Amoxicillin for sore throat

Despite the challenges facing the study of PID due to anaerobic organisms as a result of the fact that only one-third to one-half of PID cases are attributed to N.

trachomatis and the fact that bacterial vaginosis, anaerobic gram-negative rods, and mycoplasmal bacteria have been identified among women with PID [ 9, 10, 12, 27, 28], the microbiological efficacy of treatment regimens for both chlamydial and/or gonococcal and nonchlamydial and/or nongonococcal PID should be determined. Unfortunately, previous trials of metronidazole showed it to have limited efficacy, perhaps because poor tolerability limits adherence.

Indeed, the highest rates of adverse effects and study discontinuation in the randomized clinical trials reviewed herein occurred in women who were assigned to comparator regimens containing metronidazole [ 18–20]. This fact underscores the need for research on agents for the treatment of PID that are bactericidal for anaerobes.

Regimens

However, there is currently limited evidence for the recommendation of alternative therapies for the treatment of anaerobic PID. Although azithromycin provides coverage against a range of anaerobic and aerobic pathogens (including black-pigmented gram-negative rods) [ 20, 29], fluoroquinolones, including ofloxacin, have generally been found to have limited activity against anaerobes [ 30, 31]. In a recent trial of moxifloxacin versus ofloxacin plus metronidazole, moxifloxacin was found to be as clinically efficacious as ofloxacin plus metronidazole and to exhibit similar cure rates for C. trachomatis and Mycoplasma and better cure rates for N.

However, women treated with moxifloxacin experienced a worse cure rate for gram-positive anaerobes [ 18]. Alternatively, a study has shown azithromycin to be effective for the treatment of anaerobic PID [ 20].

Clinical cure rates and eradication of anaerobes are similar among women whose PID is treated with azithromycin alone and women treated with combination azithromycin-metronidazole (clinical cure rate, 97% vs. This initial study is promising, and further work may support the use of azithromycin monotherapy for the treatment of anaerobic PID. However, neither azithromycin nor quinolones are optimal for the treatment of gonococcal PID, because increasing drug resistance is being reported [ 32–36]. Treatment efficacy in the studies reviewed was restricted to short-term clinical and microbiological cure. There are limited data on the efficacy of any PID treatment regimen in the prevention of adverse reproductive sequelae. From the PEACH study, we have previously reported that, among women with clinically suspected mild to moderate PID treated with the standard antibiotic regimen of doxycycline and cefoxitin, endometritis and upper genital tract gonococcal and chlamydial infection were not associated with reproductive morbidity [ 37]. One interpretation is that these antibiotics that are used to treat modern-day mild to moderate chlamydial and gonococcal PID limited to the uterus are so effective that reproductive morbidity is not elevated among women with treated endometritis.

However, despite the high rates of clinical cure and eradication of N.

trachomatis observed in the PEACH study at 30 days after treatment [ 38], rates of infertility (17%) [ 38], recurrent PID (14%) [ 38], and chronic pelvic pain (37%) [ 39] were distressingly elevated over the course of follow-up. This suggests a need to discover and provide coverage against all possible damaging PID pathogens and also to focus on long-term morbidity in treatment efficacy evaluations. It is possible that women with nongonococcal PID may be more likely to experience adverse sequelae. In the PEACH study, we reported that women with nongonococcal bacteria identified in the endometrium were generally more likely to experience reproductive morbidity than were women with gonococcal infection.

trachomatis identified, 22% for women with anaerobic bacteria identified, 27% for

women

Animal models may provide insight into better regimens for the treatment of nongonococcal PID.

Rapid single-dose oral azithromycin therapy has been found to prevent infertility in a mouse model of chlamydial salpingitis [ 41]. Similarly, azithromycin was found to be

more

Ultimately, microbe-specific and optimized treatment needs to preserve fertility following PID and also prevent recurrent and persistent infection, ectopic pregnancy, and chronic pain, improving the long-term prognosis for women who have PID. (Pharyngitis; Tonsillitis; Tonsillopharyngitis) , MD, Yale University School of Medicine. 3D Models (0) Audios (0) Calculators (0) Images (3) Lab Test (0) Sidebars (0) Tables (0) Videos (1) Throat infections are usually caused by a virus but may be caused by bacteria such as streptococcal bacteria.

