Throat Infections Flashcards
Broadly speaking, what pathogens can cause tonsillitis?
Viruses and Bacteria
What symptoms suggest a bacterial cause of tonsillitis?
Fever
Exudate
Enlarged lymph nodes
Absent cough
Who is bacterial tonsillitis more common in?
Children
What type of bacteria typically cause tonsillitis?
Group A β-haemolytic strep
What algorithms can be used to decide if antibiotics should be prescribed?
Cantor Criteria
Fever-PAIN score
What do these algorithms look for?
Symptoms suggestive of bacterial tonsillitis
What antibiotic is typically front line for tonsillitis?
Penicillin V
What dose of Penicillin V is used to treat tonsillitis?
500mg QDS for 10 days
What antibiotic is used as a second line treatment for bacterial tonsillitis?
Clarithromycin
What dose of Clarithromycin is used to treat bacterial tonsillitis?
500mg BD for 5 days
How are points awarded using the Fever-PAIN score?
Fever in the last 24 hours (+1)
Purulent exudate (+1)
Attend in under 3 days (+1)
Inflamed tonsils (+1)
No cough or coryza (+1)
How should a patient with a Fever-PAIN score of 0-1 be treated?
No antibiotics
How should a patient with a Fever-PAIN score of 2-3 be treated?
Consider a 3-day delay before issuing antibiotics
How should a patient with a Fever-PAIN score of >4 be treated?
Use immediate antibiotics if severe, if not then issue 48hr delayed prescription
What viruses typically cause tonsillitis?
Rhinovirus
Adenovirus