Overcoming penicillin failures in the treatment of Group A streptococcal pharyngo-tonsillitis

Int J Pediatr Otorhinolaryngol. 2007 Oct;71(10):1501-8. doi: 10.1016/j.ijporl.2007.06.006. Epub 2007 Jul 17.

Abstract

The causes of penicillin failure in eradicating Group A beta-hemolytic streptococcal pharyngo-tonsillitis (GABHS PT) are described. These include the presence of beta-lactamase producing bacteria that "protect" Group A beta-hemolytic streptococci (GABHS) from penicillins; the absence of bacteria that interfere with the growth of GABHS; co-aggregation between GABHS and Moraxella catarrhalis; and the poor penetration of penicillin into the tonsillar tissues and the tonsillo-pharyngeal cells. The use of antimicrobials that can overcome and modulate these phenomena and achieve better cure of the infection is described.

Publication types

  • Review

MeSH terms

  • Humans
  • Moraxella catarrhalis / drug effects
  • Moraxellaceae Infections / complications
  • Moraxellaceae Infections / drug therapy
  • Penicillins / pharmacology*
  • Penicillins / therapeutic use*
  • Pharyngitis / drug therapy*
  • Pharyngitis / microbiology*
  • Streptococcal Infections / complications*
  • Streptococcal Infections / drug therapy*
  • Streptococcus pyogenes / isolation & purification*
  • Tonsillitis / drug therapy*
  • Tonsillitis / microbiology*
  • Treatment Failure
  • beta-Lactam Resistance / drug effects
  • beta-Lactamases / metabolism

Substances

  • Penicillins
  • beta-Lactamases