The most effective children's antibiotics for angina. Children's sore throat: when antibiotics are needed

Antibiotics for angina are prescribed when the cause of the disease is a bacterial infection. Most often, bacterial tonsillitis is caused by streptococcus. If a sore throat has developed as a result of a viral infection, then the appointment of antibacterial agents is impractical and can even cause complications in the form of an allergic reaction in a child. Therefore, before prescribing antibiotics to the baby, the doctor will send him to take a general blood test from a finger and a throat swab for bacteriological culture to determine the “culprit” of the disease.

Symptoms of bacterial sore throat

Often, with angina in children, antibiotics are prescribed by ENT doctors without preliminary tests, only on the basis of symptoms. Bacterial angina is characterized by the following features:

• Body temperature above 38 degrees.
• The lymph nodes are enlarged, with pressure on them there is a painful sensation.
• Light yellow coating on tonsils.
• No cough, no rhinitis.

If a child under the age of 15 has these symptoms, it is highly likely that the sore throat is caused by a streptococcal infection and the doctor will prescribe an antibacterial agent. If the child has only some of the listed signs, most likely, the sore throat is of a viral origin, and the use of antibacterial drugs will not give any results. Unfortunately, quite often antibiotics are prescribed to children "just in case, to be safe."

What antibiotics are given to children with angina

When choosing an antibiotic, the doctor takes into account the age and weight of patients. Usually, for the treatment of angina caused by streptococcus, antibiotics of the penicillin group are prescribed: Bicillin, Benzylpenicillin, Amoxiclav, Amoxil, Gramox, Flemoxin, Hikoncil. If the baby is allergic to penicillin, he should not be prescribed drugs from this group. In this case, antibacterial drugs from the group of lincosamides or macrolides are used: Clarithromycin, Erythromycin, Roxithromycin, Spiramycin, Lincomycin, Amoxicillin, Autmentin, Sumamed, Hemomycin or Azithromycin.

Antibacterial agents are available in different dosage forms: suspensions, tablets, capsules. When deciding which antibiotic to prescribe, the pediatrician takes into account whether the child can take the drug in this form. For example, a baby will not swallow a capsule or tablet in any way, so he is prescribed a suspension. So, children under 3-6 years old take antibacterial drugs in the form of suspensions, from 6 to 12 years old - in the form of tablets with a small dosage of the drug, and after 12 years - capsules, like adult patients.

Amoxiclav

The maximum daily dose of Amoxiclav suspension is calculated based on the body weight of the child: 45 mg of the drug per kilogram of weight. If the infection is of moderate severity, then the dose is determined based on the calculation of 25 mg per kilogram of weight. The usual scheme for taking the drug is something like this:

• from the first days of life to 3 months, the daily dose is 30 mg per kilogram of weight, it is divided equally and taken at regular intervals;
• from 3 to 12 months - the daily dose is 20 mg per kilogram, the child takes 2.5 ml of the suspension 3 times a day with an interval of 8 hours;
• from 1 year to 6 years - take 5 ml of suspension 3 times a day with an interval of 8 hours;
• from 7 to 12 years - take 10 ml of suspension 3 times a day with an interval of 8 hours;
• children over 12 years old or weighing over 40 kg take 1-2 tablets every 8 hours 3 times a day.

Sumamed (macrolide antibiotic)

Sumamed in the form of a suspension is given to the child once a day one hour before meals or 2 hours after. The daily dose of the drug is calculated by the formula: 10 mg of the drug per 1 kilogram of body weight. The antibiotic should be taken within 3 days. The doses of the drug in this case will be approximately as follows:

• with a child's body weight of 5 kg - a daily dose of a suspension of 2.5 ml;
• with a body weight of 6 kg - 3 ml of suspension;
• with a body weight of 7 kg - 3.5 ml of suspension;
• with a body weight of 8 kg - 4 ml of suspension;
• with a body weight of 9 kg - 4.5 ml of suspension;
• with a body weight of 10-14 kg - 5 ml of suspension.

Children from 3 to 12 years old (or weighing at least 45 kg) are given a tablet containing 125 mg of the drug once a day. With a child weighing over 45 kg, Sumamed is prescribed in capsules with a dosage of 250-500 mg.

Side effects

The main side effect of all antibacterial agents is that they, together with pathogenic bacteria, kill beneficial ones. And this leads to disruption of the functioning of the digestive system, which manifests itself in the form of diarrhea, vomiting, nausea, abdominal pain, and increased gas formation. In some cases, the side effect of antibiotics can manifest itself in the form of a skin rash.

To reduce the likelihood of side effects, along with taking antibiotics, antihistamines (for example, Erius) and drugs that normalize the intestinal microflora (for example, Linex) are prescribed.

What antibiotics are contraindicated in angina

Not all antibacterial drugs can treat a sore throat in a child. There are some drugs that have a negative impact on the health of the baby. And the benefits of their use will be incomparably less than the harm from side effects. These antibacterial drugs have a negative effect on the development of hematopoietic organs and bone tissue, thereby causing pathologies in the formation of the musculoskeletal system and circulatory system. They also have a toxic effect on the ENT organs, which leads to a decrease in hearing acuity.

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Angina is an acute infectious disease manifested by inflammation of the palatine tonsils. Since inflammation of other tonsils (lingual, tubal and laryngeal) develops very rarely, the term angina always means inflammation of the palatine tonsils. If it is required to indicate that the inflammatory process has affected some other tonsil, then doctors talk about lingual, laryngeal or retronasal tonsillitis. Any sore throats are caused by the same pathogenic microorganisms that enter the mucous membrane of the pharynx and oral cavity, so the principles of their therapy are also the same. Therefore, it is advisable to consider the legitimacy and necessity of applying antibiotics with tonsillitis affecting any tonsils.

Antibiotic for angina - when to use?

General rules for the use of antibiotics for angina

• The age of the person with angina;
• Type of angina - viral (catarrhal) or bacterial (purulent - follicular or lacunar);
• The nature of the course of angina (benign or with a tendency to develop complications.

