Streptococcal pharyngitis in children: to treat or not to treat?
Unlabelled: Controversy remains about the need for antibiotic therapy of group A streptococcal (GAS) pharyngitis in high-resource settings. Guidelines on the management of GAS pharyngitis differ considerably, especially in children. We performed a literature search on the diagnosis and treatment of...
| Publicado en: | European Journal of Pediatrics Vol. 173; no. 10; pp. 1275 - 1284 |
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| Autores principales: | , , , , , , , |
| Formato: | review Journal Article |
| Publicado: |
Springer Nature
Oct2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103846323&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103846323 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03406199 CR1 jtl: European Journal of Pediatrics issn: 03406199 maglogo: N pubinfo: dt: Oct2014 vid: 173 iid: 10 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 103846323 NLM25113742 2012734413 10.1007/s00431-014-2395-2 NLM25113742 103846323 ppf: 1275 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Streptococcal pharyngitis in children: to treat or not to treat? aug: au: Van Brusselen, Daan Vlieghe, Erika Schelstraete, Petra De Meulder, Frederic Vandeputte, Christine Garmyn, Kristien Laffut, Wim Van de Voorde, Patrick affil: Department of Pediatrics, University of Leuven, Herestraat 49, 3000, Leuven, Belgium, daan.vanbrusselen@gmail.com. sug: subj: Antibiotics Therapeutic Use Pharyngitis Drug Therapy Streptococcal Infections Drug Therapy Streptococcus Child Pharyngitis Complications Pharyngitis Diagnosis Pharyngitis Microbiology Practice Guidelines Streptococcal Infections Complications Streptococcal Infections Diagnosis Child: 6-12 years ab: Unlabelled: Controversy remains about the need for antibiotic therapy of group A streptococcal (GAS) pharyngitis in high-resource settings. Guidelines on the management of GAS pharyngitis differ considerably, especially in children. We performed a literature search on the diagnosis and treatment of GAS pharyngitis in children and compared different guidelines with current epidemiology and the available evidence on management. Some European guidelines only recommend antibiotic treatment in certain high-risk patients, while many other, including all American, still advise antimicrobial treatment for all children with GAS pharyngitis, given the severity and re-emerging incidence of complications. Empirical antimicrobial treatment in children with sore throat and a high clinical suspicion of GAS pharyngitis will still result in significant overtreatment of nonstreptococcal pharyngitis. This is costly and leads to emerging antibiotic resistance. Early differential diagnosis between viral and GAS pharyngitis, by means of a 'rapid antigen detection test' (RADT) and/or a throat culture, is therefore needed if 'pro treatment' guidelines are used.Conclusion: Large scale randomized controlled trials are necessary to assess the value of antibiotics for GAS pharyngitis in high-resource countries, in order to achieve uniform and evidence-based guidelines. The severity and the possibly increasing incidence of complications in school-aged children suggests that testing and treating proven GAS pharyngitis can still be beneficial. pubtype: Academic Journal doctype: review Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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