The infection of the pharynx (pharyngitis) or tonsils (tonsillitis) is commonly referred to as a throat infection. Although most throat infections are caused by viruses, the bacterium group A Streptococcus is the major cause of bacterial infections. Popular symptoms of a throat infection include discomfort in swallowing, a sore throat (inflammation) and fever. Other symptoms include an erythematous pharynx, presence of exudates on the tonsils or pharynx, and red spots on the soft palate. Although serious complications from a throat infection are possible, they are rare.
Are Antibiotics Required?
Because antibiotics can destroy bacteria but have no impact on viruses, antibiotics are prescribed only if your throat has been infected by bacteria. In fact, when you visit the hospital, one of the major tasks of your physician is to find out if your throat is infected with bacteria and if an antibiotic is needed. For this diagnosis, a throat culture or an antigen-detection test is carried out. Benjamin Schwartz, MD and his group, in their study, "Pharyngitis---Principles of Judicious Use of Antimicrobial Agents," discourage the use of antibiotics in children unless infection by group A Streptococcus or other bacteria has been diagnosed.
Penicillins
In 1995, the American Academy of Pediatrics published a report titled "Treatment of Acute Streptococcal Pharyngitis and Prevention of Rheumatic Fever" (available on the American Heart Association's website), which summarizes the treatment options for throat infection. The recommended oral penicillin dosage for children is 250 mg (two to three times a day), and the same for adults is 500 mg (two to three times a day) for 10 days. For patients at risk of rheumatic fever, injectable penicillin G is also available. Besides narrow-spectrum penicillins such as phenoxymethylpenicillin, broad-spectrum penicillins such as amoxycillin and ampicillin can also be prescribed.
Other Antibiotics
Your doctor may prescribe a cephalosporin if you are allergic to penicillins. Common cephalosporins include cefadroxil and cefalexin. Other antibiotic options include macrolides such as erythromycin, clarithromycin and azithromycin. However, because Streptococcus strains resistant to macrolide antibiotics have been found, the latter three may not be the physician's first choice. Also, the antibiotic treatment scheme can get considerably altered if bacteria other than group A streptococci are responsible for the throat infection.
References
- Pediatrics; Pharyngitis---Principles of Judicious Use of Antimicrobial Agents; B Schwartz, et al.; 1998
- American Heart Association: Treatment of Acute Streptococcal Pharyngitis and Prevention of Rheumatic Fever