So, to resolve the issue of the need to take antibiotics, it is necessary to determine whether angina is viral or bacterial. The fact is that viral tonsillitis occurs in 80 - 90% of cases and does not require the use of antibiotics. And bacterial tonsillitis occurs only in 10 - 20% of cases, and it is she who requires antibiotic treatment. Therefore, it is very important to be able to distinguish between viral and bacterial tonsillitis.

Viral angina is manifested by the following symptoms:

• Sore throat is associated with nasal congestion, runny nose, sore throat, cough and sometimes sores on the oral mucosa;
• Angina began without temperature or against the background of its increase to no more than 38.0 o C;
• The throat is just red, covered with mucus, but without pus on the tonsils.

• The disease began with a sharp rise in temperature to 39 - 40 o C, at the same time, pain in the throat and pus on the tonsils appeared;
• Abdominal pain, nausea and vomiting appeared simultaneously or shortly after the sore throat;
• Simultaneously with the pain in the throat, the cervical lymph nodes increased;
• A week after the onset of a sore throat, the palms and fingers began to peel off;
• Simultaneously with purulent tonsillitis, a small red rash appeared on the skin (in this case, the person fell ill with scarlet fever, which is also treated with antibiotics, like bacterial tonsillitis).

The second important factor that determines whether it is necessary to take antibiotics for angina in this particular case is the nature of the course of the disease. In this case, it is necessary to determine whether the sore throat proceeds favorably (without complications) or whether complications have begun to develop in a person. Signs of the onset of complications of angina, requiring the use of antibiotics, are the following symptoms:

• Some time after the onset of the sore throat, ear pain appeared;
• The condition worsens rather than improves as the disease progresses;
• Sore throat increases as the disease progresses;
• There was a noticeable bulge on one side of the throat;
• There were pains when turning the head to the side and when opening the mouth;
• On any day of the course of angina, chest pains, headaches, and pains in one half of the face appeared.

Based on all of the above, we present situations in which it is necessary and not necessary to use antibiotics for angina for people of different ages.

First, if the sore throat is viral and proceeds favorably, then antibiotics should not be used, regardless of the age of the patient. That is, if a child or an adult falls ill with a viral sore throat, which proceeds favorably, without the appearance of signs of complications, then none of them should use antibiotics for treatment. In such cases, the sore throat will pass on its own within 7 to 10 days. Only plentiful drinking and the use of symptomatic remedies that relieve sore throats and reduce fever are justified.

However, if with viral sore throat in an adult or child there are signs of complications, then antibiotics should be started as soon as possible. But you should not drink antibiotics to "prevent" complications, as this is ineffective. It is necessary to start taking antibiotics for viral sore throat only when there are signs of complications.

Secondly, if angina is bacterial (purulent) , then the need for antibiotics is determined by the age of the patient and the nature of the course of the disease.

If purulent tonsillitis has developed in an adult or adolescent over 15 years old, then antibiotics should be used only when signs of the complications indicated above appear. If angina in people over 15 years of age proceeds favorably, then antibiotics should not be used, since the infection will pass without their use. It has been proven that antibiotics reduce the duration of uncomplicated bacterial tonsillitis in people over 15 years of age by only 1 day, so their use is routine, in all cases it is not advisable. That is, all people over 15 years of age should use an antibiotic for angina only if there are signs of complications listed above.

Pregnant women and nursing mothers should take an antibiotic for angina in the same cases as other adults, that is, only with the development of complications from the ears, respiratory and ENT organs.

If a child of any age under the age of 15 develops a viral sore throat, then antibiotics are not needed to treat it. With viral sore throat, antibiotics should be started only if there are signs of complications in the ears, respiratory and other ENT organs.

If a child aged 3-15 years has developed purulent tonsillitis, then it is imperative to use antibiotics to treat it. In children of this age group, the need to use antibiotics for purulent sore throat is not associated with the treatment of the disease itself, but with the prevention of possible severe complications in the heart, joints and nervous system.

The fact is that bacterial tonsillitis in children under 15 years of age very often gives complications in the form of infection of the joints, heart and nervous system, causing much more serious diseases, such as rheumatism, arthritis and PANDAS syndrome. And the use of antibiotics for such tonsillitis in children under 15 years of age allows almost 100% to prevent the development of these complications from the heart, joints and nervous system. It is for the prevention of severe complications in children under 15 years of age that it is imperative to use an antibiotic for purulent tonsillitis.

Moreover, in order to prevent complications of bacterial tonsillitis on the heart, joints and nervous system, it is not necessary to start taking antibiotics from the first day of infection. Studies and clinical trials have shown that complications of bacterial tonsillitis in children are effectively prevented if antibiotics are started up to 9 days inclusive from the onset of the disease. This means that it is not too late to start giving your child antibiotics at days 2, 3, 4, 5, 6, 7, 8 and 9 after the onset of the sore throat.

As for tonsillitis in children under 3 years of age, they should use antibiotics only if there is pus on the tonsils or if complications develop in the ears, respiratory and ENT organs. Since there are practically no purulent bacterial tonsillitis in children under 3 years of age, in fact, antibiotics should be used in them to treat inflammation of the tonsils only with the development of complications from the respiratory and ENT organs.

In this way, antibiotics for angina in people of any age and gender should be used only in the following cases:

• Purulent (follicular or lacunar) tonsillitis, even with a favorable course in children aged 3 to 15 years;
• The development of complications of angina on the ears, respiratory and ENT organs in people over 15 years old;
• Complications of tonsillitis in the ears, respiratory and ENT organs in children under 3 years of age.

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Are antibiotics always used for angina? Symptoms, diagnosis and treatment of angina - video

Antibiotics for purulent tonsillitis (follicular and lacunar)

Antibiotic for angina in adults

Accordingly, in people over 15 years of age of both sexes, it is necessary to use antibiotics for purulent tonsillitis only with the development of complications in the ears, respiratory and ENT organs. Given this rule on the use of antibiotics for purulent tonsillitis in people over 15 years old, it is necessary to be able to distinguish between a favorable course of infection and the development of complications. To do this, you need to know the signs of the onset of complications in which you need to take antibiotics. So, the symptoms of complications of follicular or lacunar tonsillitis on the ears, respiratory and ENT organs, with the appearance of which it is necessary to start taking antibiotics, are the following:

• There was pain in the ear;
• After 2 - 4 days after the onset of angina, the state of health worsened;
• The pain in my throat got worse;
• When examining the throat on one of its sides, a noticeable bulge is visible;
• There was pain when opening the mouth or turning the head to the right or left;
• After 2-3 days of antibiotics, the condition did not improve;
• Sore throat and body temperature above 38 o C last longer than 7 - 10 days;
• There were chest pains, headaches, and pains in one half of the face.

