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

The antibiotic management of tonsillitis, acute otitis media, sinusitis and bronchitis is critically reviewed. Tonsillitis due to Group A streptococci must be treated with penicillin for 10 days in order to prevent complications. Antibiotics should not be used locally in pharyngitis or tonsillitis. Tonsillectomy does neither reduce the incidence of streptococcal tonsillitis nor of rheumatic complications. Antibiotic cover for tonsillectomy is not indicated except in patients with rheumatic heart disease or in those with prosthetic heart valves. The indications for the prophylactic use of antibiotics in ear, nose and throat surgery are discussed.
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PMID:[Antibiotic therapy - a critical review (author's transl)]. 45 63

Patients with acute otitis media, tonsillitis and upper respiratory tract infections were divided into 2 groups and treated with ampicillin-cloxacillin (Rectocillin) 1 g/day or ampicillin (AB-PC) 1 g/day, respectively. The therapeutic effect and side effect of these two drugs were studied comparatively by double blind tests. The effective rate in the Rectocillin group was 85.1%, and that in the AB-PC group was 86.7%. There was no significant difference in the therapeutic effect between two drugs. Ten cases in the Rectocillin group and 4 cases in the AB-PC group complained of disorders supposedly due to administration of these drugs. Such side effects in the former group were all gastrointestinal disorders, but in the latter, 2 cases of eruption, one case of headache and one case of gastrointestinal disorder.
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PMID:[Double-blind studies of the effect of ampicillin-cloxacillin (Rectocillin) on acute otorhinolaryngological infections (author's transl)]. 77 45

The incidence of respiratory tract infections in patients seeking medical advice at a community care centre (Dalby) during 1973 and 1974 was studied. About every third patient seen at this primary health station presented with signs of such infections. In the age groups less than 10, 10-19, 20-39, 40-59 and greater than or equal to 60 years, respiratory tract infections accounted for 65, 45, 32, 18 and 9% of the fotal number of diagnoses made during 1974. The aetiology of acute respiratory tract infections in a series of patients seen at this health station was studied. The series included randomly selected cases, but excluded children under seven years of age and patients presenting with signs of acute otitis media and tonsillitis. Attempts to establish the aetiology were made on the basis of the history, the clinical examination, and cultures for beta-haemolytic streptococci and Mycoplasma pneumoniae, complement foxation tests for influenza A and B, para-influenza 1, 2, and 3, adeno, cytomegalovirus and respiratory syncytial virus, and Chlamydia psittaci. Paul-Bunnell test and tests for cold agglutinins were also performed. With this test battery, an aetiological diagnosis was obtained in only 33% of the 101 patients studied. The findings suggest an infection with M.pneumoniae in 16%, with beta-haemolytic streptococci in 9%, and with viruses (adeno and para-influenza) in 7% of the patients. The present communication highlights the role of M.pneumoniae in upper respiratory infections, as few data have appeared on such infections in patients seen in general practice. The difficulty of establishing the aetiology of respiratory tract infections and the consequent treatment dilemma is discussed.
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PMID:The incidence and aetiology of respiratory tract infections in general practice--with emphasis on Mycoplasma pneumoniae. 78 48

These guidelines deal with the evaluation of anti-infective drugs for the treatment of respiratory tract infections. Five clinical entities are described: streptococcal pharyngitis and tonsillitis, otitis media, sinusitis, bronchitis, and pneumonia. A wide variety of microorganisms are potentially pathogenetic in these diseases; these guidelines focus on the bacterial infections. Inclusion of a patient in a trial of a new drug is based on the clinical entity, with the requirement that a reasonable attempt will be made to establish a specific microbial etiology. Microbiologic evaluation of efficacy requires isolation of the pathogen and testing for in vitro susceptibility. Alternatively, surrogate markers may be used to identify the etiologic agent. The efficacy of new drugs is evaluated with reference to anticipated response rates. Establishment of the microbial etiology of respiratory tract infections is hampered by the presence of "normal flora" of the nose, mouth, and pharynx, which may include asymptomatic carriage of potential pathogens. This issue is addressed for each category of infection described. For example, it is suggested that for initial phase 2 trials of acute otitis media and acute sinusitis tympanocentesis or direct sinus puncture be used to collect exudate for culture. Acute exacerbations of chronic bronchitis also present difficulties in the establishment of microbial etiology. These guidelines suggest that clinical trials employ an active control drug but leave open the possibility of a placebo-controlled trial. For pneumonia, the guidelines suggest the identification and enrollment of patients by the clinical type of pneumonia, e.g., atypical pneumonia or acute bacterial pneumonia, rather than by etiologic organism or according to whether it was community or hospital acquired. For each respiratory infection, the clinical response is judged as cure, failure, or indeterminate. Clinical improvement is not acceptable unless quantitative response measures can be applied.
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PMID:Evaluation of new anti-infective drugs for the treatment of respiratory tract infections. Infectious Diseases Society of America and the Food and Drug Administration. 147 53