Symptoms include severe pain with swallowing and swollen, red tonsils. The diagnosis is based on an examination of the throat.

If untreated, tonsillopharyngitis that is caused by bacteria may become a tonsillar abscess. Pain is relieved with analgesics, and a streptococcal infection is treated with antibiotics.

Sometimes the tonsils have to be surgically removed. The tonsils contain lymphoid tissue that is part of the body's immune defense system. Thus, the tonsils and nearby throat tissue frequently become infected by organisms that enter the nose and throat. People who have had their tonsils removed can still get throat infections.

Most often, it is one of the viruses that cause the common cold, such as rhinovirus, adenovirus, influenza virus, or respiratory syncytial virus.

Less often, another virus is involved, such as the Epstein-Barr virus (which causes mononucleosis) or human immunodeficiency virus (HIV). In less than one third of people, throat infections are caused by a bacterial infection.

Group A streptococcus (strep throat) is the most common bacterial cause and usually occurs in children between age 5 and age 15. Strep throat is less common in children under age 3 and in older adults.

Untreated strep throat sometimes causes complications. Complications can include tonsillar cellulitis or

abscess

Some people have fever, headache, and an upset stomach.

The tonsils are red and swollen and sometimes have white patches on them.

Lymph nodes in the neck may become swollen and tender. In people who have frequent tonsil infections, the normal small pits in the tonsils sometimes become filled with white, hardened secretions that resemble tiny stones.

These stones can trap odor-causing bacteria, causing chronic bad breath,

and

People

with

People with mononucleosis often feel extremely tired and have many swollen lymph nodes, and their increasing tonsillar swelling may begin to block air when a person breathes, causing noisy breathing.

Doctors recognize a throat infection by viewing the throat.

However, because viral infections and bacterial infections often cause the same appearance in the throat, it is difficult for doctors to know whether the cause is a viral or bacterial infection just by looking at the throat.

However, people with a runny nose

and

Because it is often considered important to identify strep throat (which is generally treated with antibiotics), doctors sometimes swab the person's throat and do tests to identify streptococcus bacteria. Typically, doctors test most children but test adults only if they meet certain criteria, such as having white patches on the tonsils (tonsillar exudates), swollen and

tender

However, not all experts agree on when testing should be done or even when antibiotics should be given. Pain relievers (analgesics) For strep throat, antibiotics.

Analgesics given by mouth, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), often help reduce pain in people with a throat infection.

Gargling with warm salt water has often been recommended but has not been shown to help. Some doctors also give a single dose of a corticosteroid, dexamethasone , which may shorten the duration of symptoms.

It may also help lessen airway blockage caused by mononucleosis. People with a strep infection are given an antibiotic, usually penicillin or amoxicillin . People who are allergic to penicillin may be given clindamycin . People who

have

Doctors consider tonsillectomy if the child has an acute infection that is severe and persistent despite being treated with antibiotics, if the child has significant obstruction (including obstructive sleep disorder) or a recurrent peritonsillar abscess, or if they suspect cancer. For adults , doctors do not use these specific criteria for when to do tonsillectomy.

However, doctors may do tonsillectomy in adults who have severe bad breath due to tonsillar stones.

For both children and adults , doctors do allow for individual differences when deciding whether to recommend a tonsillectomy. There are numerous effective techniques for tonsillectomy. Doctors can use a scalpel or an electrocautery device, or they can destroy the tonsils using radio waves. Fewer than 2% of

people

Partial tonsillectomy is sometimes done in patients with tonsillitis that causes some blockage in the throat.

Part of the enlarged tonsil can be removed by shaving the tonsil using special scissors, or using other devices such as laser, radiofrequency, or electrocautery. It works as well as total tonsillectomy to relieve airway obstruction that is causing snoring and interruption of sleep.

Tonsils do not usually grow back, and what is left after partial tonsillectomy is helpful in maintaining immune function during early childhood. Клиника лечебного питания ФГБУН «ФИЦ питания и биотехнологии» по основному профилю медицинской деятельности.