Antibiotics for angina in children

The fact is that at this age, purulent tonsillitis can give much more severe complications compared to otitis, abscesses and others characteristic of adults over 15 years old, because due to the imperfection of the lymphoid tissue, pathogenic bacteria from the tonsils can penetrate with the blood and lymph into kidneys, heart, joints and central nervous system, causing inflammatory processes in them, which are very difficult to treat and often become the cause of chronic diseases of these organs.

If the pathogen that provoked purulent tonsillitis enters the kidneys, then it causes glomerulonephritis, the outcome of which is often acute renal failure with a transition to chronic. If the microbe enters the heart, then it causes an inflammatory process in the tissues of the valves and partitions between the chambers, which lasts for years, as a result of which the structures of the heart change and defects form. From the moment the microbe-causative agent of purulent tonsillitis enters the heart until the development of the defect, it takes from 20 to 40 years. And a person already in adulthood is faced with the consequences of a purulent tonsillitis suffered in childhood, which are rheumatic heart defects.

When a microbe from the tonsils enters the joints, acute arthritis develops, which disappears after a while, but creates fertile ground for joint diseases in the future. And when a microbe from the tonsils enters the central nervous system, the PANDAS syndrome develops, characterized by a sharp decrease in emotional stability and cognitive functions (memory, attention, etc.), as well as the appearance of spontaneous uncontrolled movements and actions, for example, involuntary urination, tongue twitching, etc. In some children, PANDAS syndrome completely resolves within 6 to 24 months, while in others, to varying degrees of severity, it remains for many years.

Thus, in children aged 3-15 years, the most dangerous complications in purulent tonsillitis are complications on the kidneys, heart, joints and nervous system, and not on the ears, respiratory and ENT organs. Accordingly, the treatment of angina should be directed not so much to the infection itself, which in most cases resolves on its own without special therapy, but to the prevention of these complications from the heart, joints and central nervous system. And it is precisely at the prevention of these severe complications that the mandatory use of antibiotics for purulent tonsillitis in children 3-15 years old is directed.

The fact is that the use of antibiotics for purulent tonsillitis in children 3-15 years old can reduce the risk of developing these severe complications in the heart, joints and nervous system to almost zero. Therefore, doctors consider it necessary to give antibiotics to children aged 3 to 15 years with purulent tonsillitis without fail.

It is necessary to know that prevention and reduction in the risk of severe complications are achieved when antibiotics are started, not only from the first day of the development of angina. So, in the course of research and clinical observations, it was found that the prevention of complications is effective if antibiotics are given to the child up to and including 9 days from the onset of angina. That is, in order to prevent complications in the heart, joints and central nervous system, you can start giving your child antibiotics at 1, 2, 3, 4, 5, 6, 7, 8 and 9 days from the onset of a sore throat. Late initiation of antibiotics is no longer effective in preventing heart, joint, and CNS complications.

If for some reason parents do not want to use antibiotics for purulent tonsillitis in a child of 3-15 years old, despite the high risk of complications in the heart, joints and central nervous system, then they may not do this. However, if the child shows signs of complications from the ears, respiratory and ENT organs (increased pain in the throat, deterioration of well-being, pain in the ear, chest, half of the face, etc.), then you should definitely resort to the use of antibiotics.

Rules for the treatment of angina with antibiotics

If the sore throat is bacterial (purulent), then a child aged 3 to 15 years should start giving antibiotics as soon as possible. However, if it was not possible to start the use of antibiotics from the first days of a sore throat, then this can be done up to 9 days inclusive from the onset of an infectious disease. That is, with purulent tonsillitis, a child of 3-15 years old can begin to give antibiotics from 1, 2, 3, 4, 5, 6, 7, 8 and 9 days of illness.

Adults over 15 years of age with purulent sore throat should use antibiotics only if there are signs of complications from the ears, respiratory and other ENT organs. That is, if a person over 15 years old with purulent tonsillitis has no signs of complications, then it is not necessary to use antibiotics at all.

What antibiotics are needed for angina

• Penicillins(for example, Amoxicillin, Ampicillin, Amoxiclav, Augmentin, Oxacillin, Ampiox, Flemoxin, etc.);
• Cephalosporins(for example, Cifran, Cefalexin, Ceftriaxone, etc.);
• Macrolides(for example, Azithromycin, Sumamed, Rulid, etc.);
• Tetracyclines(for example, Doxycycline, Tetracycline, Macropen, etc.);
• Fluoroquinolones(for example, Sparfloxacin, Levofloxacin, Ciprofloxacin, Pefloxacin, Ofloxacin, etc.).

If cephalosporins or penicillins were ineffective or a person is allergic to antibiotics of these groups, then macrolides, tetracyclines or fluoroquinolones should be used to treat angina. At the same time, with angina of moderate and mild severity, antibiotics from the groups of tetracyclines or macrolides should be used, and in severe infections, fluoroquinolones. Moreover, it should be borne in mind that macrolides are more effective than tetracyclines.

Thus, we can conclude that in severe cases of angina, antibiotics from the groups of cephalosporins or fluoroquinolones are used, and in mild and moderate cases, macrolides, penicillins or tetracyclines are used. At the same time, antibiotics from the groups of penicillins and cephalosporins are the drugs of choice, the first of which are optimal for the treatment of moderate and mild angina, and the second for severe infections. If penicillins or cephalosporins are ineffective or cannot be used, then it is optimal to use antibiotics from the fluoroquinolone groups for severe angina and macrolides for mild to moderate severity. The use of tetracyclines should be avoided whenever possible.

How many days to take?

The only exception is the antibiotic Sumamed, which only needs to be taken for 5 days. The remaining antibiotics should not be taken for less than 7 days, since with shorter courses of antibiotic therapy, not all pathogenic bacteria may die, from which antibiotic-resistant varieties are subsequently formed. Due to the formation of such antibiotic-resistant varieties of bacteria, subsequent sore throats in the same person will be very difficult to treat, as a result of which drugs with a wide spectrum of action and high toxicity will have to be used.