The etiology of middle ear disease in Nijmegen, The Netherlands was studied on the basis of a data set collected in a prospective epidemiological study on otitis media with effusion (OME) in a cohort of 1439 preschool children. A factor analysis was used to evaluate two hypotheses: (1) that OME, acute otitis media (AOM), common cold and tonsillitis are manifestations of the same pathological entity, and (2) that a group of children can be distinguished who develop these conditions more frequently than average. The results only partly supported these hypotheses. The correlation between OME, AOM, common cold and tonsillitis was lower than expected from a review of the literature. Common cold appeared to be the ubiquitous ENT disease in childhood and, depending on the child's predisposition, could be accompanied by OME, AOM or tonsillitis. The course of middle ear and upper airway disease showed a gradual scale from "healthy" to "ill" with most of the children suffering from these conditions at an average frequency.
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PMID:An epidemiological approach to the etiology of middle ear disease in The Netherlands. 148 34

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

Laboratory and clinical studies on cefpirome (CPR, HR 810), a newly developed cephem antibiotic, were performed. The results obtained are summarized as follows: 1. Absorption and elimination of the drug were examined in a total of 7 children including 3 cases of administered with 20 mg/kg intravenous bolus injection (i.v.), 2 cases with 20 mg/kg drip infusion (d.i.v.) for 60 minutes and 2 cases with 40 mg/kg (d.i.v.) for 60 minutes. Maximum serum levels were attained immediately after i.v. or d.i.v. Cmax's were 233 +/- 7.6, 88.5 +/- 14.5, and 116 +/- 15 micrograms/ml, respectively for the above 3 modes of administration. These values were determined using a bioassay method with Bacillus subtilis ATCC 6633. T 1/2 (beta)'s were 1.18 +/- 0.17, 1.61 +/- 0.28 and 2.68 +/- 0.83 hours, respectively. Cumulative urinary recovery rates were 40.2-69.8% in a period of 0-6 hours after admissions. 2. Clinical efficacies were evaluated in a total of 20 patients with ages ranging from 9 months to 11 years. The treated cases were 6 cases of acute pneumonia, 4 cases of acute bronchitis, 4 cases of acute purulent tonsillitis, 2 cases of acute urinary tract infections, 2 cases of cellulitis, 1 case of purulent lympadenitis and 1 case of acute otitis media. The clinical efficacy rate was 94.7%. Adverse reactions occurred in no patients. Abnormal changes in laboratory test values involved only 1 case with elevated GOT and GPT. CPR was considered to be a safe and useful drug in treating various infectious diseases in children.
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PMID:[Laboratory and clinical studies on cefpirome in pediatrics]. 188 Sep 34

Colonization of middle ear pathogens (S. pneumoniae, H. influenzae and B. catarrhalis), potential pathogens (S. aureus and coagulase-negative staphylococci) and non-pathogens was determined quantitatively on the posterior wall of the nasopharynx (NPH) of children (four age groups: under 2 years, 2-5 years, 6-10 years and 11-15 years). None of the 90 individuals examined was suffering at the time of bacterial sampling from acute otitis media (AOM), sinusitis, or tonsillitis. All individuals under 2 years of age harboured middle ear pathogens in the NPH, but only 40% of the individuals of the oldest age group (p less than 0.001). Furthermore, in the youngest group, 57% of the cases had pathogens in the NPH, which completely dominated the bacterial flora, i.e. constituted more than 90% of the total bacterial count when calculated as CFU/cm2. The corresponding count in the oldest age group was only 20% (p less than 0.01). One important reason for the high incidence of AOM among young children in particular seems to be the noticeable accumulation of middle ear pathogens in huge quantities in the NPH in this age group.
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PMID:Occurrence of middle ear pathogens in the nasopharynx of young individuals. A quantitative study in four age groups. 210 62

The combination of sulbactam and ampicillin is a safe and effective therapy for acute otitis media and acute epiglottitis in infants and children. Despite the lack of similar studies proving efficacy for other infections of the upper airway and certain adjacent structures, such as sinusitis, tonsillitis and cellulitis/abscess of the head and neck, this drug combination should also have a therapeutic role in the future for these conditions.
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PMID:Role of sulbactam/ampicillin and sultamicillin in the treatment of bacterial infections of the upper respiratory tract of children. 266 Aug 69

During a period of one year, the contact pattern during day working hours in general practice where diseases of the ear, nose and throat were concerned was registered as part of an investigation of disease pattern in the County of Arhus. Registration included the form of encounter, reason for encounter, diagnosis and possible referrals. It was demonstrated that 8.6% of all disease and symptom-induced encounters in general practice were concerned with ear, nose and throat disease. Complaints from the throat were the commonest. Coryza and tonsillitis comprised nearly half of all the diseases. The commonest diseases of the ear were acute otitis media and wax in the ear. Among upper respiratory diseases, acute infective conditions dominated. As compared with the usual age-distribution in general practice, coryza, tonsillitis, acute and secretory otitis media and chronic allergic rhinitis were considerably overrepresented in children. Examination in consulting room was the commonest form of encounter. The majority of the patients were considered by the general practitioners to be completely treated after one consultation.
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PMID:[Otorhinolaryngologic diseases in general practice]. 273 9


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