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https://doi.org/10.14300/mnnc.2024.19028

Diagnostics and antibacterial therapy of streptococcus-associated tonsillitis

[Otorhinolaryngology]
Anzhelika Valerievna Dengina; Vladimir Pavlovich Karpov; Vladimir Baturin; Levon Sargisovich Badiryan;

The sensitivity of Group A β-hemolytic Streptococcus pyogenes (GABHS) to various antibacterial drugs in patients with chronic tonsillitis for 2019–2023 was studied. Six hundred thirty-six medical records of patients with this pathology and a positive microbiological examination of a smear from the pharyngeal mucosa for GABHS, who underwent treatment and assessment in 2019, 2021, and 2023, were analyzed. It was found that the sensitivity of S. pyogenes to penicillin antibiotics remains at the level of 100 %. Of the «reserve» antibiotics, doxycycline remains highly sensitive. There is increased resistance to second-line antibacterial drugs used in treating chronic tonsillitis in patients intolerant to penicillin antibiotics, primarily macrolides and fluoroquinolones. Thus, amoxicillin is the starting antibiotic therapy in patients with chronic tonsillitis caused by S. pyogenes. For patients with a history of allergies to penicillin antibiotics, to prescribe effective treatment, it is necessary to conduct a microbiological examination of a smear from the pharyngeal mucosa to determine the sensitivity of S. pyogenes to «reserve» antibacterial drugs.

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Keywords: group A β-hemolytic streptococcus (GABHS), Streptococcus pyogenes, antibacterial therapy, antibiotic resistance, chronic tonsillitis