Also, you can not use an antibiotic for angina for longer than 14 days, because if the drug did not lead to a complete cure within 2 weeks, this means that it is not effective enough in this particular case. In such a situation, it is necessary to conduct an additional examination (sowing discharge from the throat with the determination of sensitivity to antibiotics), based on the results of which, choose another drug to which the sore throat pathogen has sensitivity.

Names of antibiotics for angina

Names of penicillins

• Amoxicillin (Amoxicillin, Amosin, Gramox-D, Ospamox, Flemoxin Solutab, Hikoncil, Ecobol);
• Amoxicillin + clavulanic acid (Amovikomb, Amoksivan, Amoxiclav, Arlet, Augmentin, Baktoclave, Verklav, Klamosar, Liklav, Medoklav, Panklav, Ranklav, Rapiclav, Fibell, Flemoklav Solutab, Foraklav, Ecoklav);
• Ampicillin (Ampicillin, Standacillin);
• Ampicillin + Oxacillin (Ampiox, Oxamp, Oxampicin, Oxamsar);
• Benzylpenicillin (Benzylpenicillin, Bicillin-1, Bicillin-3 and Bicillin-5);
• Oxacillin (Oxacillin);
• Phenoxymethylpenicillin (Phenoxymethylpenicillin, Star Pen, Ospen 750).

Names of cephalosporins

• Cefazolin (Zolin, Intrazolin, Lisolin, Nacef, Orizolin, Orpin, Totacef, Cesolin, Cefazolin, Cefamezin);
• Cefalexin (Cephalexin, Ecocephron);
• ceftriaxone ;
• Ceftazidime (Bestum, Vicef, Lorazidim, Orzid, Tizim, Fortazim, Fortoferin, Fortum, Cefzid, Ceftazidime, Ceftidine);
• Cefoperazone (Dardum, Medocef, Movoperiz, Operaz, Tseperon, Cefobide, Cefoperabol, Cefoperazone, Cefoperus, Cefpar);
• Cefotaxime (Intrataxim, Kefotex, Clafobrin, Klaforan, Liforan, Oritax, Oritaxime, Rezibelacta, Tax-o-bid, Talcef, Tarcefoxime, Cetax, Cefabol, Cefantral, Cefosin, Cefotaxime).

Names of macrolides

• Erythromycin (Eomycin, Erythromycin);
• Clarithromycin (Arvicin, Zimbaktar, Kispar, Klabaks, Klarbakt, Clareksid, Clarithromycin, Claritrosin, Claricin, Claritsit, Claromin, Clasine, Klacid, Clerimed, Coater, Lecoclar, Romiclar, Seydon-Sanovel, Fromilid, Ecozitrin);
• Azithromycin (Azivok, Azimycin, Azitral, Azitrox, Azithromycin, Azitrocin, AzitRus, Azicid, Zetamax, Zitnob, Zi-factor, Zitrolide, Zitrocin, Sumaklid, Sumamed, Sumametsin, Sumamox, Sumatrolide Solutab, Sumatrolide Solution, Tremak-Sanovel, Hemomycin, Ecomed);
• Midecamycin (Macropen);
• Josamycin (Vilprafen, Vilprafen Solutab);
• Spiramycin (Rovamycin, Spiramisar, Spiramycin-Vero);
• Roxithromycin (Xitrocin, Remora, Roxeptin, RoxyGeksal, Roxithromycin, Roxolit, Romik, Rulid, Rulicin, Elrox, Esparoxy).

Names of fluoroquinolones

• Levofloxacin (Ashlev, Glevo, Ivatsin, Lebel, Levolet R, Levostar, Levotek, Levoflox, Levofloxabol, Levofloxacin, Leobag, Leflobact, Lefoktsin, Maklevo, OD-Levox, Remedia, Signicef, Tavanic, Tanflomed, Flexid, Floracid, Hyleflox, Ecolevid , Elefloks);
• Lomefloxacin (Xenaquin, Lomacin, Lomefloxacin, Lomflox, Lofox);
• Norfloxacin (Loxon-400, Nolicin, Norbactin, Norilet, Normax, Norfacin, Norfloxacin);
• Ofloxacin (Ashof, Geoflox, Zanocin, Zoflox, Oflo, Oflox, Ofloxabol, Ofloxacin, Ofloxin, Oflomak, Oflocid, Tarivid, Tariferid, Taricin);
• Ciprofloxacin (Basigen, Ificipro, Quintor, Procipro, Ceprova, Ciplox, Cipraz, Cyprex, Cyprinol, Ciprobay, Ciprobid, Ciprodox, Ciprolaker, Ciprolet, Cypronate, Cipropan, Ciprofloxabol, Ciprofloxacin, Cifloxinal, Cifran, Cifracid, Ecocifol).

Names of tetracyclines

• Minocycline (Minoleksin).

Names of antibiotics for angina in children

1. Penicillins:

• Amoxicillin (Amoxicillin, Amosin, Gramox-D, Ospamox, Flemoxin Solutab, Hikoncil) - from birth;
• Amoxicillin + clavulanic acid (Amovikomb, Amoxiclav, Augmentin, Verklav, Klamosar, Liklav, Fibell, Flemoclav Solutab, Ecoclave) - from 3 months or from birth;
• Ampicillin - from 1 month;
• Ampioks - from 3 years;
• Ampicillin + Oxacillin (Oxamp, Oxampicin, Oxamsar) - from birth;
• Benzylpenicillin (Benzylpenicillin, Bicillin-1, Bicillin-3 and Bicillin-5) - from birth;
• Oxacillin - from 3 months;
• Phenoxymethylpenicillin (Phenoxymethylpenicillin, Star Pen) - from 3 months;
• Ospen 750 - from 1 year.

• Cefazolin (Zolin, Intrazolin, Lisolin, Nacef, Orizolin, Orpin, Totacef, Cesolin, Cefamezin) - from 1 month;
• Cefalexin (Cephalexin, Ecocephron) - from 6 months;
• ceftriaxone - for full-term babies from birth, and for premature babies from the 15th day of life;
• Ceftazidime (Bestum, Vicef, Lorazidim, Orzid, Tizim, Fortazim, Fortoferin, Fortum, Cefzid, Ceftazidime, Ceftidine) - from birth;
• Cefoperazone (Dardum, Medocef, Movoperiz, Operaz, Tseperon, Cefobid, Cefoperabol, Cefoperazone, Cefoperus, Cefpar) - from the 8th day of life;
• Cefotaxime (Intrataxim, Kefotex, Clafobrin, Claforan, Liforan, Oritax, Oritaxime, Rezibelacta, Tax-o-bid, Talcef, Tarcefoxime, Cetax, Cefabol, Cefantral, Cefosin, Cefotaxime) - from birth, including premature babies.

• Erythromycin (Eomycin, Erythromycin) - from birth;
• Azithromycin (injections of Sumamed and AzitRus) - from the moment when the child's body weight is more than 10 kg;
• Azithromycin (oral suspension Zitrocin, Hemomycin, Ecomed) - from 6 months;
• Macropen in the form of a suspension for oral administration - from birth;
• Spiramycin (Spiramisar, Spiromycin-Vero) - from the moment when the child's body weight becomes more than 20 kg;
• Roxithromycin (Xitrocin, Remora, Roxeptin, RoxiGexal, Roxithromycin, Roxolit, Romic, Rulid, Rulicin, Elrox, Esparoxy) - from 4 years.

• Minocycline - from 8 years.

It should be remembered that fluoroquinolones should not be used for children under 18 years of age, and other antibiotics can usually be used from 12 or 14 years of age.

Antibiotic in an adult with angina in tablets

The best antibiotic for angina

Antibacterial therapy for angina is the most important part of the complex treatment of the disease. Properly selected medicines can quickly get rid of acute symptoms and, most importantly, avoid possible complications of tonsillitis.

When is it necessary to use antibiotics?

Most often, tonsillitis is experienced by parents of children aged 4-6 years. At this age, angina is often complicated. The disease requires complex treatment, otherwise it will become a constant companion. Antibacterial therapy is prescribed if angina is accompanied by the following symptoms:

• high body temperature;
• enlarged lymph nodes;
• purulent plaque on the tonsils;
• severe pain when swallowing.

Antibiotics for angina in children are used for and form of inflammation ().

Medicines can be given to a child only after determining the causative agent of the disease. Some types of pathogenic microorganisms develop resistance to broad-spectrum antibacterial agents, so prescribing a drug “at random” may not bring the expected therapeutic effect.

Choice of medicine

Each parent wonders which antibiotic is best for a child with angina, and how to take it. The best medicine does not exist, the drug will be effective, the action of which is aimed at suppressing the causative agent of inflammation. In each case, a separate drug is indicated.

No need to self-medicate. A smear from the tonsils with angina and bacterial seeding of the material obtained will help you choose a really effective medication.

Pharmacy chains offer a variety of drug names to choose from, in the assortment of which it is easy to get confused.

It must be selected according to the following criteria:

• the possibility of use for children from birth or from the age of one year;
• effectiveness against the identified pathogen;
• convenient release form.

Drug groups

In order not to get confused when choosing a drug, you need to know the names of the active substance or the group to which the drug belongs.

Treatment of angina in children is carried out with medicines of the following groups:

• penicillin;
• cephalosporins;
• macrolides;
• fluoroquinolones.

With follicular purulent tonsillitis, penicillin drugs are prescribed. Their advantage is a delicate effect on the body, with high activity against most pathogens (staphylococci, streptococci, meningococci).

Preparations of the cephalosporin group are prescribed to prevent purulent tonsillitis in an advanced case. The advantage of drugs in this group is high efficiency, regardless of the causative agent of the disease. The disadvantage is considered to be a rather aggressive effect on the body, which is successfully minimized by taking probiotics and antihistamines.

Medicines of a number of macrolides are stronger than penicillin antibiotics, but more delicate than cephalosporins. Often used in case of individual intolerance to penicillin preparations or resistance of pathogenic microorganisms to the action of these medicines.

Fluoroquinolones are antimicrobials, not directly related to antibiotics, but have a similar mechanism of action. Due to their synthetic origin, they have a number of contraindications, the main of which is children under 12 years of age.

Penicillin medicines

The list of drugs in this group is quite large, most often preference is given to:

The first two medicines are different names for Amoxicillin. The active substance is the same - it is amoxicillin at a dosage of 250 or 500 mg in one capsule or tablet. Depending on the name, drugs of this composition are available in three forms - powder for making a drink (suspension), capsules in a gelatin shell or tablets. Age restrictions for taking antibiotics:

• granules or powder - from the first days of life;
• tablets 250 mg of the active substance - from 5 years;
• capsules 500 mg of the active substance - from 10 years.

The permissible dosage of the drug for angina in children is calculated depending on the patient's body weight. The duration of treatment is an average of 7 days.

Ampiox is a combination drug based on amoxicillin. The auxiliary component is the antibiotic of the penicillin series oxacillin sodium. It is produced in various dosages and is used to treat children from the first days of life.

The treatment regimen, the permissible daily dosage and the duration of the course are selected only by the pediatrician. Which antibiotic is better to prefer - it depends on the causative agent of the disease.

Cephalosporins for children

With purulent sore throat, the use of the following drugs for children is permissible:

• Cephalexin;
• Pancef;
• Cefotaxime.

These drugs have a wide spectrum of action and are active against any pathogens of tonsillitis. Forms of release - suspension, capsules and tablets. The suspension is intended for the treatment of children from the first days of life.

The dosage is also selected depending on the age and weight of the child. Treatment rarely exceeds 5 days, usually a three-day antibiotic is enough to improve the patient's well-being. The disadvantage of this group is the high likelihood of developing side effects and an allergic reaction.

To prevent possible consequences, the antibiotic is taken together with a probiotic, which normalizes the microflora of the stomach, and an antihistamine, which reduces the risk of developing a skin allergic reaction.

Macrolides for angina

In case of intolerance or ineffectiveness of penicillin preparations, macrolides are used:

The active substance of Macropen is midecamycin. Sumamed and Azithromycin have almost the same composition, the main substance is a broad-spectrum antibiotic azithromycin.

Macropen is available for all age categories. Babies under 5 years of age are prescribed a suspension, older children and adults are prescribed tablets.

The advantage of this group of drugs is a quick result, the course of treatment does not exceed 5 days. Children's antibiotics for angina of this group have a number of contraindications and side effects, which should be familiarized with before starting the medication.

Precautionary measures

Which antibiotic to drink is decided by the doctor. Antibiotics are not used in the following cases:

• individual intolerance to the active substance;
• severe liver failure;
• impaired renal function.

Metabolism of antibacterial drugs is carried out in the liver, excretion - by the kidneys, therefore, in case of severe violations of the work of these organs, antibiotic treatment is not prescribed.

If you are prone to allergic reactions, you should definitely consult with your doctor about adjusting the treatment regimen. Antibiotic treatment of patients with allergies and intolerance to the active substance is fraught with the development of giant urticaria or Quincke's edema.

If you notice a rapidly increasing swelling of the face and neck, you should immediately call for emergency medical care.

What do you need to know about medications?

One of the common mistakes parents make is deliberately not taking antimicrobial therapy, motivated by the fact that antibiotics are harmful. Indeed, independent and uncontrolled intake of drugs of this group can harm health, however, as well as treatment with any medication without a doctor's prescription.

Timely antimicrobial therapy for angina is an effective way to speed up recovery and prevent the development of complications, as a result of which it is sometimes necessary to remove the tonsils.

To prevent drugs from causing harm, it is important to follow a few rules.

The appointment is made by the doctor

If the baby has a sore throat, the doctor should prescribe treatment. You should not buy medicines that helped last time - pathogenic microorganisms quickly develop resistance to the components of medicines.

Use of probiotics

Give your child a probiotic at the same time as the antibiotic. These are substances containing lacto- and bifidobacteria that protect the intestines from dysbacteriosis.

Antiallergic agents

With angina for children, treatment is supplemented by taking antihistamine tablets, which reduces the risk of developing allergies.

Additional funds

In addition to therapy with special drugs, a child with angina is shown rinsing and antipyretic drugs.

If angina is treated correctly, the disease quickly recedes. Acute symptoms resolve in 4-5 days. The lack of comprehensive treatment leads to complications, so it is not worth delaying a visit to a specialist.

Video: Angina

Why does this disease occur and what antibiotics are the most effective for bacterial tonsillitis in children? We will tell you about this infection and which antibiotic is best for a child with sore throat.

Bacterial tonsillitis is a condition in which a child's palatine tonsils are affected by inflammation caused by a bacterium. The tonsil is a lymphoid tissue located on either side of the pharynx, between the palatine arches. The palatine tonsils help the child's immunity to protect against various infections that enter the body through the mouth.

When the infection affects the palatine tonsils, they become inflamed and enlarged.

Causes of bacterial sore throat

Bacterial infection is the second most common cause of sore throat after the virus.

Group A streptococci are the predominant causative agent of bacterial tonsillitis.

Some other bacteria can act as the causative agent of infection - these are chlamydia, streptococcus pneumoniae, staphylococcus aureus and mycoplasma. Rarely, fusobacteria, whooping cough, pale treponema and gonococci can cause angina.

All of the above pathogens can seriously damage the health of the child if the infection lasts for a long time.

Symptoms

1. Redness in the throat. Every time the child opens his mouth, you can see a distinct redness in the throat, where the palatine tonsils are located. There may even be a yellowish or whitish coating on the top of the tonsils, which indicates purulent inflammation.
2. Pain during swallowing. The child refuses to eat or drink anything, and even if he does, he stops halfway. The tonsils touch the root of the tongue and the veil of the palate when swallowing, and in angina this action can cause excruciating pain.
3. Cough. Since the throat becomes irritated, the child will constantly cough, thereby increasing the pain.
4. Excessive salivation. The child may not want to swallow because of an infection in the oropharynx. He accumulates drool in his mouth and will drool more than usual.
5. Ear pain. Pain from the palatine tonsils can radiate to the ears, which causes the child to dig into them, especially when he swallows and coughs. He will act up and cry whenever he pulls his ears.
6. Fever. The child's body detects the presence of the pathogen and therefore increases body temperature.
7. Bad breath. Bacterial activity in the palatine tonsils creates toxins and bacterial waste products, as well as destruction of lymphoid tissue cells, which leads to bad breath in the child.
8. Enlarged lymph nodes. The palatine tonsils are part of the lymphatic system, and infection can lead to swelling of the lymph nodes in the neck and under the jaw. Enlarged lymph nodes can be of different sizes.
9. Rash. Occurs when group A streptococcus causes an infection. The bacteria release the toxin into the child's body, forming a red rash on the neck, back, abdomen, and face. The tongue develops small sores that give it the appearance of a strawberry. In severe cases, the tongue may turn dark red with white patches. This condition is called scarlet fever.

Angina can affect a child at any age. If you find any manifestations, contact a specialist to check the child.

• catarrhal angina.

The child complains of sore throat, on examination, redness of the mucous membrane with a slight swelling of the palatine tonsils is found. At first, the surface of the mucous membrane is dry and sore, the child often swallows saliva to moisten. In a short time, a secret is released, and the surface is covered with mucous pus. With severe inflammation, there is a slight swelling of the lymph nodes. Characterized by localized pain;

• lacunar angina.

The lacunae (small indentations on the surface of the palatine tonsils) are filled with a cheesy substance that protrudes from them and consists of epithelial cells and various micrococci. This gives the tonsil a patchy appearance. The mucosa between the gaps is bright red and covered with pus, sometimes resembling a film. The oropharynx becomes painful, the pain spreads to the ear. The tongue is coated, there is a bad smell from the mouth;

• follicular angina.

It is characterized by hyperemia (redness) of the mucous membrane of the oropharynx and the appearance of purulent follicles on the palatine tonsils; a whitish or yellow coating is observed on the enlarged tonsils. Nausea may occur with occasional vomiting.

Complications

Without treatment for a long time, angina leads to the following conditions:

• acute rheumatic fever. This happens when the antibodies that are trying to neutralize the bacteria on the tonsils begin to attack the skin, joints, and heart. Symptoms of acute rheumatic fever develop two to four weeks after the onset of the sore throat;
• sinusitis. This condition develops when the paranasal sinuses are blocked, leading to a violation of the outflow of the pathological secretion of their sinus cavity. Bacteria then multiply, leading to disease. Sinusitis symptoms include severe nasal congestion, coughing, and nasal discharge;
• poststreptococcal glomerulonephritis. This is a kidney disease characterized by damage to the glomeruli, which are responsible for filtering fluids and toxins from the blood. This can lead to bloody urination, reduced urine output, pain or swelling in the joints;
• toxic shock syndrome develops when group A streptococcus is in the body. It releases toxins and leads to toxic shock syndrome, a life-threatening illness. Symptoms include fever, low blood pressure and rash;
• abscesses. These are limited accumulations of pus. With angina, abscesses can develop around the palatine tonsils or in the back of the throat. In severe cases, they completely block the ability to swallow, speak, or breathe.

Diagnostics

The doctor makes the final diagnosis based on the following stages of the examination.

1. Visual inspection of the oropharynx with angina. The child's throat is carefully checked for signs of a sore throat. Visible symptoms are the first indicator for identifying an infection. Most medical professionals draw conclusions based on this examination.
2. Detection of edema of lymphoid tissue. The palatine tonsils swell when they become inflamed, which can also be accompanied by inflammation of the lymph nodes in the neck. The doctor examines the skin in the neck and lower jaw for any swelling.
3. Examination of the ears and nose. The pathogen can enter the body through these structures, causing a secondary infection in the palatine tonsils. In addition, a tonsil infection can continue its way to different parts of the ear, nose, and throat.
4. Laboratory examination of a swab from the throat. Using a sterile medical swab, a swab is taken from the tonsils, then it is sent to the laboratory to find out the exact type of bacteria that caused the sore throat. A swab from the throat helps to determine the exact cause and identify the sensitivity of the pathogen to drugs.
5. Blood analysis. A doctor may recommend a complete blood count. The presence of a large number of leukocytes in combination with other manifestations indicates the presence of angina.

As soon as the diagnosis is established - angina, the doctor recommends a medicine depending on the severity of the patient's condition.

Treatment

Treatment of bacterial sore throat should begin immediately. Therefore, when the first symptoms of the disease appear, the child should be shown to the doctor. Do not give your baby medication on your own, as incorrect therapy can lead to complications.

As a rule, treatment of bacterial tonsillitis occurs with the use of antibiotics.

Antibiotics are compounds used to treat bacterial infections. They are very useful medicines and save the lives of many children with serious illnesses such as meningitis, pneumonia and sepsis. Antibiotics may also be used to treat more common bacterial infections in children, including sore throats.

Infectious disease specialists recommend testing to confirm the presence of the bacteria before prescribing an antibiotic. As a rule, if the diagnosis of bacterial tonsillitis is confirmed, the specialist will prescribe an antibiotic for the child.

Antibiotic therapy may be started immediately (without testing) when:

• the condition of the child is moderate or severe;
• culture results will be ready in more than 72 hours;
• further observation of the patient will be difficult.

Antibiotics for angina in children will allow:

• eliminate bacteria and reduce the time of contagiousness (infectiousness). This reduces the chance of passing the infection to others through close contact. The patient is usually not contagious 24 to 48 hours after starting antibiotic therapy;
• prevent possible complications in the form of sinusitis, otitis media, rheumatic fever and post-streptococcal glomerulonephritis;
• ensure faster resolution of symptoms and faster recovery. Antibiotics shorten the duration of sore throat, discomfort, and fever.

Forms of antibiotics that are prescribed to a child with angina

• suspension.

The active part of the medicine is combined with a liquid to make it easier for the child to take the medicine or to absorb it better. Before use, the suspension for children must be shaken well;

The active ingredient is combined with another substance and compressed into a round or oval solid shape. There are different types of tablets. Soluble or dispersible tablets can be safely dissolved in water;

• capsules.

The active part of the drug is contained inside the shell, which slowly dissolves in the stomach. Some capsules can be split so the contents can be mixed with your favorite meal. Others must be swallowed whole so that the medicine is not absorbed until the stomach acid dissolves the capsule shell.

What antibiotics to take for angina?

The choice of antibiotics depends on the bacteriological and clinical efficacy, frequency of administration, duration of therapy, the presence of allergies in the patient, and potential side effects.

Penicillins

Penicillins are a group of antibiotics that block protein synthesis in bacterial cell membranes. Penicillins are a group of bactericidal agents including Penicillin G, Penicillin V, Ampicillin, Ticarcillin, Amoxicillin. They are used in the treatment of infections of the skin, teeth, eyes, ears, and respiratory organs.

Children may be allergic to penicillin due to hypersensitivity to the antibiotic. Often penicillins are given in combination with various other types of antibiotics.

Penicillin B

Advantages

A good antibiotic for angina for children, which has proven its effectiveness and safety. According to a recent study, penicillin is still considered the best choice for treating strep throat for individuals who are not allergic to penicillins. For more than 60 years, Penicillin has retained its ability to kill group A streptococci.

Penicillin has a narrow spectrum and therefore does not contribute to the development of antimicrobial resistance.

• Penicillin B is available in two forms. Tablets: 250 mg and Suspension: 125 mg or 250 mg in 5 ml; may contain sugar.

Penicillin B is usually given 5 times a day. As a rule, this happens in the morning (before breakfast), around noon (before lunch), in the evening (before tea) and before bedtime.

Amoxicillin has a wider spectrum than penicillin. However, Amoxicillin does not offer a microbiological advantage over the less expensive penicillin.

Advantages

More comfortable treatment. Some studies show that Amoxicillin, given only once a day, may work. Amoxicillin suspensions are better than penicillin suspensions.

Flaws

Gastrointestinal side effects and skin rash are more likely to develop with Amoxicillin treatment.

Antibiotic release forms

Capsules: 250 mg and 500 mg. Suspension: 125 mg or 250 mg in 5 ml; some may contain a small amount of sugar.

