[Diagnosis and treatment of acute tonsillopharyngitis. Consensus document update].

• 发表时间: Sep 2020
• 来源期刊: An Pediatr (Engl Ed)
• DOI: 10.1016/j.anpedi.2020.05.004
• PMID: 32605870
• 文章类型: Journal Article
• 作者列表: Piñeiro Pérez R,Álvez González F,Baquero-Artigao F,Cruz Cañete M,de la Flor I Bru J,Fernández Landaluce A,García Vera C,Hijano Bandera F,Pérez Cánovas C,Silva Rico JC, ,

关键词: Adecuación; Antibiotics; Antibióticos; Appropriateness; Children; Consensus document; Diagnosis; Diagnóstico; Documento de consenso; Estreptococo; Faringoamigdalitis; Niños; Rational use; Streptococcus; Streptococcus pyogenes; Tonsillopharyngitis; Tratamiento; Treatment; Uso racional

Mesh: Acute Disease; Anti-Bacterial Agents / administration & dosage; Child; Humans; Pharyngitis / diagnosis therapy; Spain; Tonsillitis / diagnosis therapy

Abstract

An update of the Spanish consensus document on the diagnosis and treatment of acute tonsillopharyngitis is presented. Clinical scores should not be used to prescribe antibiotics, unless microbiological tests are not available or there is a child at risk of rheumatic fever. There is no score better than those set out in the previous consensus. Microbiological tests are recommended in proposed cases, regardless of the result of the scores. Penicillin is the treatment of choice, prescribed twice a day for 10 days. Amoxicillin is the first alternative, prescribed once or twice a day for the same time. First-generation cephalosporins are the treatment of choice in children with non-immediate reaction to penicillin or amoxicillin. Josamycin and midecamycin are the best options for children with immediate penicillin allergic reactions, when non-beta-lactam antibiotics should be used. In microbiological treatment failure, and in streptococcal carriers, the treatments proposed in the previous consensus are still applicable.