, clinical isolates of peritonsiller abscess and mandibular ostesis were compared with those of cervical abscess, because these infections are primary infectious diseases of cervical abscess.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of cervico-mediastinal abscess, secondary to acute tonsillitis: investigation of the treatments]. 221 51

Seventy-eight of 107 general practitioners completed a questionnaire to assess the management of recurrent acute tonsillitis by the primary care physician. Penicillin was the antibiotic of choice in acute tonsillitis, used by 74 (95%) respondents. Of these, 45% recommended ampicillin/amoxycillin. In the case of penicillin allergy, 67 (86%) chose erythromycin. For the treatment of tonsillitis unresponsive to initial therapy, a wide variety of agents were quoted; the most common being erythromycin (27 cases, 35%) and co-trimoxazole (16 cases, 20%). There were 17 separate indications for surgical referral given, the most common being recurrent tonsillitis (68 cases, 87%). Two or more reasons for surgical referral were stated by 55 (71%) GPs. These findings are discussed with particular reference to recent reports of penicillinase producing bacteria in association with recurrent acute tonsillitis.
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PMID:Management of tonsillitis by the general practitioner. 239 Dec 14

Group A beta-hemolytic streptococci were found in 38% of 257 young men in military service with acute tonsillitis. Of the 108 patients tested also for viral antibodies, 42% showed a 4-fold rise in antibody titers. Adenovirus was the most frequent (31%) nonstreptococcal agent, followed by Epstein-Barr virus (6%), and influenza virus (5%). Non-group A streptococci were isolated in about the same proportion (18%) as in healthy control subjects. Other data also suggested that these bacteria were carried and not true infecting organisms. Group A streptococci and adenovirus occurred in mixed infection in 9% of the 108 cases. In group A streptococcal tonsillitis compared to others, white blood cell counts were higher (13.3 vs. 8.3 x 10(9)/l, p less than 0.01), C-reactive protein was higher (70 vs. 48 mg/l, p less than 0.01), tonsillitis was more often non-exudative (p less than 0.05), and the duration of fever was shorter (2.2 vs. 3.5 days, p less than 0.01), while there was no difference in the height of the fever or erythrocyte sedimentation rate.
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PMID:Acute tonsillitis in young men: etiological agents and their differentiation. 254 62

A newly developed cephalosporin, cefteram pivoxil (CFTM-PI, T-2588), was evaluated clinically in 40 patients. A pharmacokinetic study was also performed with 8 patients. CFTM-PI was administered as granules. One patient was given CFTM-PI at a dose of 1.5 mg/kg, each of 3 patients was given the drug at a dose of 3 mg/kg and each of 4 patients at a dose of 6 mg/kg. In most cases, serum concentrations of CFTM were determined at 2, 3, 4, and 6 hours after dosing. Urinary concentrations of CFTM were measured for urinary samples collected during periods of 0-2, 2-4, 4-6 and 6-8 hours after dosing. CFTM was assayed using the disk or the cup method using Klebsiella pneumoniae ATCC 10031 as the test organism. The clinical evaluation was conducted in 40 children including 13 patients of acute tonsillitis, 10 of acute lacunar tonsillitis, 10 of scarlet fever, 2 of acute bronchitis, 2 of pneumonia, and 1 each of pneumonia with enteritis, phlegmon and urinary tract infection. The patients were from 4 months to 13 years old. Daily doses were from 8.7 to 12 mg/kg. After CFTM-PI administration in doses 1.5 mg/kg, 3 mg/kg and 6 mg/kg, peak serum concentrations of CFTM were 0.38 microgram/ml, 0.73-2.25 micrograms/ml and 1.2-2.9 micrograms/ml, respectively, and half-lives were 1.55, 0.95-2.30 and 0.80-2.72 hours, respectively. Urinary excretion rates up to 6 or 8 hours after dosing were 10.8-24.7%. Clinical efficacies of CFTM-PI in 40 patients were "excellent" in 27 children, "good" in 12 children and "fair" in 1 with an efficacy rate of 97.5%. Twenty seven strains of causative organisms, including 15 strains of Streptococcus pyogenes, 1 of Escherichia coli, 1 of Salmonella 04, 6 of Haemophilus influenzae, 1 of Haemophilus parainfluenzae and 3 of Branhamella catarrhalis, were isolated. After treatment all strains except 1 strain of B. catarrhalis (unchanged), Salmonella 04 (unknown) and 1 strain of H. parainfluenzae (unknown) were eradicated. Side effects observed clinically were only 1 case of diarrhea. Eosinophilia was observed in 1 case.
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PMID:[Clinical studies on cefteram pivoxil granules in pediatrics]. 281 Jul 57

To study the pathogenesis of upper respiratory tract infections, we focused on acute tonsillitis and performed three experimental and clinical studies. From these studies, we found out that there seemed to be an intimate relationship between anatomical structure and adherence of S. pyogenes, and we confirmed that the M protein of S. pyogenes played an important role in adherence to the epithelium and the normal bacterial flora was actively involved in the body's defense against infections. We also identified that nearly half of causative bacteria in tonsillitis in Japan were the genus streptococcus, especially S. pyogenes with 23.4%. The incidence of Methicillin (DMPPC)-resistant Staphylococcus aureus (MRSA) was 27% in middle ear exudate and 14.3% in nasal discharge, but no MRSA was isolated from tonsillitis.
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PMID:Experimental and clinical studies of causative bacteria in tonsillitis. 306 5

Beta-streptococci isolated from patients with acute tonsillitis were tested for penicillin tolerance defined as an MBC/MIC ratio greater than or equal to 16. 11/18 strains recovered from patients with clinical treatment failure were tolerant to penicillin in comparison with 0/15 strains from successfully treated patients. The MBC/MIC ratio was less than 16 for all strains versus cefadroxil but above that ratio for many strains versus clindamycin, doxycycline and erythromycin. We suggest that penicillin tolerance may be one reason to treatment failures in individuals with streptococcal tonsillitis and that other antibiotics could be used to treat these patients since penicillin tolerance is not correlated to a general increase in antibiotic resistance.
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PMID:Penicillin tolerance in beta-streptococci isolated from patients with tonsillitis. 311 52

In a group of women, which had children with hereditary isolated and syndromal chest deformations, acute respiratory diseases, tonsillitis or influenza occurred during pregnancy in 42.9 +/- 6.6% and 53.8 +/- 13.8% of cases, respectively, whereas in the control group only 17.8 +/- +/- 7.2% of the women were impaired with identical infectious diseases during pregnancy (P less than 0.02 and P less than 0.05, respectively). Excretion of hydroxyproline was distinctly dissimilar in 22 children with isolated and in 13 children with syndromal chest deformations depending on presence or absence of the above-mentioned infections during pregnancy. Under conditions of these infections the higher level of total hydroxyproline excretion was noted as well as relatively lower content of bound hydroxyproline was detected in those peptides, which appear to be responsible for the content of newly synthesized collagen. The data obtained suggest that acute respiratory diseases, influenza, chronic and acute tonsillitis may impair collagen metabolism in children with hereditary chest deformations as well as that these infectious diseases occurred during pregnancy may increase the risk of the pathology development in the children.
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PMID:[Relation between infections during the pregnancy and the rate of hydroxyproline excretion in children with congenital chest deformities]. 319 33


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