Amoxicillin is usually prescribed three times a day: in the morning, afternoon, and at bedtime.

Amoxicillin/clavulanic acid (Augmentin)

This drug can be considered as a more powerful version of Amoxicillin, since the added component - clavulanic acid can neutralize more bacteria.

The drug is used to treat the same types of infections as Amoxicillin, but is often used if the child's infection does not respond to Amoxicillin's first choice or if the doctor thinks the child has a more serious infection.

Both Amoxicillin and Augmentin are members of the penicillin family of antibiotics and should not be taken if the child is allergic to penicillin.

The main adverse effect is diarrhea.

Release form

• tablets: 250 mg amoxicillin / 125 mg, clavulanic acid, or in the ratio of components - 500/125 mg);
• dispersible tablets: 250/125 mg;
• suspension: 125/31 mg (125 mg amoxicillin, 31.25 mg clavulanic acid), 250/62 mg or 400/57 mg in 5 ml.

It is taken three times a day.

Macrolides

These antibiotics block the biosynthesis of bacterial proteins. They are usually prescribed for the treatment of children with hypersensitivity to penicillin. The action of the antibacterial drug of this group has a larger spectrum, in contrast to penicillin. Gastrointestinal discomfort (diarrhea, nausea) is a possible side effect.

Azithromycin

Azithromycin, a macrolide antibiotic, is an effective treatment for strep throat and is considered second-line therapy.

Advantages

• a reasonable choice for patients allergic to penicillins;
• can cure streptococcal infections refractory to penicillins;
• Azithromycin reaches high concentrations in tonsil tissue;
• very simple and short, single dose, especially suitable for individuals who do not want to undergo a 10-day course of antibiotic therapy;
• relatively low risk of side effects from the gastrointestinal tract.

Flaws

• high bacterial resistance.

Release form

• tablets: 250 mg, 500 mg;
• capsules: 250 mg;
• suspension: 200 mg in 5 ml; some may contain a small amount of sugar.

Azithromycin is usually given once a day; usually in the morning.

• very effective macrolide. One study shows that 10 days of Clarithromycin may be more effective in killing group A streptococci than 5 days of Azithromycin;
• of the disadvantages: increasing resistance of bacteria;
• Clarithromycin is usually given twice a day. Ideally, the interval between appointments is 10 - 12 hours, for example, between 7 and 8 o'clock in the morning and between 7 and 8 o'clock in the evening;
• issued in the following forms:
  • tablets: 250 mg or 500 mg;
  • suspension: 125 mg or 250 mg in 5 ml;
  • granules: 250 mg (per sachet).

Cephalosporins

This category of antibiotics includes such bactericidal agents as Cefadroxil, Cefapirin, Cefradin, Cefazolin, Cefalexin and Cefalotin. Cephalosporins, like penicillins, block the synthesis of proteins in bacterial cell membranes. They treat a wider range of bacterial diseases and can be used to treat diseases that cannot be treated with penicillins. If children are sensitive to penicillins, cephalosporins are administered.

But usually, when a child is allergic to penicillin, he also develops an allergy to cephalosporins. Rash, diarrhea, cramps, and stomach cramps are adverse effects of these antibiotics.

Cefalexin

Advantages

• very efficient;
• excellent option for recurrent infections.

Cephalexin has a relatively narrow spectrum and is therefore preferred over broad spectrum cephalosporins such as cefaclor, cefuroxime, cefixime and cefpodoxime.

Flaws

• frequent intake.

Cefadroxil

Advantages

• effective;
• convenient one-time dosage;
• low incidence of gastrointestinal side effects;
• suspension has a pleasant taste.

Cefuroxime and Cefdinir

Advantages

• very efficient;
• safe for children and pregnant women (category B).

Flaws

• unreasonably wide antibacterial spectrum.

It is important that the child completes the course of antibiotic treatment. This means that he must take the medicine for the number of days prescribed by the doctor.

If you stop giving the antibiotic too soon, the remaining bacteria will begin to multiply again and may cause another illness. There is also a risk that these bacteria will be resistant (resistant) to the first antibiotic. This means it may not work next time and the child may need a different drug that may not help or cause more side effects.

Also, with antibiotic therapy, the following points should be considered:

• the dosage and type of antibiotic is selected only by a doctor, in accordance with the sensitivity of the infectious agent, as well as the age and body weight of the child;
• Children sometimes vomit or have diarrhea when taking antibiotics. Encourage drinking water to replace the fluid your child loses from these side effects. If it is difficult or the child is lethargic, see a doctor;
• do not give your child medicine to stop diarrhea unless the doctor has prescribed it;
• try to give the drug at about the same time every day. This will help you make sure that there is a constant concentration of the drug in the body in order to destroy the bacteria;
• give the prescribed medicine to the child only for the current infection;
• give the antibiotic only to the child for whom the treatment is prescribed. Never give the drug to anyone else, even when the condition appears to be the same. It may cause harm;
• Antibiotics are effective against bacteria, they do not fight viruses. This means that they do not work against influenza, viral sore throats, or other infections caused by viruses. The doctor does not prescribe antibiotics for these diseases;
• The course of therapy is 7-10 days. Children require strict bed rest, although after the start of antibiotic therapy on the 3rd - 4th day, there is an improvement in the condition as a whole;
• during illness, you should refrain from walking and visiting crowded places.

Other remedies for the treatment of angina

1. In addition to antibiotics, anti-inflammatory and antipyretic drugs (Paracetamol and Ibuprofen) are used in the treatment of bacterial tonsillitis.
2. If the throat is very swollen, antihistamines are prescribed.
3. It is also recommended to frequently rinse the mouth and throat to clear the tonsils of plugs and pus, moisturize the mucous membranes and relieve discomfort. For this purpose, you can use the following: solutions with salt, soda, furacillin; solutions with essential oils of fir, tea tree, cedar, eucalyptus; decoctions of sage and chamomile.
4. The room in which the sick child is located should be well ventilated and subject to daily wet cleaning using disinfectants.

It is very easy to get infected with bacteria, so you need to protect the health of the child and strengthen his immune system so that pathogens do not have a chance. Understanding how to treat bacterial sore throat, following the doctor's recommendations, you can quickly get rid of this disease and prevent